BFHII
(BABY FRIENDLY HOSPITAL INITIATIVE)
The Baby-friendly Hospital Initiative (BFHI) was launched by WHO and UNICEF in 1991,
following the Innocent Declaration of 1990. The initiative is a global effort to implement
practices that protect, promote and support breastfeeding.
To help in the implementation of the initiative, different tools and materials were developed,
field-tested and provided, including a course for maternity staff, a self-appraisal tool and an
external assessment tool. Additional tools were developed afterwards, such as monitoring and
reassessment tools. Since its launching BFHI has grown, with more than 152 countries
around the world implementing the initiative. The initiative has measurable and proven
impact, increasing the likelihood of babies being exclusively breastfed for the first six
months.
Since 1991, the Global Strategy for IYCF was launched with nine operational targets,
including BFHI. New evidence became available in the area of infant and young child
feeding. Additionally the HIV pandemic raised concerns and queries in relation to feeding
recommendations for children of HIV-infected mothers slowing down the process of
implementation of BFHI.
In response to the HIV pandemic and other new evidence, WHO and UNICEF collaborated
on an effort to update the Baby-friendly Hospital Initiative materials and promote the
initiative in the context of the Global Strategy for Infant and young child feeding. The
updated materials integrate Code implementation, mother-friendliness, care of pregnant
women and mothers in the context of HIV, emergencies as well as expansion towards other
type of health facilities and the community. The updated process was also used for
strengthening the BFHI-related training courses
PURPOSE OF BFHI
The BFHI is a global initiative of the World Health Organization and UNICEF that aims to give
every baby the best start in life by creating a health care environment that supports breastfeeding
as the norm.
COMPONENT OF BFHI
Breastfeeding matters.
The Baby-friendly Hospital Initiative: an overview. ...
Antenatal information.
Immediate postnatal care.
Support with breastfeeding.
Supplementation.
Rooming-in
National leadership and coordination.
Policies and professional standards of care.
Nine key responsibilities through a national BFHI Programme:
1. Establish or strengthen a national breastfeeding coordination body.
2. Integrate the Ten Steps into relevant national policy documents and professional
standards of care.
3. Ensure the competency of health professionals and managers in implementation of the
Ten Steps.
4. Utilize external assessment systems to regularly evaluate adherence to the Ten Steps.
5. Develop and implement incentives for compliance and/or sanctions for non-compliance
with the Ten Steps.
6. Provide technical assistance to facilities that are making changes to adopt the Ten Steps.
7. Monitor implementation of the initiative.
8. Advocate for the BFHI to relevant audiences.
9. Identify and allocate sufficient resources to ensure the ongoing funding of the initiative.
Critical management procedures:.
1. Have a written infant feeding policy that is routinely communicated to staff and
parents.
2. Establish ongoing monitoring and data-management systems.
3. Ensure that staff have sufficient knowledge, competence and skills to support
breastfeeding.
Key clinical practices:
Discuss the importance and management of breastfeeding with pregnant women
and their families.
Facilitate immediate and uninterrupted skin-to-skin contact and support mothers to
initiate breastfeeding as soon as possible after birth.
Support mothers to initiate and maintain breastfeeding and manage common
difficulties.
Do not provide breastfed newborns any food or fluids other than breast milk,
unless medically indicated.
Enable mothers and their infants to remain together and to practise rooming-in 24
hours a day.
Support mothers to recognize and respond to their infants’ cues for feeding.
Counsel mothers on the use and risks of feeding bottles, teats and pacifiers.
Coordinate discharge so that parents and their infants have timely access to
ongoing support and care
