Purpose for the program: Demonstrate the link between hospital culture, nursing practice and implementation of the Baby Friendly Hospital Initiative

Proposed change: Change practices within the maternity setting to promote successful breastfeeding

Implementation, outcomes and evaluation: Implementation of best practices throughout the birthing and postpartum continuum to support optimal breastfeeding for newborns. Evaluation of success is through achieving designation as a Baby Friendly Hospital.

Implications for nursing practice: Nurses are the key to ensuring that hopsital practices promote breastfeeding. Nurses have the knowledge to integrate the science of lactation with the nuances of each patient's experience to achieve breastfeeding success.

Keywords: Baby Friendly Hospital Initiative, Nursing Practice, Culture, Breastfeeding

Best nursing practices are those that combine art and science. There is evidence for specific hospital practices that will promote breastfeeding success. However, a hospital’s culture can greatly impact and influence breastfeeding success from early pregnancy through the postpartum period.

There is an intricate relationship between best practices in our maternity setting with care that is holistic and patient centered.  Practices that are ingrained into our culture include all of the elements of the ten steps to successful breastfeeding as supported by the Baby Friendly Hospital Initiative. The ability of the nurse to integrate the science of lactation with the nuances of the human response to labor and birth is the foundation for breastfeeding success.

Our journey towards designation in the Baby Friendly Hospital Initiative provided recognition that our culture, which supports an environment that trusts the birth process, provided a foundation that empowers patients to be successful. Practices that are influenced by nursing, which include: early initiation of breastfeeding and skin to skin; promoting rooming-in; and delaying the bath, create an environment where breastfeeding is promoted. The importance of an environment where the healthcare team is knowledgeable about the benefits of breastfeeding has been studied. However, the translation of the knowledge into practice, while integrating the individual needs of each mother baby dyad is key to empowering mothers and achieving best outcomes.

Hospital practices impact both the art and science of breastfeeding. Our model of care supports a family’s needs during this developmentally important time. A culture where birth is seen as a normal process, is essential to promote physiologic changes for lactation and bonding of the mother baby dyad. Recognizing that each mother baby dyad is unique, with individual experiences, while using evidence to promote best practice enables mothers to achieve success with breastfeeding.