Baby-Friendly Ten Steps to Successful Breastfeeding (Baby-Friendly Steps) and Questions Consistent with Identified Practices in the USDA's Infant and Toddler Feeding Practices Study-2 (ITPFS-2)
| Baby-Friendly Steps . | Indicator Within ITFPS-2 Consistent with Baby-Friendly Steps . | Timing of Assessment . |
|---|---|---|
| 1. Have a written breastfeeding policy that is routinely communicated to all health care staff. | Not assessed | — |
| 2. Train all health care staff in the skills necessary to implement this policy. | Not assessed. | — |
| 3. Inform all pregnant women about the benefits and management of breastfeeding. | Not assessed. | — |
| 4. Help mothers initiate breastfeeding within 1 hour of birth. | Did you start breastfeeding in the first hour after birth or later? | 1 mo interview |
| 5. Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants. | While you were in the hospital or birthing center, did your doctor, the nurses, or the hospital staff encourage you to breastfeed your baby? | 1 mo interview |
| and | ||
| Was there someone in the hospital or birthing center whose job it was to help you with breastfeeding, like a lactation consultant or another trained specialist? | ||
| and, selection of at least 1 breastfeeding hospital support service used | ||
| While you were in the hospital or birthing center, did you use any of the following support services, information, or equipment for breastfeeding?a | ||
| 6. Give infants no food or drink other than breastmilk, unless medically indicated. | What was the very first thing that [CHILD] was fed after birth? | 1 mo interview |
| and | ||
| When you left the hospital or birthing center, were you feeding your baby only breast milk? | ||
| 7. Practice rooming in – allow mothers and infants to remain together 24 h a day. | While you were in the hospital or birthing center, did [CHILD] stay in the same room with you, or in a nursery? Do not include time your child was out of your room briefly for things such as medical procedures, bathing, or weighing. | 1 mo interview |
| 8. Encourage breastfeeding on demand. | While you were in the hospital or birthing center, did you feed your baby breast milk, either from your breast or from a bottle, on a set schedule or whenever [he or she] cried or seemed hungry? | 1 mo interview |
| 9. Give no pacifiers or artificial nipples to breastfeeding infants. | When was [CHILD] given a pacifier for the first time? | 3 mo interview |
| 10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or birth center. | Not assessed. | — |
| Baby-Friendly Steps . | Indicator Within ITFPS-2 Consistent with Baby-Friendly Steps . | Timing of Assessment . |
|---|---|---|
| 1. Have a written breastfeeding policy that is routinely communicated to all health care staff. | Not assessed | — |
| 2. Train all health care staff in the skills necessary to implement this policy. | Not assessed. | — |
| 3. Inform all pregnant women about the benefits and management of breastfeeding. | Not assessed. | — |
| 4. Help mothers initiate breastfeeding within 1 hour of birth. | Did you start breastfeeding in the first hour after birth or later? | 1 mo interview |
| 5. Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants. | While you were in the hospital or birthing center, did your doctor, the nurses, or the hospital staff encourage you to breastfeed your baby? | 1 mo interview |
| and | ||
| Was there someone in the hospital or birthing center whose job it was to help you with breastfeeding, like a lactation consultant or another trained specialist? | ||
| and, selection of at least 1 breastfeeding hospital support service used | ||
| While you were in the hospital or birthing center, did you use any of the following support services, information, or equipment for breastfeeding?a | ||
| 6. Give infants no food or drink other than breastmilk, unless medically indicated. | What was the very first thing that [CHILD] was fed after birth? | 1 mo interview |
| and | ||
| When you left the hospital or birthing center, were you feeding your baby only breast milk? | ||
| 7. Practice rooming in – allow mothers and infants to remain together 24 h a day. | While you were in the hospital or birthing center, did [CHILD] stay in the same room with you, or in a nursery? Do not include time your child was out of your room briefly for things such as medical procedures, bathing, or weighing. | 1 mo interview |
| 8. Encourage breastfeeding on demand. | While you were in the hospital or birthing center, did you feed your baby breast milk, either from your breast or from a bottle, on a set schedule or whenever [he or she] cried or seemed hungry? | 1 mo interview |
| 9. Give no pacifiers or artificial nipples to breastfeeding infants. | When was [CHILD] given a pacifier for the first time? | 3 mo interview |
| 10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or birth center. | Not assessed. | — |
Baby-Friendly Ten Steps to Successful Breastfeeding are based on the World Health Organization and UNICEF's Baby-friendly hospital initiative: Revised, updated, and expanded for integrated care. 2009; Available at: http://apps.who.int/iris/bitstream/10665/43593/1/9789241594967_eng.pdf. —, not applicable; USDA, United States Department of Agriculture.
Examples of breastfeeding support services, information, or equipment: brochures, pamphlets, TV classes; lactation consultant; other trained specialist who helped with breastfeeding; support groups or classes; breastfeeding equipment (pumps, shields, or other equipment); counseling; hotline; name and number of hospital/birth center staff to call with questions; any other services.