The benefits of breastfeeding are well established and medical authorities agree breastfeeding is the optimal way to feed an infant. Birth facility policies and practices significantly impact whether women choose to breastfeed and how successful they are in reaching their infant feeding goals. The U.S. Surgeon General’s 2011 Call to Action to Support Breastfeeding cited hospital practices as a leading barrier to successful breastfeeding.

Missouri "Show-Me 5" Hospital Initiative

Taking the First Steps to Being Baby Friendly

Evidence-based maternity care practices are shown to support breastfeeding initiation and duration. Adherence to the Ten Steps to Successful Breastfeeding of the Baby Friendly Hospital Initiative is associated with increased breastfeeding rates around the world. While Missouri hospitals should strive to achieve all ten steps, research shows that adopting the five (5) steps of the Missouri “Show-Me 5” Hospital Initiative will assist mothers in meeting their feeding goals, and may offer an effective path to an incremental adoption of evidence-based maternity care practices.Show-Me 5 Hospital Logo

The Missouri “Show-Me 5” hospital practices are:

  1. Help mothers initiate breastfeeding within the first hour of birth.
  2. Practice “rooming-in”, allowing infants to stay in the same room as their mothers.
  3. Give infants no food or drink other than breast milk, unless medically indicated.
  4. Do not give pacifiers or artificial nipples to breastfeeding infants.
  5. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge.

The Guidelines and Evaluation Criteria provides specific information on each of the Missouri “Show-Me 5” hospital practices and how to evaluate that a birthing facility meets the criteria. The Self-Appraisal Tool is used for birthing facilities to review current maternity care policies and practices in optimal feeding and help assess where their facility is in the process.

Missouri “Show-Me 5” Hospitals

* Hospital has also completed the Ten Steps to Successful Breastfeeding through the Baby Friendly Hospital Initiative.

Facilities ready to apply should complete the Application for the Missouri “Show-Me 5” Hospital Initiative and send to the contact on the application. If you have questions or would like a printed copy of the Missouri “Show-Me 5” Resource Kit, please contact Lisa Schlientz, State Breastfeeding Coordinator, at or by phone at 573-751-6468.