Many of my clients tell me that they want their breastfeeding policy to conform to the requirements set forth by Baby-Friendly USA. But conforming to Baby-Friendly’s requirement, while necessary, is not sufficient. Your policy must also be functional!
To be functional, a policy — about breastfeeding or anything else — must establish clear expectations for practice, and it must provide a basis for rewarding an employee when those expectations are met, and reprimanding them when they are not.
After all, the word policy comes from the same root as the word “police.” Hence, the policy is more akin to a law than a suggestion. Your wording must be clear. Here are 4 tips to help you avoid unclear, impotent, or inappropriate words and make sure your policy is functional.
1. Use strong words in your policy
Choose words such as “shall”, “must,” “require,” “prohibit,” “forbid” “will,” “ban,” and “allow.” Weak words, such as “may,” “can,” and “preferably” leave loopholes for interpretation (and hence, care-giving), add to confusion, and render your policy impotent.
Here are examples of strongly-worded statements that leave no loopholes.
- Patient education materials with formula company logos are forbidden.
- Formula must be purchased at a fair market price.
- Use of pacifiers, unless medically indicated, is prohibited.
Without strong words, the policy is so weak that its implementation cannot be measured, analyzed, improved, or controlled. And, people who want to resist the policy will find loopholes.
2. Use precise, objective, clear words or phrases
Above, I advised against using weak words for what to do. Now, it’s time to consider weak, vague, imprecise, or subjective terms or phrases that indicate when or how to do those actions.
- as soon as possible
- as soon as feasible
- quickly
- everything possible
- soon after
- within reason
- if reasonable
- if needed (as in, “give supplement, if needed”)
- when appropriate
- permits (as in, “when condition permits”)
- good (as in a “good” feeding)
- little (as in “give a little formula”)
- late (as in “a late start”)
- short (as in, “a short feeding”)
- extended (as in, “an extended time of separation”)
- better (as in, until a baby gets a “better” latch)
- appropriate (as in, “appropriate” weight gains)
These vague phrases are open to multiple interpretations, and they are essentially useless for a functional hospital breastfeeding policy. Think about it. What might be “reasonable” to one person, is “unreasonable to another.” Instead, use words that precisely convey exactly what you mean. Instead of “extended amounts of separation,” specify the maximum number of minutes for separation. Instead of “rooming-in,” specify “24-hour rooming in,” and so forth.
3. Consider creating a section for definitions
Few hospital policies have a section for definitions, even though this can go a long way toward eliminating confusion about what specific terms mean.
Does everyone understand what “supplement” means? Do YOU understand what that word means? Does supplement mean formula, or donor milk, or the mother’s own milk? (Hint: to be consistent with the World Health Organization, use the word supplement to mean something other than the mother’s own milk.)
Yesterday, I saw a hospital’s policy that mentioned DHM. Seriously. Do you think an RN who just joined your unit yesterday knows what DHM is? No? Okay, then, spell out donor human milk, and put DHM in parentheses. Define it as milk from a HMBANA-regulated donor milk bank, to distinguish it from community “donor” milk.
4. Avoid inappropriate words
Some words simply have no place in a policy! It’s entirely possible that inappropriate words will creep into your initial draft, but you will need to edit them out before your final draft. Here are examples of words or phrases that are inappropriate in your policy:
- weak words, as listed above
- words or phrases that are not policy-related. Including a phrase on how to wash the pump parts is entirely inappropriate for a policy
- words that contradict the World Health Organization’s directive for a Baby-Friendly Hospital. “Baby must breastfeed within the first hour of life” is not required, and has no place in your functional policy.
- brand names. I often see “Supplemental Nursing System” or “SNS” in a hospital policy. That’s a brand name. Instead, say “Nursing Supplementer”
A policy that does not have clear directives will suffer from an inability to enforce it, or to measure its success. Using strong, clear, precise terms isn’t difficult. The committee that writes the policy needs to be aware of the pitfalls that can make their policy impotent.
Weak language and inappropriate words can trip us up not only with policy-writing but, before that, in everyday practice. What’s one step that you can take to make sure that your policy doesn’t suffer from weak language to be a functional policy?
For other posts about hospital policy, and the Baby-Friendly process, click here.