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What does "Baby-Friendly" mean?
About 500 hospitals in the United States have earned "Baby-Friendly" status, according to the organization that accredits these hospitals. The hospitals must adhere to certain rules, including talking to moms about the benefits of breastfeeding, helping them initiate breastfeeding one hour after the birth, not giving formula to babies unless medically necessary, and keeping moms and babies in the same room 24 hours a day.
What is the goal of the Baby-Friendly Initiative?
The goal of the program, created by the Centers for Disease Control and Prevention (CDC) in 2011, is to increase breastfeeding rates and decrease childhood obesity. Studies show breastfeeding rather than formula feeding may help prevent obesity in children later in life.
Sounds good, right?
So why doesn't it seem to be working?
When researchers examined CDC data on breastfeeding rates for children born in the U.S. in 2015, they found that being born in a Baby-Friendly hospital made no difference in whether infants were breastfed after leaving the hospital and for up to a year afterward. Also, withholding formula at the hospital didn't appear to influence whether moms breastfed exclusively for the first 3 to 6 months, the researchers reported in The Journal of Pediatrics.
What's more, the study points to separate reports that suggest Baby-Friendly policies might be associated with an increase in problems such as newborn dehydration and jaundice (perhaps because babies that need some formula don't always get it). Also, some moms complain that the policies promote unrealistic expectations about breastfeeding, and make them feel bad because they can't measure up.
How is this affecting new moms?
In an article in Psychology Today, pediatrician Alison Escalante said she sees numerous moms who are anxious and depressed because they can't meet the program's recommendation to exclusively breastfeed their babies. This pressure can contribute to postpartum depression, she said.
Escalante argues that the Baby-Friendly policy of not feeding infants any formula can make life stressful for moms whose milk takes a while to come in, or who simply need a break. Keeping moms and babies in the same room at all times in the hospital may also increase stress if the baby is very fussy or the mom is in a lot of pain, she wrote.
In the report, the authors found that hospital policies that encourage moms to start breastfeeding soon after labor and to continue to do so after they get home did help increase breastfeeding rates. But giving birth in a Baby-Friendly hospital specifically did not.
To be clear, breastfeeding, if possible, is the best option for you and your baby because it has numerous health benefits. The American Academy of Pediatrics recommends exclusively breastfeeding your baby for the first 6 months.
But moms shouldn't be made to feel like failures if they can't follow that recommendation, Escalante wrote. Any amount of breastfeeding you do is beneficial, and formula feeding is still a valid, healthy choice. The decision to do either – or both – is up to you, and depends on what's right for your family and your circumstances.
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