10 Myths About Baby-Friendly

baby-friendly hospital initiative myths May 15, 2023

I’ve had the unique opportunity to visit hospitals around the country for various conferences and consults, and it was always amazing to me that I would hear the very same myths about Baby-Friendly repeated from one hospital to the next, and from one state to the next. It was as though there was some sort of communication going on about “Why Baby-Friendly won’t work here!”  Here is a list of the most commonly encountered myths.

#1. OUR patients are different. They won’t like it.   

Well, your patients are women who are having babies and would like to initiate breastfeeding under your care. Your patients are also newborns who would benefit from receiving their mother’s milk. In that way they are the same. Cultures do vary and so patients in an inner-city hospital may be different in some ways to patients in a rural area. But what’s interesting about this is that no matter the area – the same reasoning was always encountered!

  • Our patients are very privileged, they won’t like it. 
  • Our patients are not very educated, they won’t like it. 
  • Our patients are very educated and demanding, they won’t like it.
  • Our patients prefer to formula feed because of their culture.

The list goes on and on. The truth is, Baby-Friendly is designed to support all mothers and babies. Baby-Friendly standards have been proven to improve breastfeeding outcomes all over the world. Our patients are not so unique and different that they would not appreciate the best support available

#2. We can’t delay procedures to accommodate one hour of skin to skin following birth.

The gold standard of care following an uncomplicated birth is for mother and baby to remain together in skin -to-skin contact for at least one hour or until the completion of the first breastfeed. Here are some of the myths cited for not allowing this:

  1. Baby has to be examined on the warmer
  2. Parents want to know the weight
  3. Significant other (or other family member) wants to hold the baby
  4. We have to give eye meds and Vitamin K right away
  5. It’s unsafe
  6. We don’t have time

Any one of these arguments can be disputed. When parents are educated about the amazing effects and benefits of skin -to-skin contact, they are more than happy to wait an hour or more for family holding and baby's weight. Medications can be delayed for an hour, baby can be assessed on mom’s body and neither of these take any more time for staff. Safety is always a priority whether the newborn is in skin-to-skin contact or not. Safety for the neonate in the first hours of life includes close monitoring by staff and parents no matter where the baby is.

#3. Our providers don’t have time to talk about breastfeeding.

It’s been said that 10 seconds of positive feedback from a patient’s provider can be the difference between a mom considering breastfeeding or not. 10 seconds. Think about that. That goes to show the amount of confidence patients have in their provider. So what can you say in 10 seconds at a prenatal visit? 

  1. “Are you considering breastfeeding?”
  2. “Can I provide you with some information on breastfeeding?”
  3. “Breastfeeding can be beneficial for both you and your baby. Let me provide you with some resources.”
  4. “You have some risk factors related to your plan to breastfeed (ie: breast reduction), let me connect you with one of our lactation consultants.”

We’re not talking about long conversations here – just a bit of recognition about mom’s intentions, and that you feel it’s important enough to discuss or refer.

#4. Pediatricians can’t examine baby in the room, there’s not enough light.

When I tell you I’ve heard this around the country, I am not exaggerating. Literally the same exact words.  Did a nationwide memo go out or something?  Thousands upon thousands of pediatricians examine babies every day in mother’s presence. If lighting is an issue, fix the lighting.

#5. Hearing screenings and CCHDs (heart screens) can’t be done in the room. The equipment is too sensitive.

Please read myth #4. Don’t separate mothers and infants for the sake of your equipment. If your equipment is too sensitive, get new equipment.

#6. Baby-Friendly will force all mothers to breastfeed.

Okay, nobody is forcing anyone to do anything. Baby-Friendly does ask that mothers at least have the opportunity to make an informed choice about feeding. Providing this education is not meant to be punitive. It simply means that at least one time, somewhere along the way, healthcare providers have given parents some information on the benefits and early management of breastfeeding. Not 10 times, not 100 times. But at least once.

#7. Mothers will have to bring in their own formula.

No. Formula continues to be provided by the hospital just like any other patient receives food while they are a patient. Hospitals do have to pay for formula, just like they have to pay for the food any patient receives while they are in the hospital. 

#8. Baby-Friendly means we will have to close our nursery.

Again, not true. Hopefully there will be less traffic in your nursery, but you are not required to shut it down.

#9. Our hospital can’t afford it.

Compared to most of the health improvement initiatives in which hospitals participate (consider Magnet or Joint Commission), Baby-Friendly is a bargain. Hospitals pay for what they value. Period.

#10. Baby-Friendly is not mother friendly.

Of all the myths circulating out there, I think I find this one most troublesome.  Anyone who has worked with birthing families for any length of time knows that happy momma = happy baby. We know that the time surrounding birth is highly sensitive and no one who is engaged in post birth care is trying to make any mother unhappy. To imply that those who have dedicated their life’s work to improving infant outcomes are not friendly to mothers is bordering on offensive. Undermining a mother’s desire to successfully breastfeed, providing less than the best care and allowing the influence of infant formula marketing to flood our mothers is what’s truly not mother-friendly.   

Let me be clear – I do not speak for or represent Baby-Friendly in any way.  I was, however, involved in the process of guiding a hospital through the initiative and on to designation, then re-designation. I am proud of the transformation that I saw in that hospital, from updated polices to improved care at the bedside, to increases in breastfeeding exclusivity and duration.  Like other health care initiatives, the goal of Baby-Friendly is to improve the health of the individual and the community and to hold organizations accountable for providing best practices.  Is it easy? No.  Is it a perfect program? No.  Does it hold hospitals accountable for providing the best in breastfeeding education, care and support?  Absolutely.

Mary Foley, Lactation College Co-Founder


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