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Staff Compliance with a Baby-Friendly Hospital’s Breastfeeding Policy

Staff Compliance with a Baby-Friendly Hospital’s Breastfeeding Policy Sheina Jean-Marie, BA, Camille Powe, BA, Barbara L. Philipp, MD, FAAP, FABM, IBCLC Department of Pediatrics, Boston Medical Center/Boston University School of Medicine, Boston, MA, USA. BACKGROUND. METHODS. RESULTS.

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Staff Compliance with a Baby-Friendly Hospital’s Breastfeeding Policy

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  1. Staff Compliance with a Baby-Friendly Hospital’s Breastfeeding Policy Sheina Jean-Marie, BA, Camille Powe, BA, Barbara L. Philipp, MD, FAAP, FABM, IBCLC Department of Pediatrics, Boston Medical Center/Boston University School of Medicine, Boston, MA, USA BACKGROUND METHODS RESULTS IMPLICATIONS • Step 6 of the Ten Steps to Successful Breastfeeding: Give infants no food or drink other than breast milk, unless medically indicated • Item #11 of Boston Medical Center’s 24-item breastfeeding policy addresses step 6 of the Ten Steps. • Item 11 states, “No sterile water, glucose water or formula will be given unless specifically ordered by a MD or nurse practitioner, or by the mother’s documented and informed request. In this case, the supplement should be fed to the baby by an alternative feeding method if possible.” • Reviewed randomly selected medical records of 400 healthy, eligible-to-breastfeed infants admitted to the mother/baby unit in 2003 and 2004 • Abstracted feeding information from the 24-hour flow sheet completed for every newborn by the nursing staff • Counted the number of breast milk, formula and any other feeds for each infant • Further analyzed infants who received only breast milk but for one formula feed to determine the reason for, route of, amount of and time of the formula feed. • Maintaining the Ten Steps in a busy hospital setting requires work and vigilance • Next steps: • Share data with staff • Obtain staff feedback • Review proper documentation • Review information presented in ongoing training sessions regarding alternative feeding methods • Re-audit • A special review session on Item #11 for night staff might be beneficial RESULTS LIMITATIONS • Breastfeeding rates for 2003 and 2004 • Any breast milk (347/400, 87%) • Breast milk>formula (274/400, 69%) • Exclusive breast milk (92/400, 23%) • 39/400 (10%) infants received only breast milk but for one formula feed • 7/39 (18%) were fed the formula per MD’s order, usually for hypoglycemia • 14/39 (36%) were fed the formula “per mother’s request” • 18/39 (46%), no medical reason or parental request found • Alternative feeding method used in 8/39 (21%); a bottle in 31/39 (79%) • 30/39 infants (77%), the formula feed given between >7pm-7am • Average amount given was 26cc ANY AMOUNT OF BREAST MILK BREAST MILK > FORMULA EXCLUSIVE BREAST MILK • Small sample size • Cohort chosen to study • We studied an identified area of weakness not strength. PURPOSE To investigate compliance with one item of a Baby-Friendly hospital’s breastfeeding policy. CONCLUSION DISCLOSURE Among a small cohort of infants receiving only one formula feed, staff complied with the supplementation section of the breastfeeding policy approximately 50% of the time, and non compliance was more pronounced among staff working at night. The authors have no financial interests to disclose.

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