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Breastfeeding Initiative

Breastfeeding Model Hospital Policy Recommendations, Fourth Edition, 2022

Preview of downloadable policy recommendations

Based on the Providing Breastfeeding Support: Model Hospital Policy Recommendations (PDF), the online hospital breastfeeding policy resources below provides additional references as well as resources and web links to assist hospitals in addressing its policies. These two documents are designed to give basic information and guidance to prenatal professionals who wish to revise policies that affect the breastfeeding families. Rationale and references are included as education for those unfamiliar with current breastfeeding recommendations. When no reference is available, the interventions recommended are universally considered to be best practice.

Hospital Breastfeeding Policy Resources

American Academy of Pediatrics (AAP) Guidelines for Perinatal Care, 8th Edition, 2017 (PDF) 

Includes evidenced based discussion of infant therapies after delivery. 
Ex. administration of Vitamin K and Conjunctival (Eye) Care

American College of Obstetrics and Gynecologists (ACOG) Guidelines 

ACOG Committee Opinion. Breastfeeding Expert Work Group Committee on Optimizing Support for Breastfeeding as Part of Obstetric Practice. No. 756. 2018

Average Intake of Colostrum/Milk (PDF) 

The Academy of Breastfeeding Medicine (ABM) Clinical Protocol #3: Hospital Guidelines for the Use of Supplementary Feedings in the Healthy Term Breastfed Neonate. Breastfeeding Medicine. Revised 2009

Baby Behavior

  1. Webinars  - Includes Baby Behavior for Lactation Professionals 4-part series.
  2. Videos  - Videos for Medical Professionals 
  3. Tear Sheets  - 7 Secrets to Baby Behavior 

Baby Friendly Hospital Initiative

  1. Baby Friendly USA  includes Guidelines and Evaluation Criteria (2021) 
  2. Cost Comparison of Baby Friendly and Non-Baby Friendly Hospitals in the United States  Pediatrics   2011.
  3. Implementation Guidance: Protecting, Promoting, and Supporting Breastfeeding in Facilities Providing Maternity and Newborn Services (PDF)  - World Health Organization (WHO). 2018
  4. Competency verification toolkit: Ensuring competency of direct care providers to implement the Baby-Friendly Hospital Initiative  - WHO and Unicef, 2020
  5. 10 Steps to Successful Breastfeeding Poster and Infographics  - WHO
  6. For Neonatal Wards (PDF)  - ILCA
  7. Protecting, promoting and supporting breastfeeding: The Baby-Friendly Hospital Initiative for Small Sick and Preterm Newborns ā€“ WHO, 2020

Breastfeeding Support during Maternal Infant Hospitalization

The Academy of Breastfeeding Medicine Clinical Protocol #35: Supporting Breastfeeding During Maternal or Child Hospitalization includes 14 recommendations for supporting breastfeeding while a mother or child is hospitalized.

California Breastfeeding Laws and Regulations

Common Breastfeeding Problems

  1. Persistent Pain with Breastfeeding (PDF)  - the Academy of Breastfeeding Medicine. ABM Clinical Protocol #26: Breastfeeding Medicine
  2. Common Breastfeeding Challenges  - USDHHS: Office on Women's Health

Contraindications to Breastfeeding

American Academy of Pediatrics (AAP) Policy Statement: Breastfeeding and the use of human milk  - Pediatrics. 2022

Education Course Curriculum

  1. Baby-Friendly Hospital Initiative training course for maternity staff  complements existing courses and can be used as part of the pre-service education of health workers. WHO, 2020
  2. First Latch: Training for the Baby-Friendly Hospital Initiative 
  3. UC San Diego Lactation Specialist Training (CLS) 
  4. iLactation 
  5. Lactation Education Resources 
  6. Step 2 Education 
  7. Coffective 
  8. BreastfeedLA  - Birth & Beyond and a LEAARC approved 45 and 90 hour course curriculum

Family Planning:

  1. ACOG: Interpregnancy Care 
  2. ACOG: Birth Control Frequently Asked Questions: Especially for Teens 

Formula Preparation:

  1. Food and Agriculture Organization (FAO)/World Health Organization (WHO). Safe preparation, storage and handling of powdered infant formula. 2007 (PDF) 
  2. AAP Committee on Nutrition. How to Safely Prepare Baby Formula With Water. 
  3. Centers for Disease Control and Prevention (CDC): Infant Formula Preparation and Storage (PDF) 

Hand Expression of Milk:

  1. Technique Video 
  2. Handout 

Infant Feeding in Disasters and Emergencies (PDF)  - AAP, 2020

Lactation Accommodation

  1. State of California Department of Industrial Relations. Lactation Accommodation  - Labor Commissioner's Office
  2. Office of Women's Health: Supporting Nursing Moms at Work 

Late Preterm Infant:

  1. ABM Clinical Protocol #10: Breastfeeding the Late Preterm (34ā€“36 6/7 Weeks of Gestation) and Early Term Infants (37ā€“38 6/7 Weeks of Gestation), Second Revision 2016 (PDF) 
  2. Consensus Clinical Guidelines for Late Preterm Infant Feeding, UCSF Northern California Neonatal Consortium (PDF) 
  3. La Leche GB, Feeding Late Preterm Babies 
  4. Breastfeeding Progression in Late Preterm Infants from Birth to One Month . Maternal Child Nutrition, 2020.
  5. National Perinatal Association, Multidisciplinary Guidelines for the Care of Late Preterm Infants (PDF) 

LATCH Breastfeeding Assessment:

LATCHL A breastfeeding charting system and documentation tool  - JOGNN, 1994

  1. Mother's Milk Bank  , San Jose, California
  2. University of California Health Milk Bank  , San Diego, California
  3. Human Milk Banking Association of North America (HMBANA)   - Information about non-profit milk banks in North America

Medications and Breastfeeding

  1. LactMed Drugs and Lactation Database  - National Institutes of Health. U.S. National Library of Medicine Toxnet Toxicology Data Network
  2. Model Maternity Policy Supportive of Breastfeeding (PDF) - The Academy of Breastfeeding Medicine (ABM) Clinical Protocol #7: Model Maternity Policy Supportive of Breastfeeding. Breastfeeding Medicine, 2018
  3. Infant Risk Center 
  4. Use of Antidepressants in Breastfeeding Mothers (PDF) - Academy of Breastfeeding Medicine (ABM) Clinical Protocol #18: Use of Antidepressants in Breastfeeding Mothers. Breastfeeding Medicine. 2015
  5. MotherToBaby- Evidence-based information on the safety of medications and other exposures during pregnancy and while breastfeeding. Fact sheets and live chat with experts are available. 

Neonatal Intensive Care Unit (NICU)

  1. BFUSA Toolkit on Baby-Friendly Principles for the NICU 

Newborn's Nine Instinctive Stages 

  1. The Sacred Hour: Uninterrupted Skin-to-Skin Contact Immediately After Birth  - Newborn and Nursing Reviews. 2013

Newborn weight tool (NEWT) determines the newborn's weight loss trajectory 

Patient Education Materials

  1. The CDC Clear Communication Index User Guide 
  2. Global Health Media  - Simple breastfeeding videos for health workers
  3. Health Literacy - USDHHS: ODPHP
  4. Your Guide to Breastfeeding Office on Women's Health (PDF)  - U.S. Department of Health and Human Services. Washington, DC: 2011
  5. Smokefree Resources for Professionals  - U.S. Department of Health and Human Services. National Institutes of Health. National Cancer Institute
  6. WIC Breastfeeding Support Learn Together.  Grow Together - U.S. Department of Agriculture

Staff Breastfeeding Skills Assessment

Assessing Mothers and Infants in Maternity Facilities (PDF)  - The Academy of Breastfeeding Medicine (ABM) Clinical Protocol #7: Model Maternity Policy Supportive of Breastfeeding. Breastfeeding Medicine, 2018; 13(9): 559-575. Table 3: List of Abilities to Be Assessed Among Staff Working with Mothers and Infants in Maternity Facilities

Storage Duration of Fresh Human Milk:

  1. Proper Storage and Preparation of Breast Milk  - CDC
  2. Promoting Human Milk and Breastfeeding for the Very Low Birth Weight Infant - AAP

Title 22 California Code of Regulations Division 5 Ā§70547 Perinatal Unit

  1. General Requirements (PDF) 
  2. Practical Skills forms to help meet Title 22  - To ensure that training is being used properly by staff.by quantifying and monitoring:1) Breastfeeding and hand expression (term baby), 2) Kangaroo care/skin-to-skin contact (preterm baby), and 3) Responsive bottle feeding (preterm baby). UNICEF, United Kingdom.

Transgender and Gender Nonbinary People

  1. Health Care for Transgender and Gender Diverse Individuals  - ACOG: Committee Opinion, 2021
  2. Transgender & Non-binary Parents  - La Leche League
  3. Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People  - Center for Excellence for Transgender Health; UCSF, 2016
  4. Transmasculine individuals' experiences with lactation, chestfeeding, and gender identity: a qualitative study  - BMC Pregnancy and Childbirth, 2016
  5. ABM Position Statement on Lactation-Related  Language and Gender  2021
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