Important Change to the Evaluation Criteria for Step 9, Criterion 9.1.2

BFUSA has decided to reinstate the 2010 criterion for Step 9, Criterion 9.1.2, and will maintain the standard we are currently assessing against for this criterion when we begin using the 2016 Guidelines and Evaluation Criteria (GEC) on November 1, 2018.

The currently published version of the 2016 GEC contains the following language for Criterion 9.1.2:

“Observations in the postpartum unit and any well-baby observation areas will indicate that at least 80% of breastfeeding infants are not using bottles.”

This will now change to:

“Observations in the postpartum unit and any well-baby observation areas will indicate that at least 80% of breastfeeding infants are not using bottles, or, if they are, their mothers have been informed of the risks and this education is documented in the medical record.”

This decision allows for a closer alignment with the 2017 WHO evidence review and the 2018 WHO BFHI revisions which removes the absolute prohibition on the use of feeding bottles and artificial nipples and recommends that documented parental education be scored as an acceptable answer in the 80% minimal criteria for bottle use.

It is important to remind all staff that when a mother requests that her breastfeeding infant be given a bottle, the health care staff should explore the reasons for this request, address the concerns raised, discuss with her the potential consequences to the success of breastfeeding, and review alternative methods for soothing and feeding her infant.

There are NO OTHER CHANGES to the 2016 GEC at this time.