Baby Friendly Hospital Designation: What does it mean for Texas Children's Pavilion for Women?


After several years of preparation and training, Texas Children’s Hospital received the Baby Friendly Hospital designation on February 25th, 2016. One might argue that Texas Children's Hospital has always been friendly to babies – especially with regards to healing the sick.

So, obtaining a designation as a Baby Friendly Hospital (BFH) should be a no-brainer! Although Texas Children's has a long history of supporting breastfeeding mothers and their hospitalized infants, we have had little influence on the prenatal and early postpartum experience for these couplets. With the acquisition of the obstetrical services at St. Luke’s Hospital in 2007, and subsequent opening of the Pavilion for Women in 2012, we were able to impact this early maternity stay experience.

Origins of Baby Friendly Hospital Initiative To understand why we made the decision to pursue BFH designation, you need to know about its origins. In 1991, the BFH initiative was launched by WHO and UNICEF as a global effort to implement practices that protect, promote and support breastfeeding. The word “friendly” was used because there is a word for it in every language. Breastfeeding is the single most powerful and well documented preventive method available to reduce the risk of common causes of infant illnesses. Significantly lower rates of diarrhea, otitis media, lower respiratory tract infections, Type 1 and 2 diabetes, childhood leukemia, necrotizing enterocolitis and Sudden Infant Death Syndrome occur among infants who are breastfed. Women who breastfeed also benefit with a lower risk of Type 2 diabetes, breast and ovarian cancer and cardiovascular diseases. Given these benefits, one can see how the term fits – breastfeeding is friendly for babies!

BFH Ten Steps to Successful Breastfeeding To achieve BFH designation, we at the Pavilion for Women were required to meet the criteria outlined in the BFH 10 Steps to Successful Breastfeeding:

  • Have a written breastfeeding policy that is routinely communicated to all health care staff.
  • Train all health care staff in the skills necessary to implement this policy.
  • Inform all pregnant women about the benefits and management of breastfeeding.
  • Help mothers initiate breastfeeding within one hour of birth.
  • Show mothers how to breastfeed and how to maintain lactation even if they are separated from their infants.
  • Give infants no food or drink other than breastmilk, unless medically indicated.
  • Practice rooming-in – allow mothers and infants to remain together 24 hours a day.
  • Encourage breastfeeding on demand.
  • Give no pacifiers or artificial nipples to breastfeeding infants.
  • Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or birth center.

A Long, Multiphase Process Beginning with the acquisition of the obstetric services at St. Luke’s hospital, the Women’s Services leadership team made it their goal to work toward the BFH designation. One of the first foundational changes that occurred was to switch from maternal and infant nursing care to couplet care. This meant that instead of having one nurse take care of the mother, and another nurse take care of the infant, the nurse would take care of the mother and baby as a couple.

From 2012 until July 2015, the Pavilion for Women staff went through an intensive process to complete all the criteria necessary to achieve the BFH 10 steps for Successful Breastfeeding and prepare for the onsite survey. In July 2015, the BFH surveyors conducted their survey by interviewing medical and nursing staff, as well as patients. In mid-September, we were contacted by BFH and told we had met all criteria for the BFH 10 steps. This is a huge accomplishment, one that many hospitals fail to achieve the first time around. We were awarded our BFH designation on Feb. 25.

Great News for Texas Mothers and Babies! Since BFH began, more than 152 countries around the world have implemented this initiative. In the United States, there are currently 332 hospitals and birthing centers designated as BFH sites, 15 of which are now in Texas. Of those 15 Texas hospitals, 9 are in the Dallas-Fort Worth area, 5 in Houston and 1 in El Paso…and many more are in various phases of the BFH process. This is a great accomplishment for Texas Children's as an organization, but an even greater achievement for health care providers and staff in their commitment to provide evidence-based education and support for mothers who choose to breastfeed their infants.

This post was co-authored by Nancy Hurst, director of Women's Support Services and Lynda Tyer-Viola, director over Women’s Services.