Fact vs. FIB: The Truth About Attrition
As we said in a series of posts last year, Baby-Friendly USA (BFUSA) believes we owe it to the public and to the hospitals that have worked so hard to earn the Baby-Friendly designation to call out inaccuracies and falsehoods promoted by those seeking to undermine the Baby-Friendly Hospital Initiative (BFHI).
The latest example is a page Fed Is Best (FIB) published on its website last fall that contains a list of hospitals they claim “relinquished their Baby-Friendly status” in the 25 months between August 23, 2016 and September 21, 2018. The clear implication is that hordes of US facilities are abandoning the BFHI, an outcome FIB would clearly like to advance.
Nothing could be further from the truth. Please let us set the record straight.
What’s in a Name?
The first issue is that the list was wildly inaccurate for many months.
FIB created this list by comparing BFUSA’s published list of designated facilities on August 23, 2016 with the list from September 21, 2018. Any facility on the first list that was not on the second list was presumed to have withdrawn its Baby-Friendly designation and was counted among the “relinquished.”
But this methodology was flawed because:
- Some of these facilities experienced a name change during this time – in most cases because of a merger/acquisition or reorganization by a parent company. These facilities did not “relinquish their Baby-Friendly status” – they are still on Baby-Friendly USA’s list of designated facilities under a different name.
- Other facilities experienced shifts in business practices that affected their ability to retain Baby-Friendly status, including some that ceased offering maternity care services or the hospital closed all together. These facilities also did not “relinquish their Baby-Friendly status” – they are simply no longer eligible to be Baby-Friendly designated.
In response to push-back from BFUSA and many of the facilities inaccurately named, FIB has corrected most (but not all) of the errors on this page. However, this doesn’t change the fact that this list was widely circulated for many months and may have caused significant confusion and damage to the public perceptions of the many proud Baby-Friendly designated facilities wrongfully identified.
Growing Steadily
The second and more important issue is that any departures from the Baby-Friendly program must be seen in the broader context of the significant growth of the BFHI in the US in recent years.
A small amount of attrition is to be expected from any program. While we are disappointed about any departure from the Baby-Friendly program, the number of withdrawals pales in comparison to the numbers joining the Baby-Friendly ranks in recent years.
During the 25-month period in question, 210 new facilities were designated Baby-Friendly in the US and 64 facilities were re-designated. These gains way more than offset the departures and resulted in a net gain of 174 Baby-Friendly designated facilities during this time.
And in 2018, BFUSA celebrated two major milestones: 500 Baby-Friendly designated facilities and one million babies born each year in Baby-Friendly designated facilities in the US. The number of Baby-Friendly facilities in the US has grown 69% since the beginning of 2016 and is continuing to grow at a steady pace, as the above diagram demonstrates.
Even more convincing is seeing how proud these facilities are to be Baby-Friendly designated.
The truth is very different from the story FIB would have you believe: the BFHI is thriving and is more popular than ever in the US.
