ND Breastfeeding-Friendly
Application for Designation

Type of application*
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Hospital/Birthing Center Award Designation Requirements:

  1. Complete a minimum of a two-hour staff training for breastfeeding offered by the North Dakota Department of Health or an equivalent program.
  2. Organize an interdisciplinary team to support and implement the 5 steps and assess lactation services.
  3. Implement all 5 steps required for North Dakota Breastfeeding-Friendly designation with consideration for social and cultural diversity.
  4. Complete a program evaluation in coordination with the N.D. Department of Health to measure implementation of the 5 steps.

Assessment Procedure: a facility report will be submitted within one year of application acceptance or early upon request.

Criterial for Evaluation of N.D. Breastfeeding-Friendly Steps:

  1. Train all health care staff in skills necessary in implement breastfeeding policy
    1. Report interdisciplinary team members and designated person responsible for implementation of the breastfeeding program
    2. Report that all employees working with mother-baby dyads receive education/training related to breastfeeding policies
    3. Report staff breastfeeding training: date, duration, number of staff working directly with mother-baby dyads in attendance (minimum of 60%), presentation topic
    4. Report percentage of new employees who receive breastfeeding training within 6 months of hire
  2. Inform all pregnant women about the benefits and management of breastfeeding
    1. Report prenatal partners or prenatal/childbirth classes offering evidence-based information about the benefits of breastfeeding and breast milk feeding, along with recommended duration of exclusive breastfeeding
    2. Report how breastfeeding mothers are informed about the basic management of breastfeeding prior to discharge
  3. Help mothers initiate breastfeeding within one hour of birth
    1. Estimate the percentage of healthy newborns who are placed skin-to-skin immediately (or within 5 minutes of birth) following a vaginal delivery with a stable mother-baby dyad
    2. Estimate the percentage of healthy newborns placed skin-to-skin following C-section delivery as soon as the mother is alert and responsive to her baby
  4. Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infant
    1. Estimate the percentage of new breastfeeding mothers who are provided education on the following topics
      1. Skin-to-skin prior to beginning feeding
      2. Feeding cues
      3. Proper position and latch-on
      4. 8-12 feedings or about every 2-3 hours is expected
      5. Exclusive breastfeeding is recommended for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant
      6. Give no supplements unless medically indicated
      7. Avoid artificial nipples until breastfeeding is established (3-4 weeks of age)
      8. Maintenance of lactation if separated from infant
      9. Measure/assess elimination pattern (stools and urine output)
      10. Reasons for contacting a health care professional
  5. Give infants no food or drink other than breast milk, unless medically indicated
    1. Report staff do not offer supplements to breastfeeding infants unless medically indicated or by mother's informed, documented request
    2. Report method of delivery (spoon, cup, syringe, etc.) of supplements to breastfeeding infants when medically indicated
    3. Estimate the percentage of breastfeeding infants who receive supplements
    4. Report the charting rate for contraindication(s) for breastfeeding when applicable

Alternate route to North Dakota Breastfeeding-Friendly designation

Date of designation

Upon award of the North Dakota Breastfeeding-Friendly Designation, the facility will be reviewed every three years to maintain their status.

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Both babies and mothers gain many benefits from breastfeeding

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