The First 100 Hours© : A Refreshing Idea in Breastfeeding

A refreshing idea has arrived: The First 100 Hours©, a completely new concept in empowering new mothers and ensuring their babies experience a healthy transition to the world.  Developed by an International Board-Certified Lactation Consultant, this teaching program is specifically designed to educate and instill trust in the process of breastfeeding.

Why 100 hours? It’s simple: if a mother breastfeeds or feeds breastmilk to her baby for the first 4 days or so, both she and the baby experience the most optimal health outcomes possible.  By the time a baby is 100 hours old, breastfeeding and milk supply are generally well-established OR potential obstacles to exclusive breastfeeding have been identified.  If a mother is being supported through The First 100 Hours© program, and she chooses to continue breastfeeding or feeding expressed breastmilk beyond 100 hours, she will have received the support, assistance, and education she needs to continue for as long as she likes.  If that same mother opts to wean after 100 hours, she knows she has provided her baby an unparalleled immune system boost.

The concept of The First 100 Hours© originated, naturally, in the middle of the night, with some recent experiences helping new mothers really fresh in my mind.  It seemed like forces were conspiring against them to prevent them from exclusively breastfeeding, and their babies were less than 4 days old!  Their milk supplies were in the earliest stages of increasing.  They were in the throes of early postpartum recovery, with all its attendant discomforts, swelling, and hormonal roller coasters.  Their brains were working overtime trying to process the conflicting advice and outright encouragement to use formula. Mothers who had read, prepared, decided, committed themselves to the process of breastfeeding were experiencing a lack of breastfeeding support and observing a fundamental distrust in the process of breastfeeding from their families, friends, and even the healthcare staff assisting them.  Nothing new to me; I see those things every day in my work as a hospital-based IBCLC; various ideas have tossed around in my brain for all the time I have helped moms and babies.

But providing breastfeeding support isn't only my job.  I did it before I got paid to do it, I do it when I'm not on the clock, and I will do it long after I retire from active employment.  It is my mission, the reason God led me down the path He did.  It never leaves my mind (ask any of my friends or family :)  I believe that because this work is a calling, it remains active in my brain and my consciousness at all times in a way that allows for new ideas and thought processes to generate.

Restoring faith in the process of breastfeeding is the ultimate objective of The First 100 Hours© program. The First 100 Hours© is a broad teaching concept with tools for everyone with the potential for influence on a mother and baby, beginning with the expectant mother and following through her baby’s breastfeeding experience until the time mother and baby choose for natural weaning.

• The First 100 Hours© Parent Education Component is crucial to the long-term success of the program because mothers are being prepared to extend the appropriate level of commitment required to achieve 100 hours of breastmilk feeding.

• The First 100 Hours© Clinical Care Provider Component is crucial to the immediate success of the program because it provides

  

  immediate enhancement of breastfeeding support skills to its adopters, paving the path for increased adoption of the concepts by ever-widening circles of care providers

• The First 100 Hours© Community Education Project is crucial to the speed at which the concept is adopted throughout a community.

The First 100 Hours© Concept

Rare is the new mother in 2013 who innately trusts her body’s ability to produce and nourish fully her newborn infant, for reasons too numerous to list here.  The experienced mother may also have considerable doubts based on past attempts and poor information provided with previous babies.  The health care team has the ethical and moral responsibility to provide care which reflects an unswerving faith and trust in the process of breastfeeding, and which accommodates that trust by practicing care that supports it.

• The First 100 Hours© are the cornerstone of breastfeeding success

• Supplementation of breastfeeding means “feed more milk,” not “give formula”

• Trust in the process of breastfeeding

• Maintain or restore instinctive feeding behaviors

• Formula is only for times when enough extra milk cannot be expressed

• Pumping is for the future, hand expression is for today

• Babies can only breastfeed when they are close to the breast

• The objective of neonatal intensive care is to return a healthy baby to its parents’ full-time care as quickly as possible

• Not all mothers and babies need specialized lactation care

• Any mother who asks for specialized lactation care should have access to it in a timely manner, no matter what her reason for asking

• Any breastfeeding mother who has fed formula during The First 100 Hours© should have access to and encouragement to receive specialized lactation care

• Utilizing The First 100 Hours© will reduce the number of mothers and babies requiring specialized lactation care

• Utilizing The First 100 Hours© will reduce the number of babies receiving truly unnecessary formula supplementation

• Utilizing The First 100 Hours© does not guarantee that a mother will not feed her baby formula, but it ensures that she will recognize that early formula supplementation sets in motion a chain of risk factors for which she may need reinforcement of education, assistance, and/or intervention by specialized lactation care providers

• Utilizing The First 100 Hours© does not guarantee that a mother will not feed her baby formula, but it does ensure that proper intervention can be taken to restore the mother’s ability and confidence in breastfeeding for long-term success

• The First 100 Hours© is designed to specifically address common obstacles mothers and babies encounter in the hospital and at the first pediatrician follow-up appointment

• The First 100 Hours© is a broad teaching concept with tools for everyone with the potential for influence on a mother and baby, beginning with the expectant mother and following through her baby’s breastfeeding experience until the time mother and baby choose for natural weaning

• When everyone on the hospital care team for a mother and baby pair have solid basic breastfeeding management knowledge and clinical competency with breastfeeding care skills (i.e. assisting with latch, hand expression, assessment of lactation risk factors, etc.) specialized lactation care can be reserved for mothers and babies at high risk of lactation problems

• When everyone on the hospital care team for a mother and baby pair have excellent breastfeeding support skills, achieving and maintaining Baby-Friendly status is facilitated - it’s a natural fit for the Baby-Friendly process because it was designed by people involved in the Baby-Friendly journey

• The First 100 Hours© program includes dedicated tools for multiple groups of specific healthcare providers (i.e. nurses, pediatricians, neonatalogists, etc.) as well as specific navigation tools for potential obstacles (i.e.jaundice, weight loss, NICU admission, etc.) and a prenatal educational component built for parents to assist them in recognizing appropriate expectations for breastfeeding in the early postpartum period and beyond

Objective

Create an efficient, effective teaching tool to combine multiple elements of postpartum teaching in a cohesive manner.

Goals

To increase the rate of mothers breastfeeding their newborns exclusively, to increase the duration of mothers breastfeeding their infants, and to decrease the rate of non-medically necessary formula supplementation in the hospital and beyond.

Solution

An overarching concept called The First 100 Hours© to encompass multiple facets of newborn behavior and needs in a simple, comprehensive educational package.

Details

The First 100 Hours© concept is a coordinated combination of teaching instruments designed to accomplish the following:

• Establish appropriate expectations for new parents at the time of their baby's birth

• Allow for educational intervention at critical points during the hospital stay and beyond

• Provide consistent, evidence-based information to parents

• Use similar phrasing throughout to facilitate continuity of care among multiple caregivers

• Recognize and address risk factors for early weaning before they interfere with successful breastfeeding

Your comments and feedback are very much appreciated!

Christine Staricka, IBCLC, CCE    April 2013[polldaddy poll=7011800]