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Administrative Order

No.2007-0026
dated: July 10.2007

Revitalization of the MotherBaby Friendly Hospital Initiative


in Health Facilities with
Maternity and Newborn Care
Services

Historical Background
1992
Rooming-In and Breastfeeding Act
(RA 7600) Ten Steps to Successful
Breastfeeding, UNICEF/WHO Global
Criteria
1999
The Golden Era of Breastfeeding:
DOH certified 1,427 or 83% of
targeted hospitals and lying-in clinics

LEGAL MANDATES
1) Executive Order No 51 (Oct. 20,
1986); National Code of Marketing
of Breastmilk Substitutes, Breastmilk
Supplements and Related Products
2) Article 24 of the 1989 United
Nations Convention on the Rights
of the Child
3) RA 7600 Rooming-In and
Breastfeeding Act of 1992

4) Philippine Infant and Young


Child Feeding (IYCF) policy
as adopted from the
WHO/UNICEF 2002 Global
Strategy on IYCF
5) PHIC Circular No. 26 s. 2005
6) Administrative Order No.
2005-0023 of the DOH,
Formula One for Health

Breastfeeding Situationer
WHO estimates:

19% of under-five year old deaths can


be traced to inappropriate feeding
practices including formula feeding

In the first 2 months of life, non


breastfed
25x more likely to die from
diarrhea
4x more likely to die from
pneumonia

National Demographic Health


Survey, 2003

Infant deliveries attended by


health professionals or those
delivered in health facilities
are less likely to be breastfed

UNICEF estimates:
3,500 childrens lives could be saved
each day if all infants are exclusively
breastfed up to six months

breastfeeding prevents 13% of deaths


among children under five

6% deaths among children could be


averted by adequate, timely and
appropriate complementary feeding

University of the Philippines


Retrospective Study,
2006: Philippine MBFHI experience
in 15 regions covering 98 government
and private hospitals

92% sustained accreditation but policies


were communicated thru
orientations (59.1% )
meetings (42%)
52% with Lactation Coordinators
63% BF initiated w/in 1 hour
52% postpartum assisted
62% allowed provisions of formula
43% of personnel did not allow food or
drinks
26% of HF foster establishment of BF
support groups

2012 Coverage of EBF/IBF,


Capiz (FHSIS)
Exclusively breastfeed
infants = 82%
Initiated breastfeeding =
58%

Babies were provided nonbreastmilk for the following


reasons:

New Guidelines:

AO 2007-0026
Dated July 10, 2007

Objectives:
1. transform all health
institutions with maternity
and newborn services
government & private health
facilities.
2. build the critical capacity and
commitment of health care
staff
3. staff establish linkage

Whats new in the AO?


> Mother-Friendly Indicators
> Hospital as a Workplace
> Milk Code
> Process of Accreditation

Steps to a Mother-Friendly /
Safe Motherhood Initiative

1. Hospital shall incorporate


mother-friendly labor and
birthing practices
Clean birthing technique
Delayed cord clamping
Placenta removal &
disposal
Collaboration/ Referral

Steps to a Mother-Friendly Care

2. Train staff on essential and


emergency obstetric and
newborn care and non-drug
methods of pain relief
3. Motivate and refer pregnant
women for STD / HIV/AIDS
screening and voluntary
counseling and treatment

Steps to a Mother-Friendly Care

4. Provide the best antenatal,


delivery and postpartum care
with timely referral
5. Birthing mothers may be
offered access to a birth
companion
6. Birthing mothers may be
allowed the freedom to walk and
move about
7. Assume positions not limited to
the lithotomy position

Steps to a Mother-Friendly Care

8. avoid unnecessary
instrumentation that may inhibit
breastfeeding
9. Babies born by C/S are less likely
to
have early skin to skin contact
more likely to have nursery care
increasing the risk of cross infection
restricting breastfeeding

Steps to a Mother-Friendly Care

10. Linking the mother and baby


to appropriate community
breastfeeding support group
11. Encourage mothers to take
care of their premies, NB with
defects

Baby- Friendly
Institution.

The TEN STEPS to


successful
Breastfeeding

Ten Steps to Successful Breastfeeding

1.Develop a written
breastfeeding policy that is
routinely communicated to all
health care staf
Indicator: Implementation of
breastfeeding protocol that has
been communicated during
orientations or meetings

Ten Steps to Successful Breastfeeding

2. Training of all health care staf


in skills necessary to
implement the policy on
breastfeeding within the first 6
months upon entry into the
hospital
Indicator: Schedule of staf that
will attend in service training

Ten Steps to Successful Breastfeeding

3. Provide information to all


pregnant women/mothers
about the benefits and
management of breastfeeding
Indicator: Written, non
commercial prenatal info
Schedule of parents referred
to breastfeeding classes/
childbirth education

Ten Steps to Successful Breastfeeding

4. Assisting mothers to initiate


breastfeeding within 1 hour
after birth for NSVD, and
within 3-4 hours after CS
Indicators: Infant is placed on
the mothers chest to promote
pre feeding sequence of
behavior that leads to proper
latching and sucking

Ten Steps to Successful Breastfeeding

5. Train mothers how to


breastfeed and maintain
lactation even if they should
be separated from their
infants
Indicator: Manual expression
of milk; at least 8 times in 24
hours
Milk bank in the hospital

Ten Steps to Successful Breastfeeding

6.Give newborn infants no


food or drink other than
breast milk unless medically
indicated; educate mothers
on the importance of
exclusive breastfeeding
Indicator: No sterile water,
glucose water or milk
formula in the clinical wards

Ten Steps to Successful Breastfeeding

7. Practice rooming in to
allow mothers and infants
to remain together 24
hours of the day
Indicator: All babies are roomed
in and only pathologic babies
are placed in the NICU

Ten Steps to Successful Breastfeeding

8. Encourage breast feeding


on demand
Indicator: Mother are taught
behavioral feeding cues for
them to feed their infants on
cue for 8 to 12 times in 24
hours

Ten Steps to Successful Breastfeeding

9. Give no artificial teats or


pacifiers to breastfeeding
infants
Indicators: No artificial
nipples and pacifiers or any
feeding paraphernalia in the
wards

Ten Steps to Successful Breastfeeding

10. Foster the establishment of


breastfeeding support groups
supervised by a lactation
consultant/ staf nurse
Indicator: Organized peer
breastfeeding support groups
Documented regular
monitoring and coaching
activities

RA10028
AN ACT EXPANDING THE
PROMOTION OF BREASTFEEDING,
AMENDING FOR THE PURPOSE
REPUBLIC ACT NO. 7600,
OTHERWISE KNOWN AS AN ACT
PROVIDING INCENTIVES TO ALL
GOVERNMENT AND PRIVATE
HEALTH INSTITUTIONS WITH
ROOMING-IN AND
BREASTFEEDING PRACTICES AND
FOR OTHER PURPOSES

Sec. 2.
Declaration of Policy
The State adopts rooming-in as
a national policy to encourage,
protect and support the practice
of breastfeeding. It shall create
an environment where basic
physical, emotional, and
psychological needs of mothers
and infants are fulfilled through
the practice of rooming-in and
breastfeeding.

Sec. 4.
Applicability
The provisions in this
Chapter shall apply to all
private enterprises as well
as government agencies,
including their subdivisions
and instrumentalities, and
government-owned and
-controlled corporations.

Sec. 4.
Applicability
The provisions in this
Chapter shall apply to all
private enterprises as well
as government agencies,
including their subdivisions
and instrumentalities, and
government-owned and
-controlled corporations.

Sec. 11
Establishment of
Lactation Stations
It is hereby mandated that all health and
non-health facilities, establishments or
institutions shall establish lactation stations.

Sec. 11
Establishment of
Lactation Stations
The lactation stations shall be adequately
provided with the necessary equipment and
facilities, such as: lavatory for handwashing, unless there is an easilyaccessible lavatory nearby; refrigeration or
appropriate cooling facilities for storing
expressed breastmilk; electrical outlets for
breast pumps; a small table; comfortable
seats; and other items, the standards of
which shall be defined by the Department
of Health. The lactation station shall not be
located in the toilet.

Sec. 21
Sanctions
Any private non-health facility,
establishment and institution which
unjustifiably refuses or fails to
comply with Sections 6 and 7 of this
Act shall be imposed a fine of not
less than Fifty thousand pesos
(Php50,000.00) but not more than
Two hundred thousand pesos
(Php200,000.00) on the first
offense.

Sec. 21
Sanctions
On the second offense, a fine of not
less than Two hundred thousand pesos
(Php200,000.00) but not more than Five
hundred thousand pesos
(Php500,000.00).
On the third offense, a fine of not
less than Five hundred thousand pesos
(Php500,000.00) but not more than One
million pesos (Php1,000,000.00) and the
cancellation or revocation of the
business permits or licenses to operate.

Sec. 21
Sanctions
Heads, officials and employees of
government health and non-health
facilities, establishments and institutions
who violate this Act shall further be
subject to the following administrative
penalties:
First ofense Reprimand;
Second ofense Suspension for one (1)
to thirty (30) days; and
Third ofense Dismissal.

Thank you!