One-Size-Fits-All Hospital Breastfeeding Interventions Don’t Work, & That's Not Surprising

Health care providers encouraging new mothers to breastfeed sounds like a great idea, but there's a right way and a wrong way to do it. A new report by the U.S. Preventive Services Task Force has found that hospital breastfeeding interventions that are one-size-fits-all don’t work as well as individual interventions, according to Slate. After reviewing several studies, the task force found that "there was no consistent association with the rate of any or exclusive breastfeeding" and hospital system-level policies.

The report concluded that "only individual-level interventions demonstrated effectiveness at improving breastfeeding, whereas system-level interventions, including the World Health Organization's Baby Friendly Hospital Initiative, did not." The BFHI requires hospitals to adhere to a 10-step policy, some of which may adversely affect babies. For example, hospitals with the "Baby Friendly" distinction are barred from offering pacifiers, even though they greatly reduce the risk of SIDS, and the common misconception that they interfere with breastfeeding is false. The BFHI also bans formula and encourages 24-hour rooming in (keeping the baby in the mother's hospital room rather than the nursery), without consideration of the fact that these practices can be detrimental to some families. Humans, it turns out, are unique, and what works for some doesn't work for others.

The task force's final recommendation supports the continuation of individual interventions such as counseling, support, and education, but concludes that "[a]lthough there is moderate certainty that breastfeeding is of moderate net benefit to women and their infants and children, not all women choose to or are able to breastfeed. Clinicians should, as with any preventive service, respect the autonomy of women and their families to make decisions that fit their specific situation, values, and preferences."

Can I get an "amen"? It's refreshing to see health experts admitting that breastfeeding is not right for every family, and there's a big difference between encouraging new mothers to do what's best for them, and attempting to force them to breastfeed, or shame them when they can't or won't. People love to judge a formula feeding mom, and that judgement often begins in the recovery room when you ask a nurse for a bottle. But the benefits of breastfeeding have long been exaggerated, and it seems that no amount of shaming by hospital staff will convince a significant number of women to do something they either physically can't, or simply choose not to do. The evidence is clear, and I'm hopeful that hospitals will take the new recommendation to heart.