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Hospital Practices

Nearly all births in Oregon occur in hospital settings, but hospital practices and policies in maternity settings can create barriers to support a mother’s decision to breastfeed. Guidelines based on available evidence have been established to ensure the delivery of appropriate maternity care in hospital settings; however, the evidence-based guidelines are applied inconsistently. Following evidence-based practices will influence breastfeeding exclusivity and duration rates in Oregon.

National data from the Centers for Disease Control and Prevention’s (CDC) ongoing survey of Maternity Practices in Infant Nutrition and Care (mPINC) indicate that hospitals have opportunities to implement practices in labor, delivery, and postpartum care, as well as in hospital discharge planning that support mothers who want to breastfeed. Oregon's State Report summarizes the strengths in breastfeeding support of Oregon facilities, as well as the areas in need of improvement. The report identifies opportunities that Oregon can take on in order to better protect, promote, and support breastfeeding mothers and infants.


Evidence-Based Maternity Care Practices
  • The CDC Guide to Breastfeeding Interventions showcases evidence-based interventions for improving maternity care practices, including intrapartum care and immediate postpartum care. They also offer additonal resources for improving maternity care practices.
  • The Baby-Friendly Hospital Initiative (BFHI) is a global program sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) to encourage and recognize hospitals and birthing centers that provide a set of maternity care practices (known as the Ten Steps to Successful Breastfeeding ) that result in better breastfeeding outcomes. Hospitals and birthing centers that have made a commitment to following the Ten Steps to Successful Breastfeeding can apply for the Baby Friendly designation through Baby-Friendly USA.

  • The Joint Commission, an organization that accredits and certifies health care organizations and programs in the USA, has released their new Perinatal Care core measure set, which includes an exclusive breastmilk feeding core measure.  The United States Breastfeeding Committee (USBC) has published a toolkit, Implementing the Joint Commission Perinatal Care Core Measure on Exclusive Breast Milk Feeding, to aid hospitals and maternity facilities in accurate collection of data to comply with the new measure and to improve adherence to evidence-based best practices, which is ultimately reflected in rates of exclusive breastmilk feeding. View the Tool Kit.

Additional Resources for Health Care Facilities
  • The Academy of Breastfeeding Medicine has published clinical protocols on infant formula supplementation and model hospital policy.
  • A national campaign, Ban the Bags, focuses on urging hospitals to remove discharge bags that market infant formula to new mothers. Provision of commercial discharge packs implies a hospital and staff endorsement of infant formula and has a negative impact on breastfeeding duration and exclusivity. Check the list of Oregon hospitals that have made the commitment to end their role in the marketing of infant formula.
  • Many hospitals and birth centers have not implemented all of the Ten Steps to Successful Breastfeeding, however incremental changes in birth facilities contributes to improvement in breastfeeding outcomes. Tips to get started:
  1. Implement a written breastfeeding policy that is routinely communicated to all health care staff (reference);
  2. Refrain from distributing commercial hospital discharge packs containing infant formula to mothers during the hospital stay (reference).
  3. Read Healthy Birth Practices from Lamaze International: Keep Mother and Baby Together-It’s Best for Mother, Baby, and Breastfeeding.