Standards of Care for the Non-Breastfeeding Mother and her Baby

All personnel within a Baby Friendly Community Initiative (BFCI) service must ensure their knowledge about artificial feeding is current. This is to ensure that all mothers are provided with clear, accurate and impartial information so that they can make an informed decision on how to feed their babies.

All services must have a written artificial feeding policy for the feeding of a breastmilk substitute. This policy is routinely communicated to all providers who have contact with pregnant women, and/or mothers and babies.

This policy must include:

  • Information for health workers and family/whanau regarding risks associated with the use of infant formula
  • The risks of formula feeding
  • The benefits of skin-to-skin contact
  • Safe preparation of infant formula
  • Safe handling and feeding of formula and sterilisation of equipment
  • Cue-based feeding with guidelines for appropriate intake
  • Rooming-in 24 hours a day and safe sleeping
  • Referral to parenting and/or well child services
  • A minimum 3 yearly review date which is clearly visible

This policy must be self-audited annually.

The policy must be reviewed by the New Zealand Breastfeeding Alliance (NZBA) once every three years.

The policy addresses the main points of the WHO International Code of Marketing of Breastmilk Substitutes and all subsequent relevant World Health Assembly (WHA) resolutions.

Level Three and Level Four Health Practitioner/Worker Education:

An education programme must be available showing the curriculum to ensure health providers have completed the standards set in the BFCI Documents for Aotearoa New Zealand, and will receive further updates (as required) to ensure competency is maintained. This education will include:

  • the risks associated with feeding a baby infant formula
  • the importance of skin-to-skin contact
  • the importance of rooming-in 24 hours a day
  • safe and unsafe sleeping practices
  • cue-based feeding with guidelines for appropriate intake
  • safe preparation and use of infant formula

A copy of the course outline for training on the support of non-breastfeeding mothers should be available for review.

Antenatal Education:

A written description of the minimal content of the antenatal education provided to the woman who is unable to breastfeed/has decided to feed her baby infant formula is available. This education will include:

  • the risks associated with feeding a baby infant formula
  • the importance of skin-to-skin contact
  • the importance of rooming-in 24 hours a day
  • cue-based feeding with guidelines for appropriate intake
  • safe preparation and use of infant formula
  • peer and parent support group contacts on discharge

All information given to these mothers must be free from advertising and comply with the Code.

All education/information offered to pregnant women (who have a medical indication for which breastfeeding is not recommended), will be available to the assessment team. This material, for use in the antenatal period, must include:

  • the importance of breastfeeding
  • the risks and financial costs of using artificial baby milk
  • compliance with the Code
  • the criteria stipulated in the BFCI Documents for Aotearoa New Zealand

BFCI Assessment of Non-breastfeeding mothers:

Documentation of the care for the non-breastfeeding mother and her baby will be available for review by the BFCI Assessors at the time of audit.

A review of documentation indicates that printed information is discussed and distributed to mothers on an individual basis as set in the criteria of the BFCI Documents for Aotearoa New Zealand.

All information offered to these women must be available and BFCI Assessors will interview non-breastfeeding and partially breastfeeding mothers.

To pass the BFCI standards of care for the non-breastfeeding mother and her baby the service must show compliance of all applicable questions relating to the above criteria.