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The complicated problem with ‘baby-friendly’ hospitals

They might not be as 'mom-friendly' as we need them to be.

The complicated problem with ‘baby-friendly’ hospitals

There was a time when giving birth in a hospital meant little chance for skin-to-skin contact and breastfeeding. Decades ago, babies were whisked away to nurseries and given formula (and moms were often given samples of formula to take home). If you wanted to breastfeed your baby, these hospital policies and routines could make it difficult.

That's why in the early 1990s the World Health Organization (WHO) and the United Nations Children's Fund began championing the Baby-Friendly Hospital Initiative (BFHI), "a global effort to implement practices that protect, promote and support breastfeeding." In recent years more and more hospitals in the United States have adopted the principles of BFHI in order to increase breastfeeding rates.

The goal was laudable, but 30 years in, new research published in The Journal of Pediatrics suggests BFHI isn't having a positive impact on breastfeeding rates, and some argue it is having a negative impact on new moms. Specifically, "Statewide breastfeeding initiation rates were positively associated with targeted breastfeeding outcomes. Similar associations were not found for Baby-Friendly hospital designation penetrance."

A core tenant of BFHI is "rooming in"—babies and mothers are supposed to be kept together 24 hours a day. In theory, this is supposed to increase breastfeeding rates and bonding, but some moms and doctors say leaving infants solely in the care of exhausted people can be dangerous. Mothers can end up falling asleep while caring for the baby.

Dr. Colleen Hughes Driscoll of the University of Maryland School of Medicine in Baltimore was the lead author of a study published earlier this year that examined the number of infant falls at a hospital that was implementing practices to encourage breastfeeding in order to receive the baby-friendly designation.

"We found that as we improved our ability to support mothers with successful breastfeeding there was a surge in newborn falls," Driscoll told Reuters. "This suggests that we may be adding to the burden of maternal fatigue, and increasing the risk of newborn falls."

According to Driscoll, the old school practice of taking babies to the nursery were a barrier to successful breastfeeding, but also provided time for mothers to rest and recover. And it isn't just exhaustion, but also the intense pressure to breastfeed that has some advocates worried that baby-friendly hospitals aren't very mother-friendly.

Sarah Christopherson is the Policy Advocacy Director for the National Women's Health Network and had her own experience with BFHI. A mom multiple times over, Christopherson had previous experience with birth and infant feeding by the time she had a C-section in a baby-friendly hospital. With her previous babies she'd successfully supplemented her breastmilk with formula in the hospital, but this time, when she asked for a bottle she was met with criticism from hospital staff, she writes.

"The nurse was stern and disapproving," Christopherson writes, noting that the nurse implied that giving formula would be "giv[ing] up" on breastfeeding and that she would have to sign a waiver "acknowledging all of the risks associated with my terrible choice."

She continues: "'Reasons for supplementation' listed on the form include "'mothers who are critically ill,' have 'intolerable pain during feeding unrelieved by interventions,' or have 'breast pathology.' For mothers who simply choose to supplement, the form makes clear: 'The American Academy of Pediatrics says that routine supplements of formula for breastfed newborns should not be used.'"

Christopherson says the form made her doubt herself, and she tried to exclusively breastfeed. In the end, her daughter ended up dehydrated and jaundiced and was fed the formula that her mother had wanted in the first place.

Christopherson and others suggest that the problem with BFHI is that it is removing mothers' needs and voices from the equation.

The new research published in The Journal of Pediatrics suggests BFHI isn't having a positive impact on breastfeeding rates, but Baby-Friendly USA, Inc. (BFUSA) disputes the research. BFUSA, the "accrediting body and national authority for the BFHI in the United States...responsible for coordinating and conducting all activities necessary to confer the prestigious Baby-Friendly® designation and to ensure the widespread adoption of the BFHI in the United States," says the research was flawed and came to "damaging conclusions from incomplete data."

Critics of BFHI and BFUSA disagree on methodology but agree that mothers should be respected and have the information they need when making their own decisions about infant feeding.

That is, after all, why BHFI came about. Perhaps it is time for hospitals to worry less about adhering to strict policies and more about listening to mothers.

14 outdoor toys your kids will want to play with beyond summer

They transition seamlessly for indoor play.

With Labor day weekend in the rearview and back-to-school in full swing, most parents are fresh out of boxes to check on their "Fun Concierge" hit list. It's also the point of diminishing returns on investing in summer-only toys. So with that in mind, we've rounded up some of our favorite toys that are not only built to last but will easily make the transition from outdoor to indoor play. Even better, they're Montessori-friendly and largely open-ended so your kids can get a ton of use out of them.

From sunny backyard afternoons to rainy mornings stuck inside, these toys are sure to keep little ones engaged and entertained.

Meadow ring toss game

Plan Toys meadow ring toss game

Besides offering a fantastic opportunity to hone focus, coordination, determination and taking turns, lawn games are just plain fun. Set them up close together for the littles and spread them out when Mom and Dad get in on the action. With their low profile and rope rings, they're great for indoors as well.

$30

Balance board

Plan Toys balance board

Balance boards are a fabulous way to get the wiggles out. This one comes with a rope attachment, making it suitable for even the youngest wigglers. From practicing their balance and building core strength to working on skills that translate to skateboarding and snowboarding, it's a year-round physical activity that's easy to bring inside and use between Zoom classes, too!

$75

Detective set

Plan Toys detective setDetective Set

This set has everything your little detective needs to solve whatever mystery they might encounter: an eye glasses, walkie-talkie, camera, a red lens, a periscope and a bag. Neighborhood watch? Watch out.

$40

Wooden doll stroller

Janod wooden doll strollerWooden Doll Stroller

Take their charges on a stroll around the block with this classic doll stroller. With the same versatility they're used to in their own ride, this heirloom quality carriage allows their doll or stuffy to face them or face the world.

$120

Sand play set

Plan Toys sand set

Whether you're hitting the beach or the backyard sandbox, this adorable wooden sand set is ready for action. Each scoop has an embossed pattern that's perfect for sand stamping. They're also totally suitable for water play in the wild or the bathtub.

$30

Water play set

Plan Toys water play set

Filled with sand or water, this tabletop sized activity set keeps little ones busy, quiet and happy. (A mama's ideal trifecta 😉). It's big enough to satisfy their play needs but not so big it's going to flood your floors if you bring the fun inside on a rainy day.

$100

Mini golf set

Plan Toys mini golf set

Fore! This mini golf set is lawn and living room ready. Set up a backyard competition or incorporate into homeschooling brain breaks that shift focus and build concentration.

$40

Vintage scooter balance bike

Janod retro scooter balance bike

Pedals are so 2010. Balance bikes are the way to go for learning to ride a bike while skipping the training wheels stage altogether. This impossibly cool retro scooter-style is built to cruise the neighborhood or open indoor space as they're learning.

$121

Wooden rocking pegasus

plan toys wooden rocking pegasus

Your little will be ready to take flight on this fun pegasus. It gently rocks back and forth, but doesn't skimp on safety—its winged saddle, footrests and backrest ensure kids won't fall off whether they're rocking inside or outside.

$100

Croquet set

Plan Toys croquet set

The cutest croquet set we've ever seen! With adorable animal face wooden balls and a canvas bag for easy clean up, it's also crafted to stick around awhile. Round after round, it's great for teaching kiddos math and problem-solving skills as well.

$45

Wooden digital camera

fathers factory wooden digital camera

Kids get the chance to assemble the camera on their own then can adventure anywhere to capture the best moments. With two detachable magnetic lenses, four built-in filters and video recorder, your little photographer can tap into their creativity from summertime to the holidays.

$179

Wooden bulldozer toy

plan toys wooden bulldozer toy

Whether they're digging up sand in the backyad or picking up toys inside, kids can get as creative as they want picking up and moving things around. Even better? Its wooden structure means it's not an eye sore to look at wherever your digger drops it.

$100

Pull-along hippo

janod toys pull along hippo toy

There's just something so fun about a classic pull-along toy and we love that they seamlessly transition between indoor and outdoor play. Crafted from solid cherry and beechwood, it's tough enough to endure outdoor spaces your toddler takes it on.

$33

Baby forest fox ride-on

janod toys baby fox ride on

Toddlers will love zooming around on this fox ride-on, and it's a great transition toy into traditional balance bikes. If you take it for a driveway adventure, simply use a damp cloth to wipe down the wheels before bringing back inside.

$88

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