The IHS Baby-Friendly Hospital Initiative just added another hospital to its roster. In February 2014, Whiteriver Indian Hospital in Arizona became the seventh facility to adopt a policy of encouraging and supporting breastfeeding.
The initiative is part of the wide-ranging effort to improve the health of Native Americans. According to the IHS Clinical Reporting System, more than 80% of American Indian and Alaska Native (AIAN) adults aged 20 to 74 years are overweight or obese, and about half of AIAN children and youth are not at a healthy weight. More important, 45% of children aged 2 to 5 years are overweight or obese. It’s a very specific issue: An analysis of the Centers for Disease Control and Prevention data found that between 2003 and 2008, the rate of obesity remained stable among low-income, preschool-aged children participating in federally funded health and nutrition programs—all except AIAN children.
Noting that the risk for obesity begins as early as the perinatal period, the IHS encourages clinicians in Indian Country to support policies and practices that foster breastfeeding as the exclusive feeding choice for infants in the first 6 months of life. Studies have shown a positive association between breastfeeding and lower rates of overweight among children; the protective effect seems to last well into older childhood. Breastfeeding reduces a baby’s risk of obesity by about one-third and significantly reduces the risk of type 2 diabetes for both mother and infant. Thus, the IHS initiative encourages clinicians in Indian Country who serve new mothers to familiarize themselves with the benefits of breastfeeding, problems that may arise for breastfeeding mothers, and challenges for health facilities in implementing breastfeeding policies. The website http://www.ihs.gov/babyfriendly offers a toolkit on providing education on breastfeeding.
To be designated as a Baby-Friendly facility, the facility must follow 10 steps created by the World Health Organization and UNICEF (the United Nations Children’s Fund) and endorsed by major maternal and child health authorities in the U.S. For example, the hospital or birthing facility must have a written breastfeeding policy, train staff in the skills needed to implement the policy, inform all pregnant women about the benefits of breastfeeding, and practice rooming-in (allowing mothers and infants to remain together 24 hours a day). Research has shown women are 6 times more likely to breastfeed when delivered in hospitals that practice 6 or 7 of the steps than are women in hospitals that practice none or 1 of the steps.
The IHS is working toward the Baby-Friendly designation for 14 of its obstetric facilities and encouraging tribal obstetric facilities to adopt the initiative as well.