Commonly
Asked Questions and Answers
How does the Baby-Friendly process work?
Baby-Friendly USA is pleased to announce the new “4-D Pathway” for achieving the Baby-Friendly Designation. This new method organizes the process into manageable and achievable tasks. There are four phases to the pathway. First, in the Discovery Phase, a birthing facility commits to the Baby-Friendly process by submitting an application (including a letter from the CEO indicating support, a fee and a completed self-appraisal tool) to Baby-Friendly USA. After that, the facility works through the Development, Dissemination and Designation Phases, accessing technical assistance from Baby-Friendly USA and receiving feedback on submitted policies, curricula, etc. Finally, the facility requests an on-site assessment by the Baby-Friendly assessment team and a review by the External Review Board. Upon successful completion of this review process, the "Baby-Friendly" designation is conferred. If the facility does not pass on first assessment, it may apply for reassessment when identified problems have been rectified.
Our facility is currently registered with Baby-Friendly USA and participating in the current Certificate of Intent program. Are we required to go into the new 4-D Pathway?
Facilities that have a current Certificate of Intent (COI) by April 1, 2010 have the following options:
- Move into the new 4-D Pathway to Designation Program
- Complete the COI Program by December 31, 2011. (Have satisfied pre-assessment requirements and have secured an on-site assessment slot) After December 31, 2011 the COI pathway is closed. All facilities will be moved into the Pathway program.
- If option 2 is initially selected, facilities may to transition to the 4-D Pathway at anytime.
What if my hospital or birthing center is not "Baby-Friendly" enough to get started?
There is no such thing. The Pathway process provides an easy to follow framework for your effort to become a Baby-Friendly facility. A facility does not have to answer "yes" to all questions on the Self-Appraisal Tool to obtain a certificate of intent.
Are there any charges for the process?
Yes. Each hospital or birth center is assessed an annual fee. Please see fee schedule for more information. In addition there are optional services, support materials and videos available for a charge. The fee includes a number of hours of technical support, reviews of materials and access to a discussion list. Once a hospital has achieved Baby-Friendly status, a smaller annual fee is assessed.
What are the costs for the assessment?
Facilities in the 4-D Pathway are charged for travel costs, lodging and per diem for two assessors.
Where does the funding for the Baby-Friendly program come from?
The funds to run the Baby-Friendly USA office and programs come from fees paid by birth facilities and from the contributions of interested individuals and organizations. Baby-Friendly USA does not accept contributions of any type from companies in violation of the International Code of Marketing of Breast-Milk Substitutes.
My hospital is part of a three hospital system. Can the whole system make one application for the pathway to designation?
No. Each hospital within a system has its own unique assets and challenges regarding breastfeeding promotion, protection and support. Each hospital must be assessed on its own merit.
Are the US Ten Steps the same as the global?
Yes, except Step 4 for the US is written that breastfeeding should be initiated in the first hour of life in the U.S., as opposed to the first half-hour elsewhere. In both the US and global 10 steps, the baby should be placed skin-to-skin immediately after birth and remain there continuously until the completion of the first breastfeeding. Also, in the US we have interpreted Step 6 "Give newborn infants no food or drink other than breast milk, unless medically indicated," as "Give breastfed newborns....."
What about purchasing formula? Must my hospital purchase all formula used to pass?
Yes. The Baby-Friendly Hospital Initiative supports the International Code on the Marketing of Breast-milk Substitutes ("WHO Code"). The WHO Code stipulates that health care facilities and professionals neither accept nor offer free or low-cost substitutes for human milk. In keeping with the Code, the Baby-Friendly Hospital Initiative asks facilities to purchase all infant formula in the same manner as it purchases all other supplies. Additionally, facilities should not give infant formula samples, literature, or other items bearing the name of an infant formula product to breastfeeding mothers.
Step two says "train all staff." Our physicians on staff are not technically employees of the hospital. Do they have to be trained?
Yes. The External Review Board, composed of knowledgeable experts in the fields of medicine, public health, and nursing, have determined that any pediatrician, obstetrician, or family practice physician with a practice including breastfeeding families who has staff privileges at a hospital or birthing center must be trained in the advantages and management of breastfeeding. The amount and content of training offered may be tailored to needs of different professionals. For example, nursing staff with primary responsibility for helping mothers initiate breastfeeding should have, at minimum, 20 hours of training as identified by UNICEF. Physicians must have a minimum of 3 hours training.
Our hospital is thinking about becoming Baby-Friendly. How soon can we be assessed?
First, your hospital will need to enter the Pathway to Baby-Friendly Designation and complete all of the tasks in the 4 D Phases – Discovery, Development, Dissemination and Designation before the readiness interview. After a successful readiness interview, an on-site assessment can be scheduled.
When can we use the terminology of "Baby-Friendly Hospital?"
Only when your facility has been assessed, approved by the External Review Board, and the CEO has received the letter from the External Review Board. Use of the trademarked term "Baby-Friendly" is restricted only to fully designated facilities.
Why should our facility consider becoming a Baby-Friendly facility?
The Baby-Friendly Designation is the globally recognized symbol of world-class maternity care. In addition, the pathway to designation provides facilities the opportunity to:
- deliver patient-centered care
- improve health outcomes for mothers and babies
- improve patient satisfaction
- increase market share
- elevate the reputation and standards of the birthing facility
- enhance a professional environment of competence
- demonstrate a commitment to quality improvement
- build leadership and team skills among staff
- improve m-PINC scores as rated by the Center for Disease Control
- meet Joint Commission maternity care standards for exclusive breast milk feeding
- meet corporate compliance requirements
- lead the way to achieving Healthy People 2020 goals for breastfeeding
- become a member of an exclusive group of elite facilities around the world who have achieved this globally prestigious award
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