Baby Friendly Hospital Initiative

The Baby Friendly Hospital Initiative was begun in 1991 by the World Health Organization and the United Nations Children's Fund (UNICEF). It consists of Ten Steps to Successful Breastfeeding, developed on the basis of scientific evidence. Baby Friendly seeks to get every nursing mother and baby off to the best start.

Since it was begun, Baby Friendly has been shown to be tremendously successful in improving breastfeeding rates, and in sustaining them beyond the first few weeks, a critical period in which many women give up. One study looked at just five of the Ten Steps. It showed that women who experienced all five of these steps were 8 times as likely to be breastfeeding at two months, as compared to women who experienced none of the steps. The steps in this study were: nursing in the first hour of birth, no formula supplements, breastfeeding on demand, rooming in, and no pacifiers. (DiGirolamo et al, Birth, June 2001).

There are about 19,000 Baby Friendly hospitals in the world as of 2010, but only about 143 are in the US (as of May 2012. As of October 2012, there are 4 Baby Friendly facilities in Massachusetts: Boston Medical Center, Cambridge Birth Center, Tobey Hospital, and Melrose Wakefield Hospital, with others well on the way. Baby Friendly USA is based in Albany, NY.

Ten Steps to Successful Breastfeeding

1. Have a written breastfeeding policy that is routinely communicated to all health care providers.
2. Train all health care staff in skill 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 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 to breastfeeding infants.
10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

*The hospital or birthing site must pay fair market price for all formula and infant feeding supplies that is uses and cannot accept free or heavily discounted formula and supplies.

• Babyfriendly USA Web Site
• The Evidence for the Ten Steps (PDF File)
  A detailed analysis of the evidence supporting the ten steps to successful breastfeeding.
• The Baby-Friendly Hospital Initiative
  Information from UNICEF on the global baby friendly initiative.