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  Baby Friendly Hospital Initiative Ten Steps to Successful Breastfeeding

Baby Friendly Hospital InitiativeThe 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. Maintain 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 one hour of birth.
  5. Show mothers how to breast­feed and how to maintain lactation, even if they are separated from their infants.
  6. Give 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 unrestricted breast­feeding.
  9. Give no pacifiers or artificial nipples to breast­feeding infants.
  10. 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 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.

For further information, contact: Baby Friendly Hospital Initiative USA

© WHO Regional Office for Europe

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