Best Practices for Breastfeeding

These documents are also available in Portable Document format.

Breastfeeding Promotion Guidelines for Childcare Centers

  1. Inform parents at time of enrollment that you support mothers continuing to breastfeed and are willing to feed expressed breast milk.

  2. Emphasize the value of continuing to breastfeed after returning to work or school. Provide emotional support concerning mother's decisions about breastfeeding and weaning.
  3. Advise breastfeeding moms to begin feeding infants expressed milk at least two weeks prior to beginning daycare to ensure that infants are accustomed to bottle feeding.
  4. Maintain a list of local lactation consultants that breastfeeding mothers and/or staff could contact for assistance in locating an affordable breast pump and other issues related to breastfeeding.
  5. Provide written guidelines for parents and staff about collecting, storing and feeding expressed breast milk. Breastfeeding mothers should provide their own bottles clearly labeled with child's full name. Any milk remaining in bottle after a feeding should be refrigerated and either fed to the child later or sent home with a parent at the end of the day.
  6. Encourage mothers to visit and breastfeed during the day if their schedules permit.
  7. Designate a lactation corner to encourage mothers to breastfeed if they can visit during the day. Lactation corner should be quiet, clean, comfortable and private (if mother prefers privacy).
  8. Have consistent child care provider handling infant.
  9. Feed infant expressed breast milk on demand or coordinate feeding times according to mother's normal feeding schedule.
  10. Accidental feeding of a different mother's milk should be reported to both mothers so that proper measures can be taken to ensure the safety and health of the infant.
  11. Provide a daily record for parents tracking time and amount of expressed milk or formula fed to infants.
  12. Have a resource shelf for parents and staff, including books, videos, pamphlets and other materials about breastfeeding (excluding formula company literature or videos).
  13. Encourage mothers to participate in breastfeeding support groups within the community.
  14. Refer parents to health education programs about breastfeeding.
  15. Develop a partnership with healthcare providers and other resources to ensure best practices for breastfeeding.
  16. Model best practices for workplace breastfeeding support for own employees.

Breastfeeding Promotion Guidelines for Ambulatory Care Settings

(Physician Offices, Health Centers, PCAP, WIC)

  1. Visible support for breastfeeding, e.g. culturally appropriate pictures or posters that shows women breastfeeding in positive and realistic settings.
  2. Positive staff attitudes toward breastfeeding at all levels of the organization (from Housekeeping to the Medical Director and Chief Executive Officer)
  3. Comfortable chairs in waiting room for mothers to sit in while breastfeeding.
  4. Private space available for breastfeeding, when desired by mothers.
  5. Lactation specialist on staff, preferably IBCLC.
  6. Breastfeeding home visit and/or telephone contact with all breastfeeding mothers, provided by staff or peer counselor soon after discharge from hospital.
  7. Knowledgeable support for breastfeeding after returning to work.
  8. Breastfeeding classes on-site.
  9. Appropriate resource materials – pamphlets, books, videos from Best Start, NYSDOH, and other reliable sources.
  10. No formula company materials – pamphlets, videos, pens, mugs, other "gifts".
  11. Breastfeeding "warm line" for families to call for advice about breastfeeding.
  12. Information provided to mothers about community resources, e.g. peer counselors, sources of pump rentals and other breastfeeding supplies.
  13. Breastfeeding assessed at each pediatric and postpartum visit.
  14. Medication choices for mother consider her breastfeeding status, e.g. recommend contraceptives other than estrogen/progestin methods
  15. Duration of breastfeeding monitored.

Breastfeeding Promotion in Managed Care Settings

  1. Visible support for breastfeeding, e.g. articles, photos in member and provider newsletters.
  2. Plan monitors breastfeeding rate among enrollees at birth, 1-2 weeks, 3 months, 6 months, and 12 months.
  3. Written policy regarding breastfeeding promotion, with clear responsibility for implementation.
  4. Lactation specialist on staff, preferable IBCLC.
  5. Individual(s) identified to address enrollees' breastfeeding problems and questions.
  6. Source of follow-up care identified for newborns and mothers.
  7. Mother and infant seen within 7 days after postpartum discharge.
  8. Source identified for urgent and after-hours advice.
  9. Breastfeeding education materials given to all pregnant enrollees.
  10. Community resources (e.g. peer counselors, La Leche League) recommended to all enrollees.
  11. Offer and/or encourage support staff continuing education on breastfeeding.

Breastfeeding Promotion in the Workplace

  1. Visibly promote breastfeeding, e.g. posters, articles in employee newsletter
  2. Health benefits cover:
    • Postpartum home visits
    • Lactation consultant services
    • Hospital grade electric pump rental
  3. Maternity leave – 6 weeks minimum
  4. Flexible hours and breaks; part-time or job-sharing schedules offered
  5. Allow infants on site, e.g. in port-a-crib by mother's work station
  6. Offer on-site child care
  7. Lactation room
    • Comfortable, clean, private
    • Electric pump, sink, refrigerator
    • Resource shelf: books, pamphlets, videos
  8. Breastfeeding classes on-site to address concerns about work and breastfeeding.
  9. Staff Lactation Consultant to coordinate services:
    • Classes and individual counseling
    • Manage lactation facilities
    • Products (pumps, pump kits, coolers, books)
  10. Working parents' support group

Breastfeeding Promotion Guidelines for Hospitals

  1. Visible support for breastfeeding, e.g. culturally appropriate posters and artwork.
  2. Encourage breastfeeding on demand.
  3. Encourage breastfeeding both day and night.
  4. Written policy allowing 24-hour rooming-in.
  5. No routine orders for anti-lactation drugs.
  6. No water, glucose, water, or formula given to breastfed babies except in special circumstances.
  7. No formula company materials – pamphlets, videos, pens, mugs, other "gifts" and no formula discharge packs given to mothers of breastfed babies.
  8. No contracts with formula companies requiring the hospital to provide mothers with formula and/or formula company "gifts".
  9. No pacifiers used with breastfed babies.
  10. Designated Lactation Coordinator in place, preferable IBCLC.
  11. First breastfeeding in delivery or recovery room.
  12. No test bottle given.
  13. Breastfeeding assessment on care plan.
  14. Breastfeeding assessed and documented on every shift.
  15. Additional information on breastfeeding given to all breastfeeding mothers while in hospital.
  16. No timing of breastfeeding sessions.
  17. All breastfeeding women taught: position and latch-on, strategies to promote successful breastfeeding, signs nursing is going well, common concerns, and other topics.
  18. Breastmilk/breastfeeding encouraged and supported in NICU.
  19. Hospital has good source of breastfeeding information for mothers (not formula company literature or videos).
  20. Breastfeeding instruction sheet provided at time of discharge.
  21. Support provided to breastfeeding infants and mothers hospitalized after initial delivery stay, e.g. infant visitation, pump loan, lactation consultant visit.
  22. Breast pumps and breaks, and breastfeeding advice/consultation provided for breastfeeding staff.
  23. Mothers supported at discharge with at least two follow-up services (e.g. lactation clinic, peer counselors, phone consultation, referral to La Leche group).
  24. Arrange for breastfeeding home visit and/or telephone contact with all breastfeeding mothers – provided by staff or peer counselor soon after discharge from hospital.