The Baby-Friendly Hospital Initiative (BFHI) is a global effort initiated by World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) to encourage health facilities worldwide to better support practices that protect, promote, and sustain breastfeeding. It was launched in 1991 in response to the Innocenti Declaration and with the aim of implementing the International Code of Marketing of Breast-Milk Substitutes.
A maternity facility can be recognized as ‘baby-friendly’ when it does not accept free or low-cost breastmilk substitutes, bottles or teats, and has put in place 10 specific steps to support successful breastfeeding.
The process is currently controlled by national breastfeeding authorities, using Global Criteria that have been developed by UNICEF and WHO. More than 20,000 maternity facilities in 150 countries around the world have earned the Baby-Friendly designation.
Here are the “Ten steps to successful breastfeeding”, as stated on the UNICEF website.
Critical management procedures
1a. Comply fully with the International Code of Marketing of Breast-milk Substitutes and relevant World Health Assembly resolutions.
1b. Have a written infant feeding policy that is routinely communicated to staff and parents.
1c. Establish ongoing monitoring and data-management systems.
2. Ensure that staff have sufficient knowledge, competence and skills to support breastfeeding.
Key clinical practices
3. Discuss the importance and management of breastfeeding with pregnant women and their families.
4. Facilitate immediate and uninterrupted skin-to-skin contact and support mothers to initiate breastfeeding as soon as possible after birth.
5. Support mothers to initiate and maintain breastfeeding and manage common difficulties.
6. Do not provide breastfed newborns any food or fluids other than breast milk, unless medically indicated.
7. Enable mothers and their infants to remain together and to practise rooming-in 24 hours a day.
8. Support mothers to recognize and respond to their infants’ cues for feeding.
9. Counsel mothers on the use and risks of feeding bottles, teats and pacifiers.
10. Coordinate discharge so that parents and their infants have timely access to ongoing support and care.
World Health Organization, UNICEF, Baby-Friendly Hospital Initiative – Revised, updated and expanded for integrated care, 2009, https://www.who.int/nutrition/publications/infantfeeding/bfhi_trainingcourse/en/ (accessed 15 January 2021).
UNICEF, Baby-friendly Hospital Initiative – Ten steps to successful, May 2018 breastfeeding, https://www.unicef.org/nutrition/index_breastfeeding-ten-steps.html (accessed 5 January 2021).
World Health Organization, UNICEF, Protecting, promoting and supporting Breastfeeding in facilities providing maternity and newborn services: the revised BABY-FRIENDLY HOSPITAL INITIATIVE, 2018, https://www.unicef.org/nutrition/files/Baby-friendly-Hospital-Initiative-implementation-2018.pdf (accessed 10 January 2021).
Baby-Friendly USA, The Baby-Friendly Hospital Initiative, 2019, https://www.babyfriendlyusa.org/about/#:~:text=More%20than%2020%2C000%20maternity%20facilities,earned%20the%20Baby%2DFriendly%20designation (accessed 8 January 2021).
UNICEF, The Baby-Friendly Hospital Initiative, 2005, https://www.unicef.org/nutrition/index_24806.html (accessed 15 January 2021).