Overview: Maternity Care Practices

In the United States, nearly all infants are born in a hospital or free-standing birth center. Their stay is typically very short, but events during this time have lasting effects. Many of the experiences of mothers and newborns in the hospital affect breastfeeding.

In most cases, these experiences reflect routine practices at the facility level, and patients rarely request care different from that offered them by health professionals. Experiences with breastfeeding in the first hours and days of life significantly influence an infant’s later feeding. Due to its inextricable relationship with the birth experience, breastfeeding should be established during the maternity hospital stay, not postponed until the infant goes home.

There are several key supportive hospital practices that can improve breastfeeding outcomes. Birth facility policies and practices that create a supportive environment for breastfeeding begin prenatally and continue through discharge, and include:

• Skin-to-skin contact—Doctors and midwives place newborns skin-to-skin with their mothers immediately after birth, with no bedding or clothing between them, allowing enough uninterrupted time (at least 30 minutes) for mother and baby to start breastfeeding well.
• Teaching about breastfeeding –—Hospital staff teach mothers and babies how to breastfeed and to recognize and respond to important feeding cues.
• Early and frequent breastfeeding—Hospital staff help mothers and babies start breastfeeding as soon as possible after birth, with many opportunities to practice throughout the hospital stay. Pacifiers are saved for medical procedures.
• Exclusive breastfeeding—Hospital staff only disrupt breastfeeding with supplementary feedings in cases of rare medical complications.
• Rooming-in—Hospital staff encourage mothers and babies to room together and teach families the benefits of this kind of close contact, including better quality and quantity of sleep for both and more opportunities to practice breastfeeding.
• Active follow-up after discharge—Hospital staff schedule in-person breastfeeding follow-up visits for mothers and babies after they go home to check-up on breastfeeding, help resolve any feeding problems, and connect families to community breastfeeding resources.