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Breaking through the Communications Clutter with “Ten Steps to Successful Breastfeeding”

Ten-step-ribbon-cuttingIn an effort to cut through the constant communications clutter – websites, e-newsletters, targeted text messages and mailings, plus a plethora of pregnancy and parenting magazines – that bombards women during pregnancy and during early motherhood, Pennsylvania Hospital is taking a fresh approach to help educate and inform staff and expectant mothers about the process and benefits of successful breast feeding. 

“Ten Steps to Successful Breastfeeding” were installed along the corridor floors of the Labor and Delivery and Maternity Units at the Hospital, making it literally and figuratively a “low” tech, yet clear and readily accessible public health messaging campaign. Funded by a state grant, the graphics create a visually fun pathway of footprints through the units. 10-steps-to-Successful-BreastfeedingEach pathway is comprised of ten sets of footprints. Each individual footprint is dedicated to one of the ten steps – in English on the left and Spanish on the right.

The formal Ten Steps as established by the United Nations Children’s Fund (UNICEF) and the World Health Organization Baby-Friendly Hospital Initiative are:


Have a written breastfeeding policy that is routinely communicated to all health care staff.

2 )

Train all health care staff in skills necessary to implement this policy.

3 )

Inform all pregnant women about the benefits and management of breastfeeding.

4 )

Help mothers initiate breastfeeding within one hour of birth.

5 )

Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.

6 )

Give newborn infants no food or drink other than breast milk, unless medically indicated.

7 )

Practice “rooming in”-- allow mothers and infants to remain together 24 hours a day while in the hospital.

8 )

Encourage breastfeeding on demand.

9 )

Give no pacifiers or artificial nipples to breastfeeding infants.


Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic

Long known for obstetrical, gynecological and maternity care, Pennsylvania Hospital – the nation’s first hospital, where the most babies are delivered annually in the City of Philadelphia – is already recognized as an exemplary “breastfeeding friendly employer.”  This past summer, the hospital, along with the Hospital of the University of Pennsylvania, was also selected to participate in Best Fed Beginnings a first-of-its-kind national effort to significantly improve breastfeeding rates in US where rates are currently the lowest.

The participating hospitals are working together in a 22-month learning collaborative, using proven quality improvement methods to transform their maternity care services in pursuit of a "Baby-Friendly" designation. This designation will verify that a hospital has comprehensively implemented the American Academy of Pediatrics-endorsed Ten Steps to Successful Breastfeeding. Compared to national averages, breastfeeding rates are higher and disparities in these rates are virtually eliminated in hospitals that achieve the Baby-Friendly status.

“With the installation of Ten Steps, we kicked off our official baby-friendly journey to help significantly improve breastfeeding rates in the Philadelphia region,” said Debi Ferrarello, RN, MS, IBCLC, Director of Family Education. “At Pennsylvania Hospital we understand how a mother’s experience during her stay with us can strongly influence her ability to start and continue breastfeeding. We are committed to implementing evidence-based care through the Baby-Friendly designation process. This way we will ensure that mothers delivering in our hospital who want to breastfeed are fully supported. In the same respect, we’ll also ensure that mothers who are having difficulty or unable to breastfeed are also fully supported.”

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