Correct Answers: The answer is B Read the Abstract here

IABLE Comment by Anne Eglash MD, IBCLC, FABM

This protocol points out that the Baby Friendly Hospital Initiative (BFHI) principles of care for term infants are not necessarily sufficient to prevent all risks associated with late preterm and early term status. However, I believe these babies are safer in a BFHI certified hospital, where staff undergo 18 hours of breastfeeding training and maintain routines that optimize breastfeeding support. Many of the principles of care in this protocol outline Baby-Friendly steps such as observing feedings at the breast, rooming-in, and establishing a feeding at the breast within the first hour. These infants are often weaker at the breast, meaning that they may not be transferring milk as well, increasing the risk of readmission for dehydration, hypoglycemia, and hyperbilirubinemia. Hospital staff who are not trained in breastfeeding evaluation and management have fewer skills to assess breastfeeding adequacy. This could lead to inappropriately high supplementation, infant consequences of insufficient feeding, and risk of insufficient support for the establishment of mother’s milk supply.

This protocol should be a call to action for all hospitals to fulfill as many of the Baby Friendly Hospital Initiative steps as possible, to support breastfeeding success in this vulnerable population.