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Hospitals push breast-feeding in hopes of getting ‘baby-friendly’ label

Hospitals push breast-feeding in hopes of getting ‘baby-friendly’ label 33 Illinois institutions seeking designation must also turn down free formula
January 10, 2013|By Jennifer Delgado, Chicago Tribune reporter

Laura Griffeth pats daughter Heidi’s back to burp her after breast-feeding at a weekly meeting of new mothers last month at St. John’s Children’s Hospital in Springfield, the first hospital in the state to earn the Baby-Friendly Hospital Initiative designation. Heidi was born Dec. 10.
After the births of her first two children, Charmaine Sharkey’s neighborhood hospital gave her cans of baby formula and sent her on her way.
But Sharkey tried something different when her youngest, Dynasty, was born six months ago. The 28-year-old mother from Englewood breast-fed the 6-pound baby, a change she credits to guidance and programs offered by Stroger Hospital of Cook County.
“With breast-feeding, you really have to stay at it. A lot of moms give up; they’d rather get some formula,” Sharkey said. But the hospital staff “just encouraged me to keep on.”
Stroger is among 33 hospitals in Illinois, including 15 maternity centers in Chicago, that are promoting breast-feeding like never before, a key component for earning the “baby-friendly” designation offered by the World Health Organization and UNICEF. Three hospitals in Illinois have already gotten the title.
The Baby-Friendly Hospital Initiative was launched in 1991, but more hospitals have applied for the title in recent years, said Trish MacEnroe, executive director of Baby-Friendly USA, the nonprofit that administers the program.
That might be because hospitals appear to be less wary of the chief requirement — that they not accept free formula from makers — than they have been in past years, and because the designation might not be as costly as once thought. Experts also say hospitals are catching up to research that shows breast-feeding has major benefits for mothers and newborns.
The American Academy of Pediatrics says infants who receive formula run a higher risk of getting childhood diseases, diabetes and childhood obesity. The organization says breast-feeding helps women reduce their chance of breast and ovarian cancer, hypertension, diabetes and heart disease.
The “baby-friendly” designation shows the facility’s commitment to breast-feeding and “gives more credibility,” said Suzet McKinney, deputy commissioner of the Chicago Department of Public Health.
To get the “baby-friendly” label, hospitals must implement 10 steps that include informing all pregnant women about nursing, no longer providing pacifiers and better educating and training staff on the benefits of breast-feeding.
Researchers from medical disciplines across the world have conducted studies on each of the “baby-friendly” steps that later were examined and approved by WHO.
Most difficult of all for some hospitals, they must stop accepting free or discounted formula or supplies from pharmaceutical or other companies, a practice that dates back to at least the 1950s, experts said. That means they must buy formula at fair-market price, and also cannot give out baby milk in gift bags. (They can give formula to mothers who have medical requirements.)
“For a lot of hospitals, that’s a big hurdle, to have to pay for that when you’ve never had to before,” said Samantha Schoenfelder, a health and early childhood coordinator for Healthy Places, a wellness initiative pushing breast-feeding that is funded through the federal Affordable Care Act’s Prevention and Public Health Fund.
Data seem to agree. In a national survey published by the American Academy of Pediatrics in 2006, researchers found that paying for formula was one of the top three barriers preventing hospitals from achieving the baby-friendly status. Hospitals apparently worried that if they declined to accept free formula, their costs for formula supplies would skyrocket.
But advocates contend that breast-feeding rates increase and formula costs eventually wane after the designation goes into effect. They also point to a 2011 study published in the academy’s journal that found “baby-friendly” hospitals have minimal increased costs.
“Once they implement steps and start rolling with the new practices, they require less formula and it’s not a big cost at the end,” said Sadie Wych, a project coordinator with HealthConnect One, a Chicago-based organization that works with hospitals to increase breast-feeding rates.
Some of the requirements in the “baby-friendly” initiative, like placing newborns onto their mother’s skin to nurse within an hour after arrival, have been in place at medical institutions for years. Some hospitals may also already keep the mother and baby in the same room, but that would be required to attain the designation.
Still in the early stages of the process, Norwegian American Hospital, in the city’s Humboldt Park neighborhood, is busy sending nurses to outside education classes and encouraging them to become certified lactation counselors.
The hospital stocks a variety of about 70 cases of baby milk each month, and officials there aren’t too worried about budgeting for formula in the future.
“Any change that will have a financial impact is something we need to consider, but we feel overall we’re doing what’s best for our patients,” said Tim Egan, executive director of the hospital’s foundation board.

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Honoring the Mother

As we have just exited the Holiday Season, I feel the presence of my Mother, Nancy, so clearly. She passed away almost 2 years ago, and although the pain of losing her has become less overwhelming, the absence of her at this time of year is profound. She LOVED Christmas! As a single Mom, she never had much money to spend on the 5 of us, her children, but she made the season so special. The tree, the lights, candles everywhere, and always just the right gift, even if it wasn’t much. She knew each of us. Listened to us. Honored our individual tastes and interests. I believe that this is the most powerful Mothering tool that she inspired in me. As I enter into the frenzy of consumption and overspending that this Holiday inspires, I remember that the gifts I want most for my children are the memories of us being together as a family, and sharing our abundance with those who really DO NOT have anything. We will volunteer, we will donate coats and food, and we will try to calm the need for MORE STUFF! Like my Mother, I will try to give only one thing that will be very special for my children, and not over give. It’s important that they feel special because of who they are to us, not because they get a lot of presents during our dual Holidays. I hope that we all can remember to be present with each other and not be distracted by presents. I hope to honor my Mother by loving my family wholly and simply. I will light candles and draw her presence near. Wishing you all a Joyous and Peaceful Season of Light!

Safe Passage

I had such an interesting weekend. On Friday, I attended traffic safety school. Four hours in a classroom with people wishing to avoid a stain on their driving record for getting a traffic violation. I would like to say I was there as an observer, purely to understand the type of person who would take such a class. But no, I was there because I received a ticket for talking on my cell phone while driving. Yes, I knew it was illegal, but I had begun to swim in the river with every one else it seems who doesn’t seem to consider it a law worth following. I have even seen police officers on phones, so why shouldn’t I get to? Well, as I was reminded by the officer who pulled me over, there is nothing so important that I couldn’t have pulled over to make my phone call. Luckily, I didn’t have my kids in the car with me at the time. What a lesson to teach them.

Well, after the 4 hours of traffic safety school, I had to completely agree. There is no phone call worth making to risk my, or any one else’s safety while I am driving. The very stern, but affective retired State Patrol officer teaching the class was clear. We take too many risks because of our belief that what we do will not affect anyone else. I completely agree. And while driving, the rules of the road ARE there to remind us all to allow for that safety as we operate machines made of metal and glass that carry precious cargo, our lives and the lives of our loved ones. The rules are there to prevent harm.

The next 2 days of my weekend were spent at the Studio surrounded by women attending a training in the space to become Labor Support Doulas. The Doula is a non clinical support person for a woman during her birth experience. She has great knowledge of birth, and she is often seen as a mentor and guide for the mother, assisting along the journey as best she can, where she is needed. She is an advocate, an educator, and a “safe space” for the birthing woman.

This theme of safety and the choices we make (or don’t make) to be safe have been on my mind. In the Traffic Safety class, I was one of 30 people being reminded that ignoring safety rules while driving can lead to more problems than just a ticket. However, most of us have the belief that we will be fine, that the split second between being safe and not being safe will not happen to us, and this leads us to risky behavior while driving.

In birth, however, the opposite is true. In this country, we have the overwhelming belief that birth is very dangerous and because of this belief, we will allow any and all medical interventions to keep Mom and baby “safe”. We have moved so far away from believing that birth is a normal process of the body, a normal process that yes, can have complications. We have moved into believing that birth is a pathology of the body with unlimited complications.

In her new book, “Birth Matters, a Midwife’s Manifesta”, Ina May Gaskin writes of the history of birth practices in the United States since the turn of the century. This history can help explain how fear of birth became the norm in our modern world. Around this time, from about 1900-1930, there was a major anti midwife campaign. This just happened to coincide with the creation of maternity wards and medical obstetrical practices. “The argument that childbirth was far too dangerous for midwives to be trusted” according to Ina May, “was one of the most repeated assertions during the anti-midwife campaign”.  She also goes on to say that “maternal death rates actually rose when US women began giving birth in hospitals in large numbers.”

Working with these Doulas over 3 days, I was again reminded how important it is to believe in birth. To work with women to help them trust in their bodies. Belief that birth is unsafe and that the pain to process birth is beyond a woman’s capabilities is just that, most of the time, a belief. We take more risks when we act from the belief that medical interventions keep us safe in birth.

I love Ina May’s quote, “We need to recognize that technology is humbled in some very important ways by pregnancy and birth. Many of our current problems in US maternity care stem from the fact that we leave no room for recognizing when nature is smarter than we are.” And as I was just reminded by another amazing childbirth educator, Pam England, safety is not an action. It is an an outcome from the choices we make. Choosing to trust and believe in birth and to work to allow the process to unfold for Mom and baby continues to be the safest passage.