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Increasing Breastfeeding Support

October 2020

According to the World Health Organization, 3 out of 5 infants globally are not breastfed in the first hour following birth; 41% of infants around the world are exclusively breastfed between birth and six months; and if all children between birth and 23 months were optimally breastfed, at least 820,000 deaths could be prevented annually, (1). For those of us who have worked relentlessly for years to promote, protect, and support breastfeeding, those are discouraging facts.


Author Dr. Diane Spatz recently looked at ways to increase capacity for providing evidence-based breastfeeding support. In her study introduction, she reports “…there has been little focus on infants requiring care in a neonatal intensive care unit (NICU) at birth and the provision of human milk feeds. Data… demonstrate that over 50% of NICU infants in the USA are discharged home on infant formula… [and] less than 50% of NICUs employ International Board Certified Lactation Consultants (IBCLC) and a mere 13% of NICU nurses report providing breastfeeding support. Of further concern is the 2017 publication from the World Health Organization noting that, globally, interest in the Baby-friendly Hospital Initiative (BFHI) is waning and less than 10% of births worldwide occur in BFHI designated facilities,” (2).

As one intervention, Spatz developed a lactation program aimed at nurses in her facility. The Breastfeeding Resource Nurse (BRN) Program focuses on providing “bedside nurses within a children’s hospital with the education and training needed to provide accurate, comprehensive, and evidence-based care and support to breastfeeding/pumping mothers and families,” (2). She found that through the implementation of this program, 90% of NICU nurses reported providing direct breastfeeding support and assistance.

Of note are Spatz’s recommendations following delivery:

“Mothers should be provided with appropriate and realistic expectations regarding the first few weeks of breastfeeding. At CHOP (Children’s Hospital of Philadelphia) the message to the mother is that her only job for the first two weeks following delivery is to eat, sleep, pump, and visit her baby. For a mother who has a healthy infant, her only job should be to eat, sleep, and breastfeed. Prior to delivery, the mother’s family (however she defines it) should be empowered to assume all other household responsibilities so that the mother can focus on feeding and making milk for her baby. It is essential for the mother and her family to understand that there is a critical window of opportunity following birth and if the mother does not turn on all the prolactin receptor sites in her breast and establish a normal milk supply early on, she will jeopardise her ability to be a long-term breastfeeding mother.”

Stay safe and continue to promote, protect, and support breastfeeding!

Kathy Parkes, MSN-Ed, RN, IBCLC, FILCA CHC

Professional Development Educator

This email address is being protected from spambots. You need JavaScript enabled to view it.


1. Downloaded from https://www.who.int/health-topics/breastfeeding#tab=tab_1
2. Spatz, D.L. (2018). Increasing capacity for the provision of evidence-based human milk and breastfeeding support. INFANT; 14(2): 54-57.

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