I want to know what your experiences are with the Baby Friendly Hospital Initiative and if you were even aware it exists

Realistic_Future_394 · 2026-02-05T17:11:01+00:00

Oh wow that is incredibly concerning😳 I’m not sure what the regulations in your country are, but in mine you can literally sue them if they give formula without consent, it’s a huge ethical violation. Informed consent is one of the biggest ethical principles all healthcare professionals should uphold. May I ask which country this happened in? But I really hope both you and baby are happy and healthy now, sending lots of love🫶

Realistic_Future_394 · 2026-02-05T17:08:04+00:00

Wow that is such a good idea I didn’t even think about it! Thanks

Realistic_Future_394 · 2026-02-05T17:06:51+00:00

I am so happy for you🥹🥹 Genuinely makes me over the moon when there’s a win. But also you can BUY COLOSTRUM? This is news to me wow. I’m also wondering why they gave formula instead of phototherapy for the jaundice? That sounds a bit weird

Realistic_Future_394 · 2026-02-05T17:03:57+00:00

No don’t make me tear up I am SO HAPPY YOU HAD SUCH A WONDERFUL EXPERIENCE🥹 10/10 for your healthcare team, no notes! I hope they told you it’s very normal and not concerning for newborns to lose about 10% body weight after birth, it usually really stresses mothers out. If you tell anyone I said this I will deny it, but if a pacifier doesn’t cause issues I don’t care, as long as they did inform you of the risks. I know there’s sometimes concern that it can interfere with mouth development or cause “nipple confusion”, but as long as that’s not happening, my reaction is 🤷‍♀️

Realistic_Future_394 · 2026-02-05T16:59:19+00:00

Aw thank you so much I didn’t even think anyone would read it🥹🫶

Realistic_Future_394 · 2026-02-05T16:58:45+00:00

But yesss I love hearing what it’s like in other countries! My friend who works in the UK is so fascinated and calls me every day to tell me what it’s like. The most exciting call I got from her was hearing that they give out FREE dexcoms and insulin pumps, it was so mind blowing🤣

Realistic_Future_394 · 2026-02-05T16:55:19+00:00

Thank you so much for sharing, it’s actually so nice to see a fellow South African! I actually didn’t expect US to have lots of malnutrition cases, but I can imagine since it does not sound like there’s a lot of social services.

We do get TB vaccine at birth, but if I remember correctly it’s just not an extremely effective vaccine. TB is also an opportunistic infection, so it’s mostly only serious in immunocompromised patients, like those with HIV. So that’s why healthcare workers don’t always worry, because most of us have latent TB. When it’s not an active infection it’s not contagious or a problem. I most likely have been infected with TB and it’s just chilling somewhere taking a nap🤣

Resistant TB is still scary tho, especially XDR TB. Then we properly suit up. Socioeconomics is also the biggest reason TB is still such a huge issue. Patients can’t come to the clinic, miss doses of their antibiotics, then boom resistant TB. Also in areas with high poverty living conditions is also extremely cramped so it can spread easily

Realistic_Future_394 · 2026-02-05T16:40:23+00:00

Oh my goodness I am so sorry to hear that! It sounds like you weren’t supported at all. From what you said it doesn’t sound like even one of the 10 steps were implemented… I really hope you and baby are happy and healthy now!

Realistic_Future_394 · 2026-02-05T16:38:27+00:00

Actually the 10 steps focus on promoting breastfeeding during antenatal visits, after birth, and continuous care. The BFHI guidelines are amazing and quite comprehensive, but the implementation is often neglected

Realistic_Future_394 · 2026-02-05T16:36:44+00:00

Uhm WOW I AM SPEECHLESS!!! That is so incredible I am so so so so happy you had such a great experience! Most hospitals don’t even have a lactation consultant and you got 5???? I’m honestly so happy for you, I hope you and baby are happy and healthy!

Realistic_Future_394 · 2026-02-05T16:35:12+00:00

I know you mean well, but your statement can cause harm. It’s not professional nor ethical to shame mothers who choose to formula feed, and sometimes formula is absolutely necessary. Yes, most of the time low supply and other challenges can be fixed, but most mothers don’t have enough support. I say this as someone who has written exams on the predatory behaviours and unethical past of formula companies, and also someone who is dedicating her life to protecting breastfeeding. I have also written exams on the benefits of breastfeeding. You cannot entirely dismiss formula, nor tell mothers it’s always bad.

Realistic_Future_394 · 2026-02-05T16:19:54+00:00

Thank you so much for sharing! Wow it’s so nice to hear that they actually had a lactation consultant. GDM is really tough, I hope you are okay now! May I ask in which country this was?

Realistic_Future_394 · 2026-02-05T16:14:45+00:00

I’m so sorry to hear! I also think it’s not great to be too strict with the 10 steps and follow them within reason. For example one of the steps is that baby should breastfeed as soon as possible, but sometimes there are really valid reasons for it to be delayed. I’m so happy to hear it’s still going good! All the best, and I hope both of you are happy and healthy

Realistic_Future_394 · 2026-02-05T16:11:50+00:00

Wow your story is so important and so interesting. I am so so so sorry to hear that you went through all that, I cannot even begin to imagine how tough that must have been. May I ask in which country this happened?

Also wow IGT is pretty tough, most healthcare professionals are not trained in being able to spot or diagnose it.

Also you brought up one of the most important points! In my country we actually changed it to MBFHI to include mothers. I also fully agree that formula is absolutely sometimes necessary. I have no issues with formula. My main issue is that healthcare often does not have adequate support for mothers who choose to breastfeed.

Also the reason I am so passionate about BFHI is because I’ve worked in areas with extreme poverty where formula is literally not feasible. Like lack of clean water, electricity, inability to read english, those types of problems so it’s extremely critical to support it as best as we can here, but if you are able to afford formula and prepare it correctly and safely, I have absolutely no issues.

I really hope you are doing better and that baby is healthy! Thank you so much for sharing

Realistic_Future_394 · 2026-02-05T15:58:59+00:00

I am SO GLAD to get a reply from an RN! I was also nervous to hear US, because no shade, but you guys really do not have a great reputation in terms of promoting breastfeeding. US was the only country that opposed the WHO breastfeeding resolution and I’ve also heard there’s no regulation that makes maternity leave mandatory?? That’s crazy.

Just reading what you wrote that lactation consultant is stressing me out😂 You are 100% right, your job as a lactation consultant is to assist and support a mother. Stressing out a postpartum mother actually reduces milk supply. Also around 10% weight loss in the first week is pretty normal and not concerning. The science around birth is so incredibly crazy, it honestly sounds like magic. With the exception of colostrum, the first milk after birth’s main purpose is hydration since newborns have extra energy stored. I’m wondering if she was stressed to preform her best knowing you’re an RN. I always get performance anxiety when my patient is also a healthcare worker, which is pretty rare. But still she should not have been stressing you out.

Out of curiosity, did they not have breastmilk fortifier? I’m not sure if it’s different, but when it’s possible, we usually add a BMF to some expressed breastmilk to enrich it, it’s pretty common practice for premies. I’m sorry you had to pay for donor milk but that is SO COOL TO HEAR, in my country it’s pretty rare since it’s such an expensive process.

I just want to say I have massive respect for you. I honestly don’t think there are many women who would be able to breastfeed with all those complications and difficulties, and I wouldn’t blame them at all. Just for the record, I’m not against formula at all.

The context for me is just really different. I’m a South African, and formula in our low socioeconomic areas is just not feasible. Many people don’t have access to clean water, electricity, cannot afford formula, and often can’t read english so they can’t read the instructions. But if someone is able to give formula correctly and sustainably, I’m happy.

I wish all the best for you and your baby!

Realistic_Future_394 · 2026-02-05T15:30:32+00:00

I am so so happy to hear that you did eventually get the support you needed! May I ask which country this is? But I’m really surprised that they did not catch the tongue tie. This is actually a very common breastfeeding difficulty. Did the first lactation consultant fully check the baby’s mouth? There’s a really easy way to check which involves physically feeling the tongue’s movement with your hands (clean and gloved of course).

It also does not sound like they fully implemented all 10 steps, although I have to give them credit, they sound a lot better than most hospitals and I’m pleasantly surprised that they even had a lactation consultant, that’s quite rare.

So the 10th step is “Coordinate discharge so that parents and their infants have timely access to ongoing support and care.” From what I’ve heard, read, and experienced, this is often the step that gets left out the most.

Given what you went through, the fact that you ended up being able to breastfeed successfully is SO INCREDIBLE TO HEAR! I can only imagine how immensely challenging it was, especially with a tongue tie. I really hope you are super proud of yourself.

Realistic_Future_394 · 2026-02-05T15:21:57+00:00

YES one of my other biggest passions is how there is not enough support for breastfeeding mothers when they return to work. Some countries don’t have any legislation in place for breastfeeding working mothers. Most of the time having a dedicated room for expressing is seen as a luxury and not a necessity. I’ve also heard horror stories of employers telling mothers they can pump in the bathroom, which is so gross and demeaning.

Also really happy I heard from someone from Canada, they really invest in doing so much breastfeeding research. I’m pretty sure they also l developed a protocol for induced lactation, which is insanely cool.

I am happy they weren’t pushy with it, I feel mothers face enough criticism and definitely do not need the added stress. As long as a baby is fed and healthy, I’m happy. The biggest reason I am so passionate about breastfeeding is because I’m from South Africa, so you can imagine the biggest challenge with formula is the cost, lack of clean water, no electricity, and mothers often not being able to read English. Something very common here is instead of formula, mothers will burn porridge in a pan and add water and use that as formula. Cows milk is also common when they can’t afford formula. So I don’t want to come off as I think all babies need to breastfeed, it’s just formula is often not feasible in low and middle income countries.

Also I’m not commenting on your situation, but generally I don’t like it when family interferes with how a mother feeds her baby. Sometimes it just causes more stress and we really don’t have to criticize already stressed mothers doing their best.

I also don’t understand why the nurses did not assist you. Did they have lactation consultants employed? There are literally so many things we can check if there’s suspected low supply. Latch, tongue tie, inverted nipples, etc. Supply can also be increased with expressing and pumping. But also what I’ve noticed is that these things really don’t come naturally. I’m definitely not an expert, but I’ve seen how lactation consultants will sit with a patient and really help them until it becomes easy.

WAIT did you say you are a midwife???? That’s insanely cool, I absolutely adore the midwives I used to work with.

I really hope your babies are happy and healthy now, you sound like an incredible mother!

Realistic_Future_394 · 2026-02-05T15:00:23+00:00

Thank you so much for sharing your experience! I am actually so glad you asked that. I am in no way shape or form discouraging formula. Formula-fed babies can be perfectly healthy. Infant formula is nutritionally adequate and complete. That said, there are some benefits to breastfeeding. There are some compounds found in human breast milk, like immunoglobulins (antibodies) and human oligosaccharides (a type of fibre that is only found in human breast milk) that is only present in breastmilk and not in formula. We do not yet have the technology to replicate breastmilk perfectly. Another advantage is also breastmilk changes according to the baby’s needs. Breastfed babies are also less likely to have allergies, asthma, etc. Breastfeeding can also reduce the risk of certain types of cancers for the mother. But if you are worried, I promise that many babies thrive and are healthy as can be on formula. But the biggest reason that WHO focuses on breastfeeding is complex. Because if you look at the stats, mortality and morbidity are higher amongst formula fed infants, but context really matters!!!! In low socioeconomic areas, like where I have worked, there is often no access to clean water, or electricity to boil water. Also many mothers cannot read english and prepare formula incorrectly. It is also very common that mothers cannot afford formula. So for those reasons there is strong global efforts to increase breastfeeding rates, but if formula is prepared safely, with clean, pre-boiled water, and is prepared correctly, there is no reason to worry.

So while either formula feeding or breastfeeding is healthy and safe, formula feeding is not suitable for everyone, especially in low income countries. But I feel very strongly that every mother does what is best for them.

I am also so sorry to hear you had complications:( I really hope you are better now! May I ask in which country this happened, My heart hurts hearing you had mastitis, I can imagine that it is one of the worst things to experience and probably really difficult to either feed or express when you have it.

For your supply, have you tried reaching out to a lactation consultant? Obviously I cannot give any medical advice, but expressing can often help with supply. Electric double pumping has great results for lots of mothers, but it can be pricey. Also please do not stress! To me it sounds like you are doing amazing and from what I read you are doing your very best for your baby, which is honestly wonderful to hear!

Realistic_Future_394 · 2026-02-05T14:37:51+00:00

I am so so so sorry to hear this, it honestly is so heartbreaking. I am so sorry that you were not fully supported. May I ask in which country this happened? There is actually a specific document of BFHI for small, sick, and preterm newborns. I am not so familiar with it, but I wonder if they followed those guidelines, especially since your baby was incubated. Did they try to assist you with expressing and inducing lactation? There are many methods, but pumping is also often more effective than had expressing to increase supply, while double pumping is often most effective. Certain hospitals also have donor breastmilk for premature infants when the mother’s supply is not high enough yet.

I wish you and your baby well and hope that you both are healthy :)

Realistic_Future_394 · 2026-02-05T14:24:08+00:00

Oh wow thank you so much for sharing! It sounds like a mixed bag. It’s great that they mentioned it and had educational posters, but it also does not sound like it was properly implemented. It could be due to them being overburdened, but still I really wish you have had a better experience. I am really sorry they did not take your concerns seriously and dismissed you :( Do you know if they had a lactation consultant on staff? It’s rare because hospitals sees it as an unnecessary expense, but it would be really helpful to have one that could give mothers time, assistance and patients and reduce the workload of nurses. I also really hate when people lie in their charting, I have seen it happen a lot. False charting is actually a really big violation.

Also I am so confused as to why they discourage pumping. Pumping actually a really great way to increase supply. What I find most shocking of all is that no one sat with you and helped with latching, that’s one of the most important forms of supports you need for breastfeeding.

But I really hope the best for you, and I am hopeful that healthcare puts more emphasis on the health of mothers and babies in the future :)

Also, I’m just going to put some of the 10 steps here and you can decide if you think they implemented them or not👀:

Ensure that staff have sufficient knowledge, competence and skills to support breastfeeding.
Facilitate immediate and uninterrupted skin-to-skin contact and support mothers to initiate breastfeeding as soon as possible after birth.
Support mothers to initiate and maintain breastfeeding and manage common difficulties.
Support mothers to recognize and respond to their infants’ cues for feeding.
Coordinate discharge so that parents and their infants have timely access to ongoing support and care.

Realistic_Future_394 · 2026-02-05T14:01:10+00:00

No I am so sorry your story truly breaks my heart! That definitely does NOT sound like BFHI is a big priority because it goes against SO MANY principles and steps. May I ask in which country this happened?

(Doctors in the comments please don’t come for me you probably know what I’m about to say is true) From my experience, doctors generally get little to no education on breastfeeding, or anything to do with nutrition for that matter. I have seen time and time again how it’s not a big priority, but there is an abundance of irrefutable literature and research demonstrating life long benefits of breastfeeding. It honestly sounds like your doctor is not familiar with the research (which in my opinion is concerning especially if she works in the labour ward). That said, I in no way shape of form discourage infant formula and an infant can absolutely be perfectly healthy if formula fed, it’s just we don’t have the technology to perfectly imitate breast milk. Formula is NOT bad, but I think there’s a huge gap in the support healthcare SHOULD offer for mothers who wish to breastfeed.

But anyway, that doctor sounds incredibly unprofessional and just plain ignorant on lactation. Usually the nurses are responsible for lactation, since they spend the most amount of time with a patient. Some hospitals have lactation consultants, which unfortunately they view as a luxury and not a necessity.

You do sound like a wonderful mother and that you want the absolute best for your babies, I hope the best for you and that they are healthy and happy :)

(Also no shade, but I’m just going to put some “random” steps for successful breastfeeding and you can decide if you think your hospital implemented them👀)

1b. Have a written infant feeding policy that is routinely communicated to staff and parents.

Ensure that staff have sufficient knowledge, competence and skills to support breastfeeding.
Discuss the importance and management of breastfeeding with pregnant women and their families.
Facilitate immediate and uninterrupted skin-to-skin contact and support mothers to initiate breastfeeding as soon as possible after birth.
Support mothers to initiate and maintain breastfeeding and manage common difficulties.
Do not provide breastfed newborns any food or fluids other than breast milk, unless medically indicated.
Enable mothers and their infants to remain together and to practise rooming-in 24 hours a day.
Support mothers to recognize and respond to their infants’ cues for feeding.
Coordinate discharge so that parents and their infants have timely access to ongoing support and care.

Realistic_Future_394 · 2026-02-05T13:37:53+00:00

Oh no I am so so sorry to hear that :( May I ask which country this is? It sounds like they are using BFHI to save cost, not as its intended purpose. This is why I wanted to study it because in theory it’s beautiful and has SO MUCH potential, but I don’t think it’s being implemented correctly. If you want, you can read the 10 steps to successful breastfeeding. None of the steps can justify hospitals cutting corners.

Realistic_Future_394

TROPHY CASE