Thursday, November 08, 2007

Important information for accountants about UNICEF Baby Friendly Initiative

Is your local maternity hospital saving money or wasting it? It all comes down to whether it is providing support for breastfeeding or not.

Yesterday I learned of a study that shows the cost benefits. I was speaking at the Annual General Meeting of the Breastfeeding Network, an inspiring UK mother support group, whose trained counsellors provide support to mothers and operate a 24 hours helpline. They were celebrating 10 years of abiding by the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly. I'll explain what that means at the end of this blog.

My presentation was about the Code and Resolutions and the current UK law campaign. I ran through some of the economic benefits of protecting, promoting and supporting breastfeeding. In the course of the discussion, I learned of an important cost analysis conduced by the National Institute for Clinical Excellence (NICE) on "Postnatal care: Routine postnatal care of women and their babies". You can find a comprehensive set of documents setting out best practice guidance for health workers, information on what to expect for parents and cost analysis for those holding the purse strings. See:

I'll say a bit more about the best practice guidance tomorrow, but a key recommendation is to implement the practices in UNICEF's Baby Friendly Hospital Initiative as a minimum standard. This involves 9 steps in hospital and a further step of community support from peer support groups, such as the Breastfeeding Network.

There are just 52 out of 317 maternity hospitals in the UK which are accredited as Baby Friendly. The scheme began in 1992 and the UK Government has voiced its support for initiatives such as the Innocenti Declaration which call for the scheme to be promoted.

The NICE analysis considers national savings and the local savings for an "’average‘ maternity unit with 220 staff members and an average number of births per year of 2,534." See page 31 of the document available by clicking here:

Nationally the Government - and tax payers - could save over a million pounds per year after initial investment in training and resources to make all hospitals Baby Friendly.

If such a hospital is already accredited, it will be saving £23,436 per year in expected increases in breastfeeding rates. Increased rates mean fewer sick infants and so less expenditure on treatment as well as saving on the cost of providing formula and equipment. Even after extra spending to support breastfeeding, there would be a net saving of around £9,000 per year. Extra expenditure covers:
  • UNICEF BFI fees for work planning and assessment
  • training costs, and
  • employment costs for a breastfeeding coordinator.
If a hospital has not yet started the training programme for staff it will take three years before cost savings kick in at high enough level to counter expenditure, which decreases over time.

So it takes a longer-term view from the accountants to support the up-front expenditure. But after three years the budget will benefit as well as mothers and babies.

You can find out the status of your local hospital and more about Baby Friendly at:

Making a hospital Baby Friendly also benefits mothers and babies who use formula. UNICEF produces materials on how to reduce risks from formula providing information that companies fail to give on their labels. For further details see my blog:

Now, what does it mean to say the Breastfeeding Network is complying with the International Code and Resolutions? It means ensuring that information provided to parents is accurate and independent and avoiding conflicts of interest with regard to sponsorship. The Breastfeeding Network, like Baby Milk Action and our partners in the International Baby Food Action Network (IBFAN), refuses funding from companies with an interest in infant feeding, including breastpump companies. This is not an issue of whether such products are needed, but about the importance of giving and being seen to give impartial advice.

We have a great resource for health workers on how to comply with the Code and Resolutions. Find it here:

No comments: