Understanding Baby-Friendly USA – What IBCLCs Need to Know with CEO Eileen Fitzpatrick

Episode Summary:In this episode of The IBCLC Mentor Podcast, Margaret Salty interviews Eileen Fitzpatrick, CEO of Baby-Friendly USA, about the Baby-Friendly Hospital Initiative (BFHI), its implementation in the U.S., and how political changes are impacting breastfeeding outcomes. They discuss the history of Baby-Friendly, the challenges hospitals face in meeting the designation requirements, and what IBCLCs need to know to support Baby-Friendly practices.Understanding Baby-Friendly USA and the Baby-Friendly Hospital InitiativeEileen explains the structure and mission of Baby-Friendly USA, including:The difference between Baby-Friendly USA and the global Baby-Friendly Hospital Initiative (BFHI)How Baby-Friendly USA is an independent nonprofit that follows WHO/UNICEF guidelinesThe role of Baby-Friendly USA as the accrediting body for hospitals in the U.S.How the U.S. Compares to Other Countries in BFHI ImplementationEileen highlights how Baby-Friendly programs are structured differently around the world:Some countries integrate BFHI into their government health systemsOther countries operate BFHI under their national UNICEF programsThe U.S. runs Baby-Friendly USA as an independent organization due to government refusal to adopt the programThe History of the Code and Baby-Friendly in the U.S.Margaret and Eileen discuss the history of the International Code of Marketing of Breastmilk Substitutes and its rejection by the U.S. government:The code came before the BFHI and was designed to curb formula industry marketingThe U.S. never signed onto the code due to commercial interests in infant formulaBaby-Friendly USA remains the only U.S. organization requiring compliance with the codeCurrent Status of Baby-Friendly Hospitals in the U.S.Eileen shares key statistics on Baby-Friendly hospitals:Approximately 530 Baby-Friendly designated hospitalsBaby-Friendly facilities account for 25% of all U.S. birthsThe impact of maternity care deserts and hospital closures on Baby-Friendly participationHow Hospitals Earn Baby-Friendly DesignationEileen explains the 4D Pathway, the structured process hospitals follow to earn Baby-Friendly designation:Development: Hospitals create policies and train staffDissemination: Implementation of Baby-Friendly practices beginsDesignation: Hospitals undergo an official assessmentDesignation Maintenance: Hospitals submit ongoing quality data and undergo reevaluationsData Collection and ChallengesBaby-Friendly hospitals must collect and submit annual data, including:Race and Ethnicity Metrics – Ensuring equitable breastfeeding support across all patient populationsBreastfeeding Initiation Rates – Tracking progress in early lactation supportExclusive Breastfeeding Rates – Though not a required benchmark, data helps track trendsPatient Experience Surveys – New tools to assess how Baby-Friendly practices are perceivedChallenges in data collection include:Hospitals struggling to access race and ethnicity data from electronic medical recordsThe discontinuation of perinatal core measures by CMS and The Joint Commission, making Baby-Friendly one of the only organizations still tracking exclusivity ratesWhat It Takes to Maintain Baby-Friendly StatusHospitals must uphold the 10 Steps to Successful...

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