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

“TenSteps to Successful Breastfeeding” were installed along the corridor floors ofthe Labor and Delivery and Maternity Units at the Hospital, making it literallyand figuratively a “low” tech, yet clear and readily accessible public healthmessaging campaign. Funded by a state grant, the graphics create a visually funpathway of footprints through the units. 10-steps-to-Successful-BreastfeedingEach pathway is comprised of ten setsof 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 Stepsas 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, gynecologicaland maternity care, Pennsylvania Hospital– the nation’s first hospital, where the most babies are delivered annuallyin the City of Philadelphia – is already recognized as an exemplary “breastfeedingfriendly employer.”  This past summer, the hospital, along withthe Hospital of the University ofPennsylvania,was also selected to participate in Best Fed Beginnings a first-of-its-kind national effort to significantlyimprove breastfeeding rates in US where rates are currently the lowest.

The participating hospitals are workingtogether in a 22-month learning collaborative, using proven quality improvementmethods to transform their maternity care services in pursuit of a"Baby-Friendly" designation. This designation will verify that ahospital has comprehensively implemented the American Academy ofPediatrics-endorsed Ten Steps to Successful Breastfeeding. Compared to nationalaverages, breastfeeding rates are higher and disparities in these rates arevirtually eliminated in hospitals that achieve the Baby-Friendly status.

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

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