Baby-friendly hospitals boost breastfeeding in New Zealand

July 2014

A woman breastfeeding her baby with support from a health worker
NZBA

If you are born in New Zealand, it is highly likely you will be born in hospital, delivered by the same midwife who attended your mother during her pregnancy. It is also highly likely you will be breastfed by your mother right from the start.

When they go home, more than 8 out of 10 newborns in New Zealand today are exclusively breastfed, compared with just over half in 2000. This success is largely down to the country’s efforts to ensure its maternity services are ‘baby friendly’, using criteria set out in the WHO/UNICEF Baby-friendly Hospital Initiative (BFHI).

“Implementing the initiative has had a big impact on New Zealand’s maternity services. Staff are trained to be able to give breastfeeding advice and support to mothers. Before, health workers often used to give out formula. Now they only supply breast-milk substitutes for medical reasons,” says Julie Stufkens, who heads the New Zealand Breastfeeding Authority (NZBA), which audits the BFHI accreditation programme in the country, on behalf of, and funded by, the New Zealand Ministry of Health.

“The practice of having new mothers hold their newborns, skin-to-skin, right after birth is now common and this makes a big difference in helping the baby to latch on to the breast for the first feed. It’s also common to have babies sleep in the same room as their mother while they’re in hospital, which is good for making sure they can feed whenever they like,” she adds.

96% baby-friendly hospitals

These are among the 10 steps a maternity care facility needs to implement to be certified as baby friendly according to WHO/UNICEF criteria. All New Zealand’s maternal facilities are required to achieve and maintain baby-friendly accreditation – currently 96% do.

“When the BFHI was launched in 1991, there were very few countries that had dedicated authorities or committees to oversee and regulate infant feeding standards. Now, 156 countries have assessed their hospitals and designated at least one as ‘baby friendly’,” says Dr Carmen Casanovas, a WHO breastfeeding expert.

Helping mothers continue breastfeeding

New Zealand’s next challenge is to help mothers to continue breastfeeding. WHO recommends that babies be exclusively breastfed for the first 6 months of life, which means giving them breast milk and any medicines they may need, but no other food or drink, not even water. Some 42% of babies are still being exclusively breastfed at 3 months in New Zealand, but this drops to 16% at 6 months. The global average for exclusive breastfeeding for 6 months is 37% globally, but country rates vary widely.

Most countries show increased percentage of mothers exclusively breastfeeding their babies for the full six first months of life if they have support after they leave hospital, time off work, and a safe and clean place to express and store breast milk in the workplace.

“The Ministry of Health and NZBA’s aim is to see breastfeeding become the cultural norm in New Zealand,” says Ms Stufkens. “Our focus now is on improving breastfeeding rates among Maori and Asian women who often have a lower breastfeeding rate than the overall population.”

This involves making sure families get good support, that communities are consulted to establish what they really need, and that health workers are educated to understand cultural issues, she adds.

Family support was crucial for Nicki, who struggled to get her son, Cruz, to continue to breastfeed after they came home from hospital, despite the continued support she received from her midwife. Fortunately, Nicki’s mother and in-laws live close by and helped her as she struggled for up to 45 minutes to get Cruz to latch on.

“He was getting expressed milk in a cup, in a bottle…and milk straight from the breast,” Nicki says. At two weeks, Cruz just went straight for his mother’s breast – a welcome relief all round.

Nicki and Cruz’s experience shows that although breastfeeding is natural, and best, it doesn’t always come naturally. Guidance and support right from the baby’s birth can be a big factor in ensuring every mother and family can give every child the best start in life.

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