Promoting and supporting breastfeeding during the postpartum period has been an important and appropriate priority for maternity units in recent years. The Ten Steps to Successful Breastfeeding of the Baby-Friendly Hospital Initiative have been implemented by an increasing number of hospitals as the standard of care for optimally supporting breastfeeding from birth to hospital discharge.1 As some or all of these steps are increasingly being promoted as standard of care by government agencies (eg, the Centers for Disease Control and Prevention) and by The Joint Commission, it is important to be certain that the basis for the recommendations has been documented in reproducible scientific studies and that the benefits of the practices recommended outweigh the risks. Unfortunately, there is now emerging evidence that full compliance with the 10 steps of the initiative may inadvertently be promoting potentially hazardous practices and/or having counterproductive outcomes.
Bass JL, Gartley T, Kleinman R. Unintended Consequences of Current Breastfeeding Initiatives. JAMA Pediatr. 2016;170(10):923-924. doi:10.1001/jamapediatrics.2016.1529