Why More Hospitals Are Closing Their Baby Nurseries

Thinking about sending your newborn off to the nursery so you can catch up on sleep? Your hospital might have other plans.

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My first two children were born in different hospitals, each with their own strengths and flaws. When I gave birth to our third child, it was a completely different experience.

Insurance issues required me to pick a new hospital, and this one was unusual because it didn’t have a nursery for newborn babies.

As long as your baby was healthy and didn’t need extra medical support, they were expected to “room in” with you. For me, this was a good fit. I have always slept best with my baby in a bassinet next to my bed. I was curious about the change, however, since each of my first two kids had spent a couple hours away from me during our stay in the hospital.

When I asked around at one of my prenatal visits, I learned my hospital wasn’t the only one making these changes; it wasn’t even one of a handful of hospitals. My hospital was part of a bigger initiative happening globally to make hospitals and birthing centers more baby friendly.

What makes a hospital “baby friendly”?

A Baby-Friendly Hospital isn’t simply a hospital that is safe for newborn babies. These hospitals follow very specific guidelines created by the World Health Organization (WHO) with one goal in mind—to increase breastfeeding rates.

Baby-Friendly Hospitals are set up in a way that provides the best environment for moms and babies to get their breastfeeding relationship off to a strong start.

The Baby-Friendly Hospital Initiative (BFHI) was started in 1991, spearheaded by WHO and the United Nations Children’s Fund (UNICEF), after research showed that breastfeeding rates were as low as they had been since 1979.

Researchers believed that this decline was in part due to a lack of support and poor education. By encouraging more hospitals to work toward a Baby-Friendly designation, these organizations hoped to boost breastfeeding rates all over the world.

To be deemed Baby-Friendly, a hospital has to go above and beyond supporting breastfeeding by complying with 10 set standards and applying for a Baby-Friendly designation.

Since the implementation of this program in 1991, more than 20,000 hospitals and birthing facilities in 150 countries have been designated as Baby-Friendly, according to Baby-Friendly USA, and 447 of these facilities are located in the United States and Puerto Rico.

Baby-Friendly hospitals have to follow 10 standards.

Before a hospital can be given a Baby-Friendly designation, they have to strictly adhere to the 10 standards that are at the core of the BFHI. At the hospital where I gave birth to my second son, there were actually posters on the walls of each office outlining these standards exactly.

Each of these standards was created to support expectant and new moms in their breastfeeding journey. Baby-Friendly Hospitals are required to create a clear breastfeeding policy, train their staff member extensively on their policy, and make sure every new mom is fully educated on the benefits of breastfeeding.

Additionally, official Baby-Friendly hospitals must actively assist the mother during the first few days of breastfeeding her new baby. Specifically, they are required to help Mom initiate breastfeeding with her new baby before their first hour of life is up and talk with Mom about how to continue breastfeeding when they leave the hospital.

This is accomplished through education during her hospitalization and the offering of support groups after discharge. Moms who give birth at BFHs are encouraged to breastfeed on demand, and their babies are not offered formula, sugar water, or a pacifier during the hospital stay.

Lastly, mothers are encouraged to room in with their baby, which is what has led to the rapid disappearance of baby nurseries in hospitals across the globe.

Why are mothers being encouraged to room in?

Mothers have not always been encouraged to share a room with their babies after birth. In fact, in the past, when mothers stopped giving birth at home and started choosing hospital births instead, they were expected to room separately from their infants.

Mothers were believed to get more sleep if their babies slept in a nursery at night, according to the Journal of Perinatal Education.

Since then, opinions about where babies should sleep during their first few days of life have certainly changed. Research has shown that when mothers share a room with their baby, they both benefit. When their baby is nearby, mothers are quicker to learn their hunger cues.

In general, they are also more responsive to their needs, which sets them up for breastfeeding success. Additionally, moms who room in with their baby actually get more sleep at night, according to the Cleveland Clinic.

For babies, rooming in also means getting better sleep. In general, babies who sleep near their mother are more content and experience less crying-related stress.

Additionally, being near their mother has a stabilizing effect on their body temperature, and breastfeeding on demand regulates their blood sugars.

What has been the response to these policies?

Since their implementation in 1991, the 10 standards of BFHs have received a mixed response. On one side, there are mothers and professionals who strongly believe that a fed baby is a healthy baby and that Baby-Friendly Hospitals push an agenda that puts moms and babies in danger.

For instance, an organization by the name of Fed Is Best has recently received a lot of media attention for sharing the story of one family whose child tragically starved after exclusive breastfeeding with an inadequate milk supply.

This organization, along with their supporters, believe that Baby-Friendly Hospitals and the message of “breast is best” can be harmful to young families because it fails to educate moms on the alternatives to exclusive breastfeeding and increases the stigma that exists around formula feeding.

Their research indicates that exclusively breastfed babies are at a higher risk for excessive weight loss, may experience jaundice at a higher rate, and may have developmental complications associated with hypoglycemia.

Of course, this is just one side of the story. The Baby-Friendly Hospital Initiative was not founded with the intention of isolating or shaming moms who are not able to breastfeed.

Instead it was begun to encourage increased education on the benefits of breastfeeding along with providing moms with the support they need to successfully breastfeed their baby if this is what they choose.

Since the founding of the BFHI, there has been improvement in breastfeeding rates. A 2001 survey by the journal Pediatrics found that BFHs had a breastfeeding initiation rate of 83.8 percent compared with a rate of 69.5 percent at hospitals without a Baby-Friendly designation. Most recently, a 2017 study published in the Journal of the American Medical Association Pediatrics found that BFHs have a breastfeeding initiation rate of 89 percent.

And when it comes to rooming in, not every mother wants to sleep with her baby next to her bed all night.

In fact, some mothers have reported that rooming in made their postpartum recovery more difficult and that being expected to respond on demand to each of their baby’s cries contributed to extreme exhaustion and frustration after birth, according to BMC Pregnancy and Childbirth.

Ultimately, this is a choice, and many believe it should not be mandatory. For mothers who prefer not to room in with their babies, this leaves them with one option—to find a hospital that doesn’t adhere strictly to the Baby-Friendly standards.

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