by Amy Spangler
July 30, 2010

The concept of no free formula has taken on new meaning at The Rosie Maternity Hospital in England. In addition to nightgown, robe, and slippers, women giving birth at The Rosie and planning to bottle-feed their babies are required to bring their own supply of formula. In lieu of free formula, all moms will be offered greater support for breastfeeding.

This policy change reflects efforts by the hospital to better comply with the Baby Friendly Hospital Initiative, a program launched in 1991 by the World Health Organization (WHO) and UNICEF and designed to increase breastfeeding rates worldwide. The policy change applies to all babies born at The Rosie with the exception of those needing special care.

“The most valuable medicine we have within the hospital is mothers’ milk,” says Dr. Jag Ahluwalia, medical director of Cambridge University Hospitals National Health Service Foundation Trust. “Currently 83 percent of women giving birth at The Rosie intend to breastfeed. But this number drops considerably as women encounter difficulties and either give up or resort to mixed feedings (breast and bottle). Becoming a ‘Baby Friendly’ unit will help to maintain rates of breastfeeding and give women the skills and confidence needed to continue.”

The action received high praise from Patti Rundall, policy director for Baby Milk Action, a Cambridge-based charity. Says Rundall, “Mothers should not feel that they are being forced to breastfeed. However, health care facilities have a responsibility to ensure that mothers are aware of the risks associated with formula feeding.”

With data showing that hospitals influence breastfeeding success, this welcome change comes just three weeks before the celebration of World Breastfeeding Week (WBW), August 1-7. Sponsored by the World Alliance for Breastfeeding Action (WABA), in keeping with this year’s theme, “Breastfeeding: Just 10 Steps. The Baby-Friendly Way,” communities are being asked to “…join hands in taking the reliable Ten Steps to making this world a Baby-Friendly World.”

WBW is celebrating its 19^th year in a world where less than one in three maternity facilities have implemented the Ten Steps to Successful Breastfeeding—steps proven to be effective time and time again:

1. Have a written breastfeeding policy that is routinely communicated to all health care staff.
2. Train all health care staff in skills necessary to implement this policy.
3. Inform all pregnant mothers about the benefits of breastfeeding and management of breastfeeding.
4. Help mothers initiate breastfeeding within a half-hour of birth.
5. Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants.
6. Give newborn infants no food or drink other than breast milk unless medically indicated.
7. Practice rooming-in—allow mothers and infants to remain together—24 hours a day.
8. Encourage breastfeeding on demand.
9. Give no artificial teats or pacifiers (also called dummies and soothers) to breastfeeding infants.
10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

Some will argue that The Rosie is taking the Ten Steps too far by requiring that pregnant women who intend to bottle-feed bring their own supply of formula. Some will feel that maternity facilities should provide food for all of its patients including moms and babies, or that all foods (including infant formula) should be purchased and none provided free-of-charge or at a reduced rate by manufacturers eager to ensure continued use of its products after moms and babies return home. But none will argue that The Rosie’s policy is anything less than brave and bold. It is a policy change that addresses the critical need for better breastfeeding support, a glaring deficiency that many feel best explains why 74 percent of U.S. mothers initiate breastfeeding but only 33 percent breastfeed exclusively for just three months.