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2.1 Steps 1 & 2; Points 1 & 2

These first two Steps/Points relate primarily to the responsibilities of the management team in your Unit, ensuring the Policy is evidence-based, widely distributed and all staff are competent to uphold the standard it describes.

1: Have a written breastfeeding policy that is routinely communciated to all healthcare staff

  • If you work in a hospital setting your breastfeeding policy must incorporate each of the Ten Steps to Successful Breastfeeding.
  • If you work in a community setting your policy will incorporate the 7-Point Plan.
Your policy will also reflect compliance with the relevant provisions of the WHO International Code on the Marketing of Breast-milk Substitutes and subsequent WHA Resolutions.

Implementation

  • A copy of the policy that incorporates the Baby Friendly criteria must be provided to all new staff at commencement of their employment and orientation to the policy scheduled for all new staff, including volunteers.
  • The policy, or a summary of the policy, must be displayed in all areas that serve mothers and babies.
    • Your policy should be available in easily understood language in the languages mostly commonly spoken by women using your Unit.

Activity

As you walk around your health facility look around to see where the policy (or summary of the policy) has been posted. It should be easy for you to see in such areas as the emergency department, the paediatric ward, the ultrasound and screening clinics, the birthing rooms, the baby-change or feeding rooms provided for the general public, as well as the more obvious places such as each room in the maternity/obstetric unit.

Evaluation:
In your Unit who has the responsibility for confirming that the Policy is displayed as required?
How frequently is this task performed?
Where is its successful completion recorded?

  • Indicate where you would access the Breastfeeding Policy in your Unit should a member of the public or another health professional (or the Baby Friendly assessor!) ask you for it
Display the breastfeeding policy in the most common languages spoken.

Display the breastfeeding policy in the most common languages spoken.
© D.Fisher, IBCLC

2: Health professional education in order to implement the policy

All new staff should be orientated to the breastfeeding policy within their first week of employment, and then fully trained to implement the breastfeeding policy, according to their role, within six months.

All staff who assist mothers with breastfeeding are required to complete a comprehensive course that incorporates the backgound knowledge and clinical skills needed in order to implement best practice standards successfully.

Implementation

Educational component

The knowledge required by different levels of staff determines the education they are required to undertake. For example, the nursing and midwifery staff who provide hands-on care for mothers and/or infants during the perinatal period require a minimum of 20-hours of education which includes all aspects of breastfeeding initiation and management, while doctors or midwives who supervise such care require a reduced number of hours. Other ancillary staff educational needs should be determined by the level of contact they have with mothers and infants.

Clinical competency

All staff must be able to provide education to mothers or their families on all aspects of infant-feeding decision-making, breastfeeding initiation and management, and artificial infant feeding.
Clinical competency in the following key skills must be assessed and recorded:
  • communication skills, in particular regarding infant-feeding counseling during the prenatal period
  • teaching positioning and latching of the baby to the breast
  • teaching hand expressing of breastmilk
  • teaching safe preparation and feeding of breastmilk substitutes
Hand expressing colostrum

Hand expressing colostrum.
© E.Grunis IBCLC

Refer to the Breastfeeding Policy

Find the section in the Policy that states what education each staff member has to receive.
Does the Procedure to implement it:
  • state the timing of that education in relation to commencement in the unit?
  • outline what should be covered in the didactic part of the education?
  • note that each individual staff member must be directly supervised in the clinical skills required?

What should I remember?

  • all the places you should see a summary of your Breastfeeding Policy displayed
  • where you can find a full copy of the Breastfeeding Policy
  • what the Breastfeeding Policy must include
  • when staff are to receive their education to implement the Policy
  • the clinical skills in which each staff member must be assessed to be competent to teach to mothers