What makes a hospital ‘baby-friendly’?

Gone are the days when you’d stand at a window and gaze at 15 babies lined up in bassinets in a hospital nursery. Nurseries for healthy babies are disappearing from hospitals across the country, including ours.  

Instead, moms and babies now stay together in the same room 24/7. The main driver behind this trend is the Baby-Friendly Hospital Initiative (BFHI). There are plenty of benefits to this program, but the main one is that it promotes breastfeeding.  

We were proud to receive this prestigious designation in June 2017 after spending the past couple years implementing new policies, curriculum, action plans and training, as well as completing a rigorous on-site assessment.

In fact, Baby-Friendly designation is more than a 'seal of approval.' It requires extensive engagement and education of the staff. We had more than 200 nurses in our Labor and Delivery, Mother/Baby and Infants’ Services units who received extensive additional lactation training.

What’s a Baby-Friendly hospital?

The World Health Organization and United Nations Children’s Fund launched the Baby-Friendly Hospital Initiative in 1991 to encourage hospitals to create environments that promote mother/baby bonding and support women who choose to breastfeed.  

Facilities that achieve the Baby-Friendly designation have successfully implemented the 10 steps to successful breastfeeding, which include:

  • Have a written breastfeeding policy that is routinely communicated to all health care staff.
  • Inform all pregnant women about the benefits and management of breastfeeding.
  • Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
  • Practice rooming in – allow mothers and infants to remain together 24 hours a day.
  • Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or birth center.  

Many healthcare organizations have endorsed these steps, including the American College of Obstetricians and Gynecologists, American Academy of Pediatrics and U.S. Preventive Services Task Force. Over the past two years, this philosophy has become a part of our culture and what we do. 

"Promoting mother/baby bonding and breastfeeding is part of our culture." via @MedStarWHC

What we did to become a Baby-Friendly hospital

As we examined our longstanding policies and procedures over the past few years, we identified three areas in particular that we could adjust to better encourage successful breastfeeding: nursery, formula and pacifiers.


In the past, when mom wasn’t feeding her baby, the baby was in the nursery. This proved to be a barrier to breastfeeding.

We used to encourage feeding every three to four hours. Now, we promote breastfeeding on cue. In general, moms are feeding their newborns eight to nine times a day. Having the baby in the room with you 24/7 facilitates easier breastfeeding and helps mothers learn their baby’s feeding cues. If separated, mothers have a harder time learning to identify the early signs the baby is ready to nurse.

“Rooming in helps moms learn their baby’s feeding cues and make it easier to breastfeed." via @MedStarWHC

Some women ask us, “I have two toddlers at home and I just want to get some sleep before I go home. Can the baby go to the nursery?” In these cases, we gently tell mom that we can’t take the baby to the nursery. We explain the benefits of sleeping when the baby sleeps. We also recommend asking a family member to stay and help so mom can get some sleep.  

We make sure to talk to our moms before they have their babies about what to expect and explain why we do what we do.  

We haven’t gotten rid of the nursery altogether. Some newborns need additional monitoring, but not the advanced care given in the neonatal intensive care unit (NICU). In those cases, they may spend time in the nursery. We also may do some exams or minor procedures in the nursery, but many exams are done right in the room so we don’t have to separate mom and baby.  


It used to be routine for a nurse to say, “Mom is sleeping and I don’t want to wake her, so I’ll give her baby a bottle.” We don’t do that anymore.  

We don’t use formula unless mom requests it or there is an issue with the baby’s or mom’s health. If you don’t want to breastfeed, we may ask you why to address any concerns you may have. We want you to understand your options and the benefits of breastfeeding. However, if you choose not to breastfeed, we will respect your decision.  


Artificial nipples such as pacifiers can interfere with breastfeeding, so we no longer use them in the hospital. Latching and sucking on a pacifier is different than sucking on a breast. We don’t want to confuse baby in the first few days of learning to breastfeed.  

You tell us: What Baby-Friendly elements did you enjoy at your hospital, or what would you like to see in the future? Connect with us through Facebook and Twitter.  

The benefits of breastfeeding

We made these changes because we know that breastfeeding has great benefits for the health of baby and mom.  

Research has shown that breastmilk:

  • Provides an optimal mix of nutrients
  • Contains antibodies that protect newborns from certain illnesses
  • Is easier to digest than formula
  • Lowers the risk of sudden infant death syndrome (SIDS)

Breastfeeding also makes it easier for mom to lose the weight gained during pregnancy and may reduce her risk of breast cancer and ovarian cancer.

Learn about what to expect when breastfeeding, common problems and concerns, tips for successful breastfeeding and how to avoid sore nipples by registering for one of our breastfeeding classes.  

Breastfeeding is not always easy. But by providing an environment that facilitates and supports breastfeeding immediately after birth, we hope to help you achieve your goal.   

Breastfeeding: Providing Infants with Optimum Care from the Start of Life

Celebrate World Breastfeeding Week!

This week, the Midwives of MedStar are celebrating World Breastfeeding Week from August 1-August 7. This year’s theme, “Breastfeeding: A key to Sustainable Development,” aims to raise awareness not only about the significant maternal and infant health benefits of breastfeeding, but also its advantages for a healthy planet.  While the marketplace may try to convince you otherwise, all a mother and baby really need to breastfeed is one another.  Certainly breast milk pumping and storage generates some consumer products and waste, but much less than what is associated with using breast milk substitutes.  Breast milk also is free and is always the right temperature for your baby.

One of the best ways to ensure you achieve your breastfeeding goals is to begin the conversation about how you will feed your baby with your partner and your provider early in your pregnancy.  Did you know that the benefits of breastfeeding extend beyond infancy? In addition to providing disease-fighting antibodies, and all the vitamins and nutrients your baby needs in the first few months of life, babies who are breastfed have lower risks of asthma, lower respiratory infections, eczema, diarrhea, type II diabetes, childhood obesity and SIDS.  As for mom, it also lowers the risk of postpartum depression, anxiety, certain breast cancers and ovarian cancer.

At MedStar Washington Hospital Center, all nurses who work with new mothers and infants receive 20 hours of breastfeeding specific education and skills development.  We also have lactation consultants who help you and baby get off to a good start.  More important, the hospital has adopted the 10 best practices recommended by the World Health Organization (WHO) to support breastfeeding mothers and infants, including immediate skin to skin time after delivery. 

It’s not unusual for some mothers who start the process of learning to breastfeed to feel nervous and tentative.  Yet with knowledgeable and support, these hesitant starts quickly blossom into successful feeding rhythms with a confident mother and content, healthy baby. 

For moms returning to work, be sure to review your insurance coverage.  Many plans under the Affordable Care Act cover electric breast pumps (with many covering lactation services as well). A good rule of thumb is to begin pumping about two weeks before returning to work, so the baby can get used to eating from a bottle and you can begin to build up a supply of stored breast milk.

Did you know that workplaces are required by law to provide adequate time and a clean, private place to pump (bathrooms don’t count). Ensure you have a refrigerator or cooler to store the breast milk until you return home.

Need more information? Check out the upcoming Baby Care & Breastfeeding Basics, District of Columbia Breastfeeding Resource Guide, the Breastfeeding Center for Greater Washington, La Leche League and the World Health Organization for more information.

World Breastfeeding Week is coordinated by the World Alliance for Breastfeeding Action (WABA).

Happy breastfeeding!


Have Questions?

Please call the Midwives of MedStar Washington Hospital Center at 202-877-2303 and ask to speak to a nurse coordinator.

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