Breastfeeding key to Baby-Friendly
By Nancy Lofholm/For St. Mary’s Medical Center
Austin Andrews is sleeping in his mother’s arms in her maternity room at St. Mary’s Hospital. He has spent much of the first two days of his life right here, contentedly curled up next to his mother’s heart.
That uninterrupted closeness isn’t just his mother’s preference. It is an important part of a new emphasis at St. Mary’s on mother and baby health that is particularly focused on breastfeeding.
St. Mary’s last summer was designated a “Baby-Friendly” hospital after several years of planning, training, data collection and setting up new protocols in all parts of the hospital that care for mothers and babies. St. Mary’s is now one of ten hospitals in Colorado certified as Baby-Friendly.
Two others are on the Western Slope—Aspen Valley Hospital and Valley View Hospital in Glenwood Springs.
An organization called Baby-Friendly USA certifies hospitals that demonstrate “an optimal level of care for mothers and babies.” That movement began with global pushes by the World Health Organization and the United Nations Children’s Fund to promote breastfeeding as the normal way for human infants to be nourished. Breastfeeding is scientifically proven to be an important contributor to newborn well-being, as well as to their long-term health and development.
“It is just amazing what a difference this makes,” said Therese Houk, a registered nurse who coordinates the Baby-Friendly program at St. Mary’s. “Mother’s milk helps protect infants from illness and infection. It helps brain function and lowers the risk of some childhood diseases. It also benefits the mothers in many ways.”
Promoting breastfeeding may sound simple. But to make it a truly effective and uniform effort, and to earn the certification, St. Mary’s had to work through a dozen steps. The effort began with a recognition by maternity ward nurses that seeking Baby-Friendly certification would benefit patients. Those nurses were able to convince the hospital’s top administration of the benefits even though the process would be costly and time-consuming.
It required the establishment of an in-house task force and a complete self-evaluation of maternity services. Hospital policies regarding breastfeeding had to be formalized.
Training was a big part of becoming Baby-Friendly. More than 130 St. Mary’s employees went through 20 hours of training. Physicians had four hour classes.
Once all those requirements were complete, St. Mary’s underwent interviews and on-site inspections by Baby-Friendly USA. That credentialing oversight continues with yearly audits.
If that sounds complicated, surprisingly, so is breastfeeding.
Societal attitudes in the United States have made breastfeeding less of an automatic and natural way of feeding babies than it is in some countries. Nurses in maternity wards find that too many new mothers today have not learned about breastfeeding from seeing their mothers and other female relatives breastfeed. Many are nervous about it.
“Part of this Baby-Friendly emphasis is just making it normal,” Houk said.
Some mothers fear their babies won’t get enough nutrition from breastfeeding even though breast milk contains dozens of nutritious ingredients not found in formula. Some fear they don’t have enough milk. St. Mary’s childbirth coordinator Charlotte Balerio is one of those tasked with teaching staff and patients about breastfeeding, and she has a simple way of helping to dispel this fear. She holds a marble out on her palm: it is the size of a newborn’s tummy. It is easy for mothers to see that it doesn’t take much milk to fill that.
Houk and Balerio said hospital caregivers have more and more taken on what used to be a family role by being the ones who inform maternity patients about the benefits of, and the best way to manage, breastfeeding.
At St. Mary’s, that effort begins as soon as a newborn makes his or her entry into the world. The immediate skinon- skin contact helps a baby to recognize there is a source of nutrition with the mother.
That contact is maintained for an hour or two. Mothers are encouraged to initiate breastfeeding within the first hour after birth.
Baby-Friendly has other elements that are now a standard part of protocol at St. Mary’s:
• Mothers and infants “roomin” after births, which means infants stay with the mother around the clock rather than being taken off to nurseries or whisked away for routine medical procedures.
• Mothers are encouraged to breastfeed on demand. That means babies are encouraged to eat when they want, not on a schedule.
• Infants are not given pacifiers or artificial nipples because those can make it more difficult for an infant to breastfeed.
• Infants are not given nutrition other than breast milk unless it is medically necessary, or if a mother wishes to use formula rather than breastfeeding.
• Mothers are shown how to breastfeed and to maintain lactation even if they must be separated from their infants.
• Discharged mothers are given information about breastfeeding support groups that meet weekly. Every new mother goes home with a 48-page booklet of helpful postpartum advice.
Not every mother is able to breastfeed even with lots of expert sources on hand to answer questions and help with techniques. That fact ties in with another important piece of St. Mary’s Baby-Friendly focus: St.
Mary’s is a Milk Donation and Outreach Center. Mothers who produce extra milk bring it to the hospital where it is frozen and shipped to the Mothers’ Milk Bank in Arvada for processing and pasteurizing.
Since St. Mary’s began participating in that program in 2015, the hospital has sent 18,202 ounces of donated milk to the bank.
Some of that has come back as an important part of treatment for babies in St. Mary’s Neonatal Intensive Care Unit. Babies in isolettes are given breast milk that has been pumped by their mothers or that comes from the bank. For these fragile babies, human milk promotes growth and healing much better than formula.
Baby Austin is a good example of the many ways that Baby-Friendly has made a difference at St. Mary’s. He was lifted from the womb and placed on his mother’s bare skin after Cesarean section delivery.
He stayed with her during her recovery. When her milk temporarily wasn’t giving him as much nutrition as he needed, it was supplemented with milk from the bank.
“It was all so welcoming and so much easier for me and for the baby,” said mother Jaclyn Seaburn as she and Justin’s father, Jeremy Andrews, prepared to pack up Austin and head home. “It truly was baby friendly.”