Hi,

A couple of weeks ago someone asked about BFHI assessments and what
do hospitals do with mothers who do not want to breastfeed.  I am a
BFHI assessor and educator in Australia.  I am an IBCLC and an
Australian Breastfeeding Assoc. breastfeeding counsellor --not a
midwife or nurse.  So my reply is from the assessor and educator point of view.

When assessing a hospital, we look for:
- no advertising, no free give aways of bottles, teats or artificial
formulas.  (In fact in my 6 years of assessing I have not seen any of this)
- that any artificial formula kept for use for medical reasons (as
per WHO 2009 acceptable medical reasons for the use of breastmilk
substitutes) is in a locked cabinet or in a cabinet in a room that is
closed access.
- that staff know what is an acceptable medical reason for the use of
the artificial formula.

I a mother has decided to not breastfeed that:
- she has been told about the risks of not breastfeeding
- she has had time skin to skin with her baby after the birth unless
there are medical reasons--the same for mothers who do plan to
breastfeed.  It can be difficult to have this happen in some
facilities due to staffing and caesarean birth.
- the mother and if possible other adult members of the family have
one on one instruction on how to make up the artificial
formula.  Hospitals are now keeping a tin that is well marked and
kept in a locked cabinet. (In two hospitals I have seen the type of
formula has been covered by the sign, so there is no promotion of
specific brands.)  They demonstrate how to make up the feed.  This is
then tossed out.  The mother then makes up her baby's feed from the
artificial formula and bottle that she has brought into the hospital.
She is asked to keep the tin safe in her room to minimise possible
contamination, and how to clean and disinfect/sterilize bottles and teats.

Does it always work well?  No, but as a part of the role of the
assessor is to also education staff and parents into the potential
harms.  My sample is very small.  However, because the hospitals do
work together for regional education and support, there can be
indirect education and information.

HTH,
Ruth Berkowitz

   ,-._|\    Ruth Berkowitz, IBCLC; BFHI Assessor & Educator; Grad.
Dip.
  /  Oz  \       Counselling; ABA breastfeeding counsellor; B.Sci.(Ed, USA);
  \_,--.x/   M.L.S.(Monash). KEW EAST VICTORIA AUSTRALIA
               ~

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