I work in a hospital that is currently preparing for external assessment for the BFHI. We 
have over 7000 births a year and are a tertiary care hospital for the province and 
community hospital for the local community.

Let me start with my own experience.  I completed my midwifery diploma in the UK in 
1994.  At the time it was rare to see women BF past 10 days PP.  I hear things are 
changing for the better.  When I moved back home I started work in my current hospital.  
At the time I was a staff nurse in LDR.  Post delivery, there are lots of things to do, 
observations to take, charting to catch up on, paperwork to do, mom to prepare for 
transfer once stable.  I would aim to move her by about 2 hours post delivery.  
Breastfeeding was my last priority and often the babies did not feed before transfer.

In 1997 our hospital opened a 7 bed single room maternity care unit.  I was there 
working on opening day.  Since the women were not moved post delivery, priorities were 
different.  I soon learned a few things.  Babies stay warmer if left skin to skin with their 
mothers.  All baby checks can be done without moving them.  If baby feeds in the first 2 
hours, they will breastfeed successfully eventually and it makes the upcoming shifts much 
easier because there is less work to do helping with feeding.  

Several years back the hospital started making changes to be certified baby friendly.  We 
have had a committee assigned to each step.  One was working on skin to skin and 
initiating feeding within the first hour.  Things have vastly improved.  I think what has 
helped is having nurses work in SRMC unit and learn more about post partum care.  
Educating LDR staff about how easy it is to incorporate STS after delivery and sharing 
how this can decrease the amt of work you need to do.  One of the biggest helps was to 
get physicians and pediatricians on side.  Now if peds is called to a delivery, they will 
delay their initial assessment if the baby is not needing any resuscitation.  Family docs do 
baby's assessment last ect....  Weighing can be delayed.  Baby's vital signs can be 
checked while baby is skin to skin.  Initial steps of resuscitation can happen while baby is 
in mom's arms (this is taught to staff when recertifying NRP).  

I am currently on mat leave and I am aware that they are working on skin to skin contact 
in the OR.  Babies stay with mothers in recovery unless mom or baby is unstable.  

Hope this helps, email me if you have more questions.

Cordelia

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