Miami-Dade County

To promote breastfeeding, Jackson Health System stops giving out infant formula samples

In an effort to promote breastfeeding, Jackson Health System is no longer handing out goody bags with infant formula samples and instead is giving new mothers its own breastfeeding discharge bags that include information on support groups, where to find breast pumps and how to collect and store breast milk.

The change in the longtime policy is part of an effort to achieve the Baby Friendly designation, a global standard of care program launched by the World Health Organization (WHO) and UNICEF to encourage breastfeeding and recognize hospitals and birthing centers that offer support for what the American Academy of Pediatrics considers the optimal level of infant feeding. All the formula bags were removed last month from Jackson Health System’s three maternity hospitals, JMH, Jackson North Medical Center and Jackson South Community Hospital.

Jackson decided to do without the commercially sponsored formula bags given to discharged mothers “because it undermines our message and what we’re trying to accomplish,” said Marta Galarza, the University of Miami neonatologist who has spearheaded the designation effort. “This is an important way of telling new mothers, ‘You can do it.’ ”

As the medical director of the newborn intermediate care unit at Holtz Children’s Hospital at Jackson, Galarza noticed that as many as 85 percent of mothers said they wanted to breastfeed their infants, but those who actually did for any period of time was much lower. The American Academy of Pediatrics, which considers breastfeeding one of its “high priority” initiatives, recommends that infants be fed human milk exclusively for about six months, followed by continued breastfeeding with complementary foods until a year. The practice can then continue for as long as it is mutually desirable for mother and child.

But many new mothers give up, often frustrated by the lack of support or by misunderstanding of how and how often an infant should be fed. Those who quit often think they are not producing enough milk, but that happens in only 1 percent of cases, Galarza said.

“The failure rate occurs in the first few days, and it’s usually in the hospital,” Galarza added. “But if the mother is aware of what to expect, if she is encouraged to continue, it’s much easier.”

Jackson is not the only hospital that has stopped handing out infant formula samples to mothers. Memorial Health System in Broward, for example, stopped doing so in January. But Jackson’s policy to eliminate the formula sample bag is important because of the medical center’s size, said Ruth Jeannoel, a lead organizer for the Miami-based Power U Center for Social Change, a grassroots organization that helps low-income women of color in Overtown, Liberty City and Little Haiti. Jackson is considered to be the largest public hospital in the country and the fourth largest overall, she added. “This is a huge step because Jackson is setting an example. It’s a leader. Others will be looking at what Jackson has done and maybe do the same.”

Power U and Public Citizen, a national consumer advocacy organization that focuses on health and safety, publicly praised the hospital in a news release, encouraging others to follow suit. Power U representatives had been meeting with Jackson administrators after the group conducted a survey in 2012 that showed low-income mothers in Miami felt they did not receive enough support for breastfeeding while receiving too much promotional incentive for the purchase of baby formula.

The organization’s push for breastfeeding, including a 2013 report titled “A Call for Birth Justice in Miami,” coincided with Jackson’s own efforts to change its practices and achieve the Baby Friendly designation. Currently there are only four hospitals in Florida with the designation, none in South Florida.

Since the Baby Friendly Hospital Initiative was launched in 1991, more than 152 countries have implemented or are in the process of implementing its standard of care guidelines. A spokeswoman for the Albany-based Baby Friendly USA said there were 883 facilities that had either achieved the designation or were in the process of meeting the requirements in the U.S. Because of privacy issues, she would not name the ones in Florida that were in the application process.

To be awarded the Baby Friendly designation, hospitals and birthing facilities must successfully implement the organization’s “Ten Steps to Successful Breastfeeding” program, which includes, among other things, having a written breastfeeding policy, training healthcare staff, encouraging breastfeeding on demand, establishing breastfeeding support groups and referring mothers to such groups on discharge.

Jackson hopes to complete its application process by the end of the year.

Other hospitals, including Baptist Hospital, Homestead Hospital and West Kendall Baptist Hospital, are also working toward the Baby Friendly designation, while the remaining Baptist Health South Florida hospitals with maternity services offer comprehensive breastfeeding education and support for mothers and babies.

Others medical centers, such as those in the Memorial Health System, apply the “10 step” principle of the initiative but are not seeking certification.