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HEALTH PROMOTION BOARD AIMS FOR ALL MATERNITY HOSPITALS TO ATTAIN BABY FRIENDLY HOSPITAL INITIATIVE CERTIFICATION FROM WORLD HEALTH ORGANIZATION

Certified maternity wards will adopt best practices that help mothers achieve long-term breastfeeding success

Singapore, 12 January 2012: Pregnant mums delivering in 2012 may find themselves doing so in 'baby-friendly' maternity wards which are in line with recommendations by the World Health Organization (WHO).

2. The Health Promotion Board (HPB) is working with maternity wards to implement the WHO guidelines that form the Baby Friendly Hospital Initiative (BFHI). Promoting exclusive breastfeeding among mothers by supporting them before birth, during their hospital stay and after they are discharged, these international guidelines have contributed to improving neo-natal infants' health worldwide.

3. “Changing maternity services so that our hospitals are certified 'baby-friendly' is a milestone for our healthcare sector,” said Mr Ang Hak Seng, Chief Executive Officer, HPB. “According to results from HPB's National Breastfeeding Survey in 2011, nine out of 10 mothers know that breastfeeding is the best form of nourishment for newborns, and try to initiate breastfeeding after birth.

4. “Yet just 50 per cent continue to do so exclusively by the time they are discharged from the hospital, only 30 per cent will do so for at least two months and fewer are still breastfeeding by the time they return to work after 16 weeks. These figures are low compared to developed Asian countries like South Korea, where statistics show 50 per cent of mothers breastfeed exclusively for at least two months respectively.”

5. Mr Ang added that a number of mothers stop breastfeeding, despite knowing its benefits, because they do not know how to maintain a constant supply of breast milk and believe erroneously that they are unable to produce enough milk for their child. According to medical experts, breastfeeding within an hour after child-birth, feeding 'on demand' and avoiding infant formula supplements unless they are medically required, all go towards establishing a more regular supply of breast milk.

6. Studies show that the ability to breastfeed successfully in the first few days after birth has a direct impact on the period of time that mothers continue breastfeeding. To help mothers enjoy greater success in breastfeeding, HPB is working with the five hospitals that account for 80 per cent of the births in Singapore – National University Hospital (NUH), KK Women‟s and Children‟s Hospital (KKH), Singapore General Hospital (SGH), Mount Alvernia Hospital and Thomson Medical Centre – on achieving BFHI certification by implementing these guidelines: 

Before delivery
  • Antenatal education on early establishment of successful breastfeeding 
 During hospital stay
  •  Personalised consultation by trained nurses
  • Skin-to-skin contact and allowing infants to remain with mother throughout the first hour after delivery as infant's sucking reflex is strongest 30 minutes after delivery
  • Rooming-in services so that mothers and infants stay together to help mothers bond with their child and recognise feeding cues 
 Upon discharge
  •  Discussing follow-up support with mother before discharge 
  • Providing information on assistance available at hospital or community settings 
7. To support mothers when they are discharged, HPB is also working with hospitals to provide lactation consultation at nominal fees. In addition, HPB partners breastfeeding advocacy groups to give parents the support structure they need, from setting up hotlines to giving mothers who experience breastfeeding problems one-on-one counselling. 

8. Previously, hospitals may facilitate services such as skin-to-skin contact during the first hour after delivery, rooming-in, breastfeeding 'on demand' as well as a formula-free infant diet upon request by the mother. With the implementation of the BFHI, maternity services will follow the WHO guidelines as a default standard operating procedure, which includes disallowing milk companies to sponsor free formula at the hospitals.

9. HPB aims to have NUH and one other maternity hospital achieve BFHI certification by the end of the year, and the rest to be similarly certified by 2014. To be certified, a hospital must have at least 80 per cent of its maternity patients following 'baby-friendly' guidelines before delivery, during their stay at the hospital and upon discharge. Currently, less than 50 per cent of mothers do so.

10. “Babies deserve the best start in life. Getting hospitals to become more 'baby-friendly' is part of the Global Strategy for Infant and Young Child Feeding. Various hospitals in Singapore not only show full support and commitment, they also have the expertise to do so, and I am confident the BFHI will be successfully implemented here,” said Ms Randa Saadeh, a WHO-appointed BFHI expert.

11. “Some mothers may need more support and encouragement to breastfeed. Over the past five years, NUH has been implementing better practices in maternity and newborn care, in accordance to the BFHI. We are committed to work with HPB to achieve BFHI certification by the end of the year,” said Dr Yvonne Ng, Chairperson, BFHI Steering Committee, NUH. Dr Ng is also a Consultant with the Department of Neonatology, NUH.

12. “Our partnership with HPB and the implementation of the BFHI in hospitals will greatly complement efforts to promote and support breastfeeding in the workplace,” noted Dr Yong Tze-Tein, President, Association for Breastfeeding Advocacy.

13. The Breastfeeding Mothers' Support Group supports mothers on their breastfeeding journey through personalised consultations and regular support-group meet-ups. Welcoming HPB's move to have hospitals attain BFHI certification, Vice-President Dr Lena Goh said it will enable “more mothers and babies to enjoy the emotional benefits of the special and close relationship formed through breastfeeding.”

14. “Educating parents on the many benefits of breastfeeding, such as an increased resistance to infections as well as the emotional bonding between mother and child, is key to securing commitment towards breastfeeding,” said Dr Chua Mei Chien, Senior Consultant, Neonatalogy, KKH.

15. “It is heartening that local hospitals are keeping abreast – no pun intended – with breastfeeding advocacy groups, taking on larger roles in educating mothers on the benefits of breastfeeding and cultivating an environment that would help babies get hooked on breast milk from the onset,” said Mr Ang.

16. “The next challenge is in ensuring that working mothers continue to breastfeed after their 16- week maternity leave. At present, the number of mothers breastfeeding after they return to work is very small. Some organisations, workplaces and shopping malls have conducive facilities such as a 'pink room' that allows mothers to pump their breast milk and breastfeed in privacy, but I urge more companies, workplaces and malls to consider implementing similar provisions, so that they can play a pivotal role in helping mothers continue breastfeeding their babies exclusively up to six months, in line with WHO recommendations,” said Mr Ang.

Issued by Health Promotion Board