Promoting Safer Formula Feeding with Breastmilk Substitutes
In order to promote safer formula feeding, we need to follow the Guideline 5.3 of The Baby-Friendly Hospital Initiative Interim Guidelines and Evaluation Criteria for Facilities Seeking and Sustaining Baby-Friendly Designation (2019). It emphasizes how mothers need to be provided with guidance when dealing with breastmilk substitutes for their infants. It states the following:
“Mothers who feed formula should receive written instruction, not specific to a particular brand, and verbal information about safe preparation, handling, storage, and feeding of infant formula. Staff should document completion of formula preparation instruction and safe feeding in the medical record. This information should be given on an individual basis only to women who are feeding formula or mixed feeding their infants,” (1).
Providing mothers with guidance on how to safely handle, store, prepare and feed infant formulas
It is important for mothers who choose breastmilk substitutes to be provided with instructions and information on safer formula feeding. According to the guidelines, below are the teachings that need to be included in the written instructions that are provided to mothers.
- Appropriate hand hygiene
- Cleaning infant feeding items (bottles, nipples, rings, caps, syringes, cups, spoons, etc.)
- Cleaning workspace surfaces
- Appropriate and safe reconstitution of concentrated and powdered infant formulas
- Accuracy of measurement of ingredients
- Safe handling of formula
- Proper storage of formula
- Appropriate feeding methods which may include feeding on cue, frequent low volume feeds, paced bottle techniques, eye-to-eye contact, and holding the infant closely
- A Reminder that powdered infant formula is not sterile and may contain pathogens that can cause serious illness in infants younger than 3 months
Developing your own teaching kit
One US-based hospital developed their own teaching kit for this step, contained in a portable plastic file box. Inside were the following items:
- Cans of concentrate and powdered infant formulas with all brand names hidden.
- Measuring cups.
- Bottle and nipple/teat.
- Disinfectant wipes.
- WHO handouts on safe preparation and storage of formula, infant cues for hunger and satiety, paced bottle feeding and safe and comfortable milk suppression.
- A model breast for teaching hand expression (to avoid engorgement);
- A teaching script; and contact information for the IBCLCs at the hospital and in the local community.
This teaching box was taken to the room of any family that made an informed decision to feed formula for any reason, and the script with demonstration of each step was covered with every family member who might be preparing infant feeds or bottle feeding the infant. All staff members where instructed on use of this teaching box and were able to provide instructions to such families on a one-to-one basis as needed, avoiding undue necessity for the IBCLC to provide all the teaching.
Final thoughts...
How does your facility teach Step 5.3? Did you develop a teaching kit of your own? Let me know your unique ideas for teaching by emailing me at kathy@breastfeedingperspectives.com.
If you found this article informative then you may also be interested in a previous post on Providing Breastfeeding Education to Mothers & Families.
Stay safe and keep up the great work toward your BFHI designation.
Kathy
Referrences
- Baby-Friendly USA. (2019). Interim guidelines and evaluation criteria for facilities seeking and sustaining Baby-Friendly Designation. Albany, NY: Baby-Friendly USA.
