Great Expectations Durham Breastfeeding Policy

The physicians and staff of Great Expectations Durham(GED) are committed to promoting, protecting and supporting breastfeeding through advocacy; implementation of “Ten Steps to Successful Breastfeeding” and “International Code of Marketing of Breastmilk Substitutes” with subsequent relevant WHO/WHA resolutions, where applicable, in the Maternal & Child Health Centres; and the creation of a positive environment in all services and workplace to support breastfeeding clients and employees.

Ten Steps to Successful Breastfeeding*

Every facility providing maternity services and care for newborn infants should:

1. Have a written breastfeeding policy that is routinely communicated to all health care staff.

2. Train all health care staff in skills necessary to implement this policy.

3. Inform all pregnant women about the benefits and management of breastfeeding.

4. Help mothers initiate breastfeeding within a half-hour of birth.

5. Show mothers how to breastfeed, and how to maintain lactation even if they are separated from their infants.

6. Give newborn infants no food or drink other than breastmilk, unless medically indicated.

7. Practise rooming-in-allow mothers and infants to remain together-24 hours a day.

8. Encourage breastfeeding on demand.

9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.

10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

*A summary of the main recommendations of the Joint WHO/UNICEF Statement (1989) called “Protecting, Promoting and Supporting Breastfeeding: The Special Role of Maternity Services”.

Summary of the International Code of Marketing of Breastmilk Substitutes*

The Code includes these 10 important provisions:

1. No advertising of all breastmilk substitutes** to the public.

2. No free samples to mothers.

3. No promotion of products in health care facilities, including no free or low-cost formula.

4. No company representatives to contact mothers.

5. No gifts or personal samples to health workers. Health workers should never pass products on to mothers.

6. No words or pictures idealising artificial feeding, including pictures of infants, on the labels.

7. Information to health workers must be scientific and factual.

8. All information on artificial infant feeding must explain the benefits and superiority of breastfeeding, and the costs and hazards associated with artificial feeding.

9. Unsuitable products, such as sweetened condensed milk should not be promoted for babies.

10. Manufacturers and distributors should comply with the Code’s provisions even if countries have not acted to implement the Code. 

*The International Code of Marketing of Breastmilk Substitutes was adopted by the World Health Assembly in 1981 as a tool to protect breastfeeding.

**Breastmilk Substitutes include: infant formula, follow-up formula, feeding bottles, teats, baby food and beverages etc.

GED physicians and staff should:

1. Participate in the efforts to promote, protect and support breastfeeding as the cultural norm.

2. Encourage breastfeeding as the preferred method of infant feeding.

3. Create a positive and supportive environment at the health care settings (e.g. by displaying breastfeeding posters in public areas; providing a private space for breastfeeding clients as required, etc.).

4. Be conversant and comply with the International Code of Marketing of Breastmilk Substitutes.

Supporting breastfeeding in GED premises accessible to the public all frontline staff working in GED’s premises which are accessible to the public should support breastfeeding by adopting the following:

1. Allow breastfeeding mothers the freedom to choose where to breastfeed; and the presence of a breastfeeding room does not mean that she must choose to use the room; 2. Do not disturb a breastfeeding mother, ask her to cover up or move to another area;

3. If a mother wishes to have more privacy to breastfeed, offer an appropriate location as far as practicable. Toilets or restrooms are not appropriate places for feeding babies and should not be offered;

4. Supporting breastfeeding mothers if they encountered difficulties.

Breastfeeding-friendly workplace policy:

1. GED supports employees to continue breastfeeding after returning to work.

2. Employees who plan or need to express breastmilk during working hours should approach their supervisors to work out an appropriate arrangement.

3. Supervisors should support by providing an enabling environment for lactating employees. Specific measures include the following:

o Allowing lactation breaks (about two 30-minute breaks during an eight hour shift) for expression of breastmilk up to a year after childbirth.

o Providing a private space with a comfortable chair and an electric outlet (for operating the breast pump) for lactating employees to express breastmilk.

o Providing refrigerating facilities for safe storage of expressed breastmilk.

4. All other staff members are requested to support their colleagues to breastfeed by adopting a positive and accepting attitude.

*This policy was adapted from the breastfeeding policy of Department of Health of Hong Kong http://www.fhs.gov.hk/english/breastfeeding/files/bfpolicy.pdf. This policy was last updated January 2017.