The Gift

The Gift

  • Breastfeeding mother with child in hospital
  • Breastfeeding mom with nurse

Tools & Resources

Useful tools and resources to help you implement the Ten Steps:

Resources for implementing Step 1:

Step 1: Have a written breastfeeding policy that is routinely communicated to all health care staff.

All policies or protocols related to breastfeeding and infant feeding should be based on current evidence-based standards.  Facilities can use the following model policies as a guide.

Below are links to model hospital breastfeeding policies, protocols and helpful toolkits:

Below are links to workplace lactation/breastfeeding support model policies and resources:

Resources for implementing Step 2:

Step 2: Train all health care staff in the skills necessary to implement this policy.

Education guidelines of the Baby-Friendly Hospital Initiative should be followed when facilities are developing breastfeeding education for staff.  The following documents and resources can be used as a guide to develop breastfeeding training for staff.

The Gift Program has made the innovative online and offline Coffective Training availalbe to participating hospitals and also sponsors community trainings for Louisiana birthing facilities and community partners.  These trainings count towards the training requirements for Gift designation.

Below are links to other online training/education:

Below are links to other toolkits and offline training tools:

Resources for implementing Step 3:

Step 3: Inform all pregnant women about the benefits and management of breastfeeding.

This step assures that consistent prenatal breastfeeding messages are included in all aspects of prenatal care.

Facilities are encouraged to provide prenatal breastfeeding education courses and work with their prenatal health-care providers to recommend attendance in these community classes. Local WIC agencies and other community breastfeeding resource organizations can be invited to provide education if the facility has limited staff.

Prenatal education topics that should be covered include: the benefits of breastfeeding, the importance of exclusive breastfeeding, basics of breastfeeding management, possible effect of analgesia/ anesthesia on infant behavior, rationale for care practices such as skin-to-skin contact, rooming-in, and infant feeding cues.

All materials and education should be presented without messages promoting artificial feeding or sponsorship.

The Gift has made the Coffective System of Tools available to participating hospitals. These tools help hospitals deliver consitent evidence-based information about breastfeeding and maternity care practices, as well as facilitate continuity of care. 

Below are links to additional patient-related resources for providers on breastfeeding:

Below are links to patient education resources on breastfeeding:

Resources for implementing Step 4:

Step 4: Help mothers initiate breastfeeding within one hour of birth.

Place babies in skin-to-skin contact with their mothers immediately following birth for at least an hour and encourage mothers to recognize when their babies are ready to breastfeed, offering help if needed.

Below are links to resources on skin-to-skin care and breastfeeding initiation:

Resources for implementing Step 5:

Step 5: Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.

A mother should be assessed within six hours after her delivery and once per shift throughout her stay. Infant feeding cues; correct latch and position; hand-expression and pumping; safe preparation, handling, and storage of infant formula for the non-breastfeeding mother; and signs of satiety and output are topics for breastfeeding reinforcement.

Below are links to resources to assist staff with showing mothers how to breastfeed and maintain lactation:

Resources for implementing Step 6:

Step 6: Give infants no food or drink other than breast-milk, unless medically indicated.

Healthy babies should not be routinely supplemented with any food or drink other than human milk unless medical indications for supplementation exist. In addition, parents should be protected from the marketing of breastmilk substitutes.

For mothers who have made the informed decision to provide breastmilk substitutes for their infants, separate education should be provided to them which discusses the risks of using this form of supplementation, how to properly prepare/bottle feed their infant, and newborn stomach capacity.

Below are links to resources to help ensure infants only receive breast milk:

​Below are links to resources on breastmilk substitutes for patient and staff education:

Resources for implementing Step 7:

Step 7: Practice rooming in - allow mothers and infants to remain together 24 hours a day.

Rooming-in should be practiced by all mothers regardless of feeding method to ensure that ample opportunities are available for skin-to-skin contact and early learning of infant feeding cues.  Healthy mothers and infants should not be separated during their stay, with the exception of no more than one hour a day to allow for any medically necessary procedures that cannot be conducted at the bedside.

A mother who requests to be separated from her infant should receive counseling on the importance and benefits to rooming-in, and staff should explore reasons for the request and provide solutions.  

Below are links to resources related to rooming-in:

Resources for implementing Step 8:

Step 8: Encourage breastfeeding on demand. Teach mothers cue-based feeding regardless of feeding method.

Mothers and their families should be educated about infant feeding cues and normal infant transitional behavior. They should be supported and provided unlimited opportunities to respond to infant feeding cues.

Below are patient education resources on cue based feeding:

Resources for implementing Step 9:

Step 9: Give no pacifiers or artificial nipples to breastfeeding infants.

Health-care providers should not offer healthy, breastfed infants pacifiers or artificial nipples.  Supplementation, when required, should be offered using alternative measures such as a cup, tube or syringe.

Below are resources to help staff with this step:

Below is a patient education resource:

Resources for implementing Step 10:

Step 10: Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or birth center.

Discharge support and follow-up for breastfeeding mothers is imperative to their success in breastfeeding duration and exclusivity. Refer all mothers to the appropriate resources and be aware of the community resources available prior to discharge. Individual care plans should be developed by the health-care team to guide the mother to continued success and achievement of her goals.

Parents /new mothers should be referred to to find local breastfeeding support.  In additon, Louisiana hospitals can provide mothers with the hospital's custom We're Prepared Checklist.  The back of the We're Prepared Checklist provides numbers and websites to breastfeeding support services as well as WIC and home visiting. 

Below are links to resources for the facility to use with patients:

Below are resources on milk banking:

Below are links to patient breastfeeding support resources:

Other Resources and General Information:

Baby-Friendly Hospital Initiative Resources
Perinatal/Lactation Consultant Staffing Recommendations

Content on this page was adapted from the Texas Ten Step Program.