I write in response to Barb Whitehead's recent concern about whether a
hospital could deceive a Baby-Friendly assessment team by pretending to be
compliant without actually having made much change.
In the US, birth facilities can apply for a Certificate of Intent at any
time by completing the self-appraisal tool and sending it together with a
letter of support from an administrator and an annual fee. Baby-Friendly
USA encourages facilities to obtain a Certificate of Intent early in their
working process in order to enhance the information flow and to provide
technical support in the implementation of the Ten Steps to Successful
Breastfeeding. This means that new Certificate of Intent facilities may
appear to be, and truly may be, very unprepared for assessment when
achieving this first milestone in the BFHI process. It may take years for
some facilities to fully implement all Ten Steps and be ready for on-site
assessment.
In our experience, facilities that create multi-disciplinary working groups
(including ideally the breastfeeding advocates as well as key breastfeeding
disbelievers, together with representatives of marketing, administration,
women's health, obstetrics, pediatrics, quality assurance, ethics/vendor
policy and community benefits) to work through the self-appraisal tool are
best able to get everyone's beliefs, objections and thoughts out in the
open. This group experience often opens possibilities for transformation
that do not exist if BFHI is perceived to be the soapbox of only one or two
rabblerousers. (:>)
Decision about the actual designation of "Baby-Friendly" hospitals is made
after an intensive on-site assessment. While the assessment process is not
perfect, it does entail several features which build a multi-faceted
picture of the breastfeeding and maternal/infant care delivered. The bulk
of the material generated in the assessment process comes not from what
hospitals report, but from tens of interviews with RANDOMLY selected
mothers (prenatal and postpartum) and staff members, as well as through
observation, review of documentation and meetings with administrators.
Facilities do not get to choose which mothers and staffers are selected for
interviews.
I strongly agree with other posters who have suggested that the type of
situation Barb presents here is a great opening for community breastfeeding
advocates and experts to help transformation happen. That is, rather than
feeling exasperated that facilities would think they were ready for BFHI,
one could choose to see this as a great opportunity to support positive
change and to help identify what is going well and what is NOT. Community
members are encouraged to contact the working group and offer their
support. Many of the Ten Steps are optimized by the involvement of the
facility with the larger breastfeeding community.
Kudos to all who strive to improve the environment for new families!
Cindy Turner-Maffei, MA, IBCLC; Coordinator, Baby-Friendly USA
8 Jan Sebastian Way #13 * Sandwich, MA 02563, USA
ph (508) 888-8092 * fax (508) 888-8050
http://www.aboutus.com/a100/bfusa/
mailto: [log in to unmask]
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