Healthcare News & Insights

The trouble with ‘baby-friendly’ policies at hospitals

More hospitals are aligning with recommendations from the World Health Organization and making their facilities “baby-friendly,” with guidelines specifically designed to promote breastfeeding for mothers and their newborns shortly after birth. However, there’s growing concern that the practice may not be as beneficial as once thought. 

GettyImages-176657564And in some cases, it may even put new babies in danger.

Reasons for problems

A new viewpoint piece from JAMA Pediatrics discusses the growing baby-friendly phenomenon in hospitals. According to an article published in Slate, hospitals participating in the Baby-Friendly Hospital Initiative must agree to adhere to 10 guidelines designed to boost breastfeeding rates.

One of the guidelines that has received much attention is “rooming in,” where babies sleep next to their mothers, instead of in a hospital nursery, throughout their hospital stay. While many mothers appreciate having easy access to their babies, some say the practice hurts women’s recovery from the delivery itself by making it harder for them to rest.

Another controversial baby-friendly practice is to ban pacifier use during the hospital stay, since pacifiers may make it more difficult for some babies to breastfeed. Formula use is discouraged in baby-friendly facilities for similar reasons.

However, these guidelines have the potential to hurt babies, according to the JAMA Pediatrics piece. Researchers warn of some significant dangers lurking beneath baby-friendly guidelines.

Example: Mothers who room in with their babies are often left unattended, since the goal is for mothers to have skin-to-skin bonding time alone. However, babies may develop serious complications if medical staff stop checking on them for extended periods of time.

Particularly, according to the Slate article, research shows there’s a higher likelihood of babies experiencing Sudden Unexpected Postnatal Collapse (SUPC), a condition where infants who were previously healthy start having breathing problems that often require resuscitation.

In addition, giving babies pacifiers has been shown to decrease the chance that they’ll suffer from sudden infant death syndrome (SIDS). So a blanket ban on pacifiers may not be the best idea for babies in the hospital. There’s also no evidence that a ban on formula is helpful for babies and mothers.

Plus, mothers may not practice safe sleeping habits with their babies while unattended. Rooming in could lead parents to think similar sleeping arrangements (such as co-sleeping in the same bed) have fewer risks once they’re at home.

Another strategy

With these factors in mind, the JAMA Pediatrics piece suggests that hospitals take a different approach for mothers and babies.

Instead of adapting baby-friendly standards strictly focused on boosting breastfeeding rates, hospitals should focus on more practical, research-supported guidelines for helping mothers and babies overall, including:

  • providing access to lactation support during and after the hospital stay, and
  • promoting the integration of safe sleeping practices with breastfeeding.

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