Booby Traps Series: Big hospitals to be evaluated on exclusive breastfeeding rates by the Joint Commission

This post is the 65th in a series on Booby Traps, made possible by the generous support of Motherlove Herbal Company.

Here’s a big piece of news in the fight against Booby Traps:  The Joint Commission will now require larger hospitals to use exclusive breastfeeding as a core measure of performance.

Wait, wake up!  I know this news is a little boring-sounding, but it’s a big deal and I’ll try to make my explanation as colorful as possible.  Upcoming words include:  panic, fear, and topless.

The Joint Commission (formerly JCAHO) accredits and certifies thousands of hospitals.  A hospital that loses its accreditation can lose its state license to operate and ability to collect Medicaid reimbursement, so they inspire a lot of fear and panic among hospital staff.  As I wrote last year:

I’ve worked in two hospitals providing breastfeeding support, and I can tell you that no two words invoke more fear among hospital staff than “Joint Commission.”

I attended a training in advance of a Joint Commission visit, and one of the directions the hospital gave was (I’m not making this up), “If you see a Joint Commission representative do not run away.”

I did in fact run into two Joint Commission representatives when I was working in one hospital.  To the mild embarrassment of some half-topless moms, they walked into the outpatient breastfeeding clinic I was running, looking for information about post-discharge breastfeeding rates.  They had been impressed with the in-hospital rate (which is a little funny since in a community like mine initiation has a lot more to do with demographics than anything else, but I was happy that they were interested in breastfeeding at all) and wanted to know if the high rates persisted in the community.

But this line of questioning was strictly voluntary.  This was a number of years ago, and there was no requirement that they explore breastfeeding outcomes.

A few years ago the Joint Commission announced that exclusive breastfeeding would be a measure hospitals would be evaluated on – but this was voluntary.  Hospitals could choose to be evaluated on it or not.

On November 30th, the Commission announced that it would be mandating the use of exclusive breastfeeding as a measure in larger hospitals starting in 2014.

This, as the Massachusetts Breastfeeding Coalition points out, is quite significant, as “research from the Centers for Disease Control and Prevention has consistently shown that giving formula without a medical reason is one of the biggest predictors of early termination of breastfeeding.”  And because 4 out of 5 hospitals report that they supplement babies for no medical reason, this will give hospitals a powerful incentive to change their practices.

So, this is great news.  I hope it paves the way for the use of this measure at all hospitals.  And that’s something worth staying awake for, right?

5 thoughts on “Booby Traps Series: Big hospitals to be evaluated on exclusive breastfeeding rates by the Joint Commission

  1. It is very exciting that health care is finally embracing the incredible nature and benefits of breast feeding. I am a Pediatrican & new Mom working towards my IBCLC, but I don’t think that striking “fear” or “panic” into hospitals is an accomplishment . I know for all of us on the health care side it’s a huge step to have official “rules” in place to help us provide the needed education, but in the long run it may work against us. The bigger focus should be on the acomplishment of teaching/educating medical professionals to WANT to provide the support and information to encourage breast feeding.Following a bunch of guidelines is not the same as true support for moms with such a huge range of breast feeding obsticals. I think most pro- breast feeding professionals & moms realize that the struggle is all about education and the amount of support every mom needs in hospital and even more once they are home. It’s definitely a step forward!


    1. Jenny,

      Just to clarify, the fear and panic refers to the power the Joint Commission (and specifically a visit) holds, not to the requirement to track exclusive breastfeeding rates. There are undoubtedly many like yourself who see the importance and welcome the challenge and accountability!



  2. So hospitals will be held accountable for whether women continue to breastfeeding after they leave? For how long? And how does that seem fair to healthcare providers.

    (In the interest of full disclosure – I do not work at a hospital, my third child is 2 mos old and none of them ever had formula, and I believe more needs to be done to raise the rates of breastfeeding).


    1. Nope, just in the hospital. See the prior post I linked to for more information on the problem with in-hospital supplementation.


  3. Now, what I would like to see then, is extended paid maternity leave so mothers can breastfeed more easily, effectively, and longer. I have nursed 1 of my children to age 2 because I was able to stay home and not work (unpaid of course). With my others it was a struggle to make it to age 1 because pumping can be so much work – and interfere with work. If moms were able to have paid extended maternity leave, we would all come away healthier and happier!


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