Table 1.

New York State Hospitals Providing Maternity Services (n=139) Whose Hospital Breastfeeding Policy Includes Each of the Ten Steps Based on the Required Components Specified in New York Codes, Rules and Regulations

Ten Steps to Successful Breastfeedinga	NYS hospital breastfeeding policy required components (2009)b	Hospitals [n (%)]
1. Have a written breastfeeding policy that is routinely communicated to all healthcare staff.	• A written policy is present, and	19 (14)
	• There is description about the procedure for dissemination/communication of policy among staff.
2. Train all healthcare staff in skills necessary to implement this policy.	• At least one person at the hospital is designated to ensure implementation of breastfeeding policy.	82 (59)
3. Inform all pregnant women about the benefits and management of breastfeeding.	• Information about the advantages of breastfeeding is provided to women who are undecided.	27 (19)
	• The process of caring for breasts is discussed with each breastfeeding mother.
	• Common problems associated with breastfeeding are discussed with each breastfeeding mother.
	• Maternal dietary requirements for breastfeeding are discussed with each breastfeeding mother.
	• Diseases and medications that might affect breastfeeding are discussed with each breastfeeding mother.
4. Help mothers initiate breastfeeding within half an hour of birth.	• Unless contraindicated, the newborn is placed for breastfeeding immediately (within 30–60 minutes) following delivery.	127 (91)
5. Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants.	• Breastfeeding mothers are to be encouraged to maintain lactation if separated from their infant.	103 (74)
6. Give newborn infants no food or drink other than breastmilk, unless medically indicated.	• Supplemental feedings are only provided for the medical condition of the newborn or mother.	125 (90)
7. Practice rooming-in—that is, allow mothers and infants to remain together—24 hours a day.	• The option for rooming-in is available to mothers, 24 hours a day (for at least 6 hours of every 8-hour shift), unless it is medically contraindicated or the hospital does not have sufficient facilities.	110 (79)
8. Encourage breastfeeding on demand.	• There is a provision for the newborn to be fed on demand (no restriction on frequency or length of newborns' breastfeeds).	136 (98)
9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.	• The hospital must respect a mother's decision to have her baby not receive any pacifiers.	83 (60)c
10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.	• Advice and information about breastfeeding is available following discharge. (Can be in the form of a contact or birth center phone number.)	101 (73)

^aJoint World Health Organization/UNICEF statement published by the World Health Organization.⁵

^bAll required components for the 2009 review were based on the requirements specified in the New York Codes, Rules and Regulations (NYCRR), Title 10, 405.21—Perinatal Services.⁴

^cHospital policies were reviewed for inclusion of language restricting the use of pacifiers, even though this is not required under the NYCRR, Title 10, 405.21—Perinatal Services.⁴

NYS, New York State.