Baby Friendly Hospital Initiative   Ten Steps to Successful Breastfeeding

The following statement is from a joint World Health Organization/UNICEF document published in 1989 by WHO, Geneva, Switzerland.

Every facility providing maternity services and care for newborn infants should:

1. Have a written breastfeeding policy that is routinely communicated to all health care staff.

2. Train all health care staff in skills necessary to implement this policy.

3. Inform all pregnant women about the benefits and management of breastfeeding.

4. Help mothers initiate breastfeeding within a half-hour of birth.

5. Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants.

6. Give newborn infants no food or drink other than breastmilk, unless medically indicated.

7. Practice rooming-in: allow mothers and infants to remain together 24 hours a day.

8. Encourage breastfeeding on demand.

9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.

10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

Objectives

The Baby Friendly Hospital Initiative (BFHI) was launched by WHO and UNICEF in 1991 at the meeting of the International Pediatric Association in Ankara, with the following objectives:

• to enable mothers to make an informed choice about how to feed their newborns;

• to support early initiation of breastfeeding;

• to promote exclusive breastfeeding for the first 6 months;

• to ensure the cessation of free and low cost infant formula supply to hospitals;

• to include, possibly at a later stage and where needed, other mother and infant health care issues.

This is a global network that aims to give every baby the best start in life by creating a health care environment where breastfeeding is the norm, thus helping to reduce the levels of infant morbidity and mortality in each country. 

Background

In the WHO European Region, as at March 1996, there were 191 BFHI hospitals in 11 countries. By the year 2000, it is hoped the number of BFHI hospitals will double and that every country in the WHO European Region will strive to have at least one BFHI hospital. All BFHI hospitals follow the ten steps to successful breastfeeding.

Maternity services and maternity hospitals have been chosen as the target hospitals that are eligible to join the BFHI network. Hospitals indicate their interest by contacting their national Breastfeeding Committee or the European Joint WHO/UNICEF BFHI Action Task Force, in WHO/Europe, WHO headquarters or UNICEF, Geneva.

Maternity services and hospitals can assess what is needed to achieve BFHI status by using the hospital self-appraisal tool specially designed for this purpose. When the hospital complies with all the stated criteria outlined in the tool, it can then request external assessment, which is organized by the national authorities. The assessment is a rigorous procedure, lasting three days and carried out by internationally trained professional assessors.

Depending on the result of the assessment the hospital is designated a Baby Friendly Hospital and receives an award (plaque) or a Certificate of Commitment.