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
- Maintain a written breastfeeding policy that is routinely
communicated to all health care staff.
- Train all health care staff in skills necessary to implement this
- Inform all pregnant women about the benefits and management of
- Help mothers initiate breastfeeding within one hour of birth.
- Show mothers how to breastfeed and how to maintain lactation, even
if they are separated from their infants.
- Give infants no food or drink other than breastmilk, unless
- Practice "rooming in" - allow mothers and infants to
remain together 24 hours a day.
- Encourage unrestricted breastfeeding.
- Give no pacifiers or artificial nipples to breastfeeding infants.
- Foster the establishment of breastfeeding support groups and refer
mothers to them on discharge from the hospital or clinic
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:
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.
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
Depending on the result of the assessment the hospital is designated a
Baby Friendly Hospital and receives an award (plaque) or a Certificate of
For further information, contact:
Friendly Hospital Initiative USA