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What Makes a Hospital “Baby-Friendly”?

In 1991, the United Children’s Fund and the World Health Initiative teamed up to develop the Baby-Friendly Initiative with the goal of  enlisting hospitals in their efforts to promote and teach breastfeeding to mothers around the world. Hospitals must undergo a rigorous process to earn the prestigious “Baby-Friendly” certificate.

In this podcast, Marin Health Medical Center lactation consultant Anne Hauss Davies discusses the Baby-Friendly Initiative and the importance of breastfeeding. Learn about the critical “ten steps to successful breastfeeding” and the difference they can make for new mothers and babies.

Anne Hauss Davies, RN, MSN, IBCLC
Anne Hauss Davies, RN, MSN, IBCLC, is a Lactation Consultant at MarinHealth Medical Center.

Host: When it comes to having your baby, you want the best. Well, Marin Health has achieved baby-friendly accreditation. So what is a baby-friendly hospital and the baby-friendly accreditation? Well, let's find out with Anne Hauss Davies, a lactation consultant at Marin Health Medical Center.

This is The Healing Podcast brought to you by Marin Health. I'm Bill Klaproth.

Anne, it is so great to talk with you. Thank you so much for your time. So first off, explain to us what is a baby-friendly hospital and the baby-friendly accreditation.

Anne Hauss Davies: A baby-friendly hospital is one that has demonstrated full implementation of the 10 steps to successful breastfeeding. And the 10 steps to successful breastfeeding are the foundation of what's known as a baby-friendly hospital initiative. That was established in 1991 by the United Nations Children's Fund, UNICEF, and the World Health Organization. And the goal of the 10 steps to successful breastfeeding and the baby-friendly hospital initiative are to raise awareness of the benefits of breastfeeding and to improve hospital practices, so women have a greater chance of success.

Host: That sounds really good. So you mentioned this certification and the 10 steps. Is that how a hospital obtains baby-friendly certification? What are some of these requirements?

Anne Hauss Davies: The requirements are extensive and it requires an interdisciplinary involvement with physicians, the administrators, and the nursing staff. And it often takes hospitals more than three years to ready themselves for the onsite assessment. Marin Health earned the designation in February of 2017 and we're currently preparing for another onsite assessment.

One thing that we have to do is show that all the nurses have had 20 hours or more of training specific to infant feeding practices and the doctors have had training as well. And a big part of what we do is make sure that what we're doing with the mothers and the babies supports breastfeeding. So we'll do a lot of times skin to skin and promoting mothers learning how to breastfeed comfortably.

Host: Right. So let's continue talking about that. You just mentioned the importance of breastfeeding. As a baby-friendly hospital, how do you promote breastfeeding?

Anne Hauss Davies: Well, we do our best to make sure that, like I said, the staff are trained. And then also we've created a culture that is supportive of breastfeeding. Foundational to that is protecting new families from false or misleading product information. So we ensure that anything they're learning about feeding their infant is based on science rather than market influences.

And we also help people understand that getting off to a good start by holding their baby skin to skin and feeding the baby. Anytime the baby looks interested helps to ensure that in that early few days, if they get a good start, there'll be able to continue breastfeeding for as long as they both would like.

Host: Okay. That's really interesting. And then you mentioned skin to skin bonding as well. Can you tell us a little bit more about that and why that is so important?

Anne Hauss Davies: Yeah, the signs is showing us that babies are most ready to feed oftentimes in that first hour. And rather than allowing routine medical procedures to interrupt that special time, we keep the babies directly on the mother's skin as long as they're both medically stable. And that has a calming influence on both the mothers and the babies. The babies are more likely to remain stable with their temperatures and their blood sugars and mothers can more quickly learn how to respond to their infant's feeding cues and practice.

Host: It just seems to really make sense to keep the baby with mom skin to skin right after birth. And they come out hungry, right? You say within the first hour, they're ready to feed.

Anne Hauss Davies: Most often they are exhibiting those feeding cues right away.

Host: You also delay bathing and weighing, right? To allow the baby to breastfeed. Is that correct?

Anne Hauss Davies: That's correct. We really don't want anything routine or unnecessary to interfere with that first opportunity for mother and baby to bond and breastfeed. And we also find that babies are more stable if they're with their moms and their temperature is protected from cold stress if they're not bathed. Mothers naturally are able to help the baby regulate their temperatures. They adjust.

Host: Right. So then baby stays with mom right after delivery. So can you tell us a little bit about what that looks like in the new hospital rooms?

Anne Hauss Davies: Yeah. Our new hospital is beautiful and almost all of the rooms have a view of Mount Tam and they're generously sized. So as the family stays together and practices rooming in, the families are finding that they're having a really nice time protected from noises and they're able to relax and bond.

By rooming in and keeping the baby with the parents, a mother can more quickly respond to her baby's cues. We're finding that even though it seems counterintuitive, people actually get more rest by keeping their baby right there in those rooms.

Host: Yeah, that just seems to make sense. The more comfortable they are, the more rest they'll get. So you've already mentioned the importance of breastfeeding. So what kind of breastfeeding help and training do you offer to women while they're recovering in the hospital?

Anne Hauss Davies: Our labor and delivery nurses are expert at assisting with positioning and latching in that first golden hour. And then we do our best to continue to support moms, because we understand that everyone's just new to this and learning. So the nurses, like I said, they've been trained for 20 hours or more. Many of our nurses have years and years of experience. And then every day, lactation consultants are available to help as mothers and babies are learning to comfortably position and to learn what's expected with their breastfeeding relationship.

Host: So you mentioned, Anne, that lactation consultants are available to help. So would you say that giving birth in a baby-friendly hospital translates to more success with breastfeeding at home, being that it seems like they're getting training at the hospital before being released?

Anne Hauss Davies: Absolutely. And it's not just me saying it. The studies show that people who deliver at baby-friendly hospitals are many more times likely to have breastfeeding success and continue to breastfeed as long as the mother had planned. At Stanford, a study showed that the number one reason that mothers wean earlier than planned is a lack of milk supply. And we know that baby-friendly hospitals are foundational for helping mothers get off to a good start with a good supply. So that goes a long way in terms of helping just lay the groundwork for longterm breastfeeding success.

Host: Absolutely. Well, this has really been fascinating. Thank you so much for talking with us about the baby-friendly hospital certification at Marin Health. We really appreciate it. Thanks again, Anne.

Anne Hauss Davies: Thank you, Bill.

Host: That's Anne Hauss Davies. And to learn more of the big reasons to have your little one at Marin Health Medical Center, please visit That's And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is The Healing Podcast brought to you by Marin Health. I'm Bill Klaproth. Thanks for listening.