In a bid to increase breastfeeding rates, Ireland is becoming more Baby Friendly, reports Claire O'Connell
Twenty-one of the State's 22 maternity units now support the Baby Friendly Hospital Initiative (BFHI), a global campaign launched by UNICEF and WHO in 1991 to promote evidence-based best practice in infant feeding and care.
Participating maternity units implement a programme of 'Ten Steps to Successful Breastfeeding' that includes informing pregnant women about the benefits of breastfeeding, training staff, keeping mothers and babies in close contact and liaising with community supporters.
Ireland adopted the initiative in 1998, supported by WHO through the Irish Network of Health Promoting Hospitals. Since then, three Irish maternity units have earned full Baby Friendly status: Portiuncula Hospital in Ballinasloe, Waterford Regional Hospital and Limerick's St Munchin's Regional Maternity Hospital.
This means around 14 per cent of births in Ireland take place at accredited Baby Friendly facilities, compared with 100 per cent in Sweden, 35 per cent in Wales, less than 10 per cent in England and none in Portugal.
According to Genevieve Becker, National Co-ordinator of the BHFI, breastfeeding rates in Ireland have risen since the initiative launched here, but it's difficult to determine whether the programme has driven a change in our attitude or simply reflected it.
However, the link between BHFI and breastfeeding rates is becoming evident in Scotland, where 55 per cent of babies are born in Baby Friendly units. These babies are 28 per cent more likely to be breastfed at a week old compared with their counterparts born in non-accredited facilities.
"The BFHI gives everyone a brief to work from," says Maura Lavery, clinical midwife specialist in lactation at Dublin's Rotunda Hospital. "A lot of work goes into education of both staff and mothers and making sure the mother is getting research-based information."
The approach is working: the Rotunda has seen breastfeeding initiation rates increase by more than half and has earned a Baby Friendly Certificate of Commitment, a stepping stone to full accreditation.
Breastfeeding rates have also gone up in Portiuncula since they adopted the initiative, according to midwife Fionnuala Reilly, who notes the majority of mothers now start breastfeeding there. "The feedback we get from parents about breastfeeding is positive," she says. "They find that they have great support from all the midwives and other staff in the hospital."
"Our breastfeeding initiation has gone way up," says midwife Clare Barry, who manages the Antenatal Clinic at Wexford General Hospital, referring to a jump from 31 per cent 42 per cent last year to 40 per cent to 55 per cent for the first six months of 2005. Barry previously worked towards achieving full Baby Friendly accreditation for Waterford Regional Hospital, and is now involved in auditing BFHI-approved practices in Wexford.
According to Becker, the resources needed to implement the BFHI are worth the input: when a mother breastfeeds in hospital there's a direct saving on formula of around €18 per baby, more for pre-term or Caesarean births.
"Plus in the longer-term, babies who are breastfed will generally require less use of the health services, so you're weighing up a bit of expenditure now against long-term savings."
Formula-fed babies also benefit from the initiative's evidence-based approach, says Becker: "BFHI is the Baby Friendly Hospital Initiative not the Breastfeeding Friendly, and virtually all of the steps also benefit babies who are not breastfed."
The initiative is currently undergoing a global refocus to better reflect the needs of all babies and their mothers. "BFHI in Ireland is very involved with this update," says Becker, "and we will be hosting the first field test of the revised materials this month."
It looks like Ireland is set to become an even friendlier place for mothers and babies.