Lactation Space Design: Supporting Evidence-Based Practice and the Baby-Friendly Hospital Initiative

Many studies support the philosophy that breast-feeding is the best nutritional option for babies.  There is a strong movement to go back to breast-feeding newborn children for their first six months of life because it has been shown that breast-feeding helps reduce the rate of illness for both mother and child.  One study done by Simkin showed that infants fed breast milk exclusively for their first three months of life were nine times less likely to be hospitalized for infection.  Dr. Melissa Bartlick from Harvard Medical School considers breast-feeding a public health issue, and AAP studies show that “the lives of nearly nine hundred babies would be saved each year, along with billions of dollars, if ninety percent of U.S. women fed their babies breast milk only for the first six months of life.” (Tanner, pg. 1). Decreased infection rates means a decrease in preventable hospital-associated infections with NICU infants and decreased hospital costs.  A few of the organizations/people that support this position include the Centers for Disease Control, the American Academy of Pediatrics, the American Dietetic Association, and the U.S. Surgeon General.

To meet these breast-feeding needs, the Baby-Friendly Hospital Initiative (sponsored by the World Health Organization and the United Nations Children’s Fund) was launched globally to promote the facilitation of breast-feeding stations in healthcare facilities.  BFHI outlines a Ten Steps to Successful Breast-feeding for Hospitals guideline to follow.  Some states within the United States have also adopted guidelines for the design and construction of healthcare facilities that require lactation support spaces adjacent to the NICU or nursery.  The lost opportunity here, however, is in understanding how conscientious design helps facilitate health benefits if incorporated into lactation spaces.

A lactating mother is encouraged to do so in a quiet, relaxing, and warm environment while sipping liquids and listening to relaxing music and viewing pictures of babies that will stimulate milk flow. While in the room, the mother may directly breast-feed or express breast milk (by using a pump and storing for bottle feeding).  A well-designed lactation room can make a new mother more comfortable to adopt breast-feeding practices.  Lactation consultants play an important role in education and guiding mothers through this process before delivery and even well after discharge from the hospital. 

Most hospitals will pair mothers with an in-house lactation consultant right away, encouraging mothers to start breast-feeding within one hour of delivery and helping them through the often stressful and painful process of breast-feeding.  According to Sonya Brown, an international board-certified lactation consultant, the ideal lactation suite would consist of two parts: an office for consultations and a private lactation room for outpatient mothers (inpatient mothers are consulted in their hospital rooms).  The space should be large enough to accommodate all the hospital-grade equipment needed to support their lactation consultations. A reference library with all needed educational materials should also be available.

This paper reviews the recommendations made by the BFHI Ten Steps to Successful Breast-feeding for Hospitals guidelines.