Debra

I always love the learning modules you send in to Lactnet, so well
researched and so beautifully explained.  Thank you for talking this time
about how infants acquire bottle or breastfeeding skills and how fragile
this learning can be.  You also mention that difficulties are addressed in
the new BFHI guidance under Step 9.

I've always been a huge fan of the Baby Friendly Hospital Initiative, which
I became familiar with from 1992 as a facilitator and an assessor.  The
BFHI was a thing of beauty and impossible to fudge, since it was designed
to ensure that all hospital staff worked towards helping mothers
breastfeed.  All the criteria were checked and double-checked against each
other, and mothers themselves were assessed at 2.5 to 1 against hospital
staff.  It worked so well.  The Zimbabwean hospitals that went through the
process achieved 100% on every Step.

One of the Steps which caused us some consternation though, to the extent
that one of our senior assessors wondered if it should be removed from the
Assessments was Step 9.  The mothers, when asked if their babies had
received bottles or teats (artificial nipples) looked confused.  The answer
was always No.  But their curiosity was aroused: they wondered - logically
in view of the question - were they _supposed_ to give bottles and dummies
to their babies?   So we thought that possibly the question should be
removed from the Assessments.

Now we have the situation where the BFHI has been sanitized to meet First
World expectations for breastfeeding - and specifically to reflect the
reality that _most_ or even All Babies will be exposed to bottles, and
artificial teats.  Whereas the original BFHI Step 9 contained the caution:

Step 9. Give no artificial teats or pacifiers (also called dummies or
soothers) to breastfeeding infants.

Now the New-Improved version encourages:

9. Counsel mothers on the use and risks of feeding bottles, teats and
pacifiers.


Does this help more mothers to breastfeed their babies?  I don't think so.
 It's such a shame.


Pamela Morrison,

IBCLC (Retired), England.

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