Purpose

The purpose of this protocol is to promote a philosophy and practice of maternal–infant care that advocates breastfeeding. Care should support the normal physiologic functions involved in the establishment of this maternal–infant process and assist families choosing to breastfeed with initiating and developing a successful and satisfying experience.

This policy is based on recommendations from the most recent breastfeeding policy statements published by the Office on Women’s Health of the US Department of Health and Human Services, 1 the American Academy of Pediatrics, 2 the American College of Obstetricians and Gynecologists, 3 the American Academy of Family Physicians, 4 the World Health Organization, 5 the Academy of Breastfeeding Medicine, 6 and the UNICEF/World Health Organization evidence-based Ten Steps to Successful Breastfeeding. 5, 7–10 In addition to evidence supporting each of the Ten Steps improving breastfeeding exclusivity or duration, there is also documentation of a dose-responsive effect: Women at hospitals implementing six of seven studied steps in one report were six times more likely to meet their exclusive breastfeeding goals than those from hospitals implementing no or only one of the steps. 11 The degree of compliance is also important: Breastfeeding duration is longer when hospitals’ selfreported compliance with the steps is better. 12