Transcript 10-Steps to Baby Friendly Hospital Initiative

The Ten Steps of the WHO/UNICEF
Baby-Friendly™
Hospital Initiative
Launched in 1991, by
UNICEF and the World Health Organization
To ensure that all hospitals, maternity facilities
and communities become
Centers of Breastfeeding Support
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The Baby Friendly - 10 Steps
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 one half-hour of
birth. Place babies in skin-to-skin contact with their
mothers immediately following birth for at least an hour
and encourage mothers to recognize when their babies are
ready to breastfeed, offering help if needed.
5. Show mothers how to breastfeed and maintain lactation,
even if they should be separated from their infants.
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The Baby Friendly - 10 Steps
6. Give newborn infants no food or drink other than
breastmilk, unless medically indicated.
7. Practice rooming in - that is, allow mothers and infants to
remain together 24 hours a day.
8. Encourage breastfeeding on demand.
9. Give no artificial nipples or pacifiers (soothers) to
breastfeeding infants.
10. Foster the establishment of breastfeeding support groups
and refer mothers to them on discharge from the hospital
or clinic.
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BFHI 10-Steps based on Research
If every baby were exclusively breastfed from
Birth for 6 months,
an estimated 1.5 million lives world-wide
would be saved each year.
Babies and Mother’s lives would be enhanced with
implementing the 10-Steps because:
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Why Breastfeed?


Immediate postpartum skin-to-skin and breastfeeding supports
Mother/Child bonding
Breastmilk Alone is the perfect food for Baby’s first 6 months
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BFHI 10-Steps based on Research
Nutrients, Antibodies, Hormones, Antioxidants, other factors
Stimulates immune system – response to diseases & vaccination
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Protects from diarrhea and acute respiratory infections
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Sense of empowerment and satisfaction for Mother
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Decreases blood loss postpartum
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Delays return to fertility
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Breastfeeding decreases the risk of breast and ovarian cancer
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Provides social/economic benefits to the Family

The Environment benefits from no-waste breastfeeding
an abbreviated list
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WHY The BFHI Initiative?
Hospitals, Maternity Units,
Birthing Centers

Set a Powerful Example for New Mothers and
Fathers

Give effective, consistent and skilled support to
breastfeeding mothers

Provide accurate information on the importance
of breastfeeding

Can instill confidence and empowerment to
mothers and fathers to continue breastfeeding
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How Facilities can
Support Exclusive Breastfeeding
Promoting BFHI

Provide information on how medical and labour
interventions can affect newborn’s ability to breastfeed
and how to compensate when necessary
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Facilitate breastfeeding as soon as possible after birth
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Provide continuous skin-to-skin contact

for at least the first hour after birth or
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until after the first breastfeeding
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before routine procedures such as weighing & measuring

some medical tests can be performed while baby skin-to-skin or
on the breast
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Confirm that parents know early feeding readiness cues
and respond to them

Help mother choose a comfortable position
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How Facilities can
Support Exclusive Breastfeeding

Observe:
Promoting BFHI
Correct positioning

Signs of correct latch-on
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Signs (in Mother and Infant) of milk transfer
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Facilitate unrestricted breastfeeding 8-12 times per 24 hours
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Ensure breastfeeding “culture” is sustained
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Refuse to accept, market, distribute or promote breastmilk
substitutes, bottles and artificial nipples
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Empower women to breastfeed their children
exclusively for six months and to continue breastfeeding, with
complementary food, into the second year and beyond
Some of the 24 Recommendations of the International Lactation Consultant Assn document
“Evidence-based guidelines for breastfeeding management during the first fourteen days.” www.guideline.gov
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Baby-Friendly™ Defined

Baby-Friendly™ designation is an International
Standard
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Baby-Friendly™ maternity services have passed an
external assessment according to the Global BFHI
Criteria.

Is not appropriately applied to other medical services,
community activities, workplaces or commercial
products.

'breastfeeding-friendly', 'mother-child friendly' or
'pro-breastfeeding' may be used for any other
complementary efforts to help mothers to breastfeed.
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WHO/UNICEF BFHI™ in Canada
Breastfeeding Committee for Canada
(BCC)
is the National Authority
for implementing the WHO/UNICEF
Baby-Friendly™ Hospital Initiative (BFHI)
in Canada
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WHO/UNICEF BFHI™ in Canada
How a Hospital with a
Maternity Facility or a
Birthing Center Becomes WHO/UNICEF Baby-Friendly™:
Decision: Doesn’t Meet or Meets
1. Self-Appraisal process
Form multidisciplinary committee
2.  Recognizes need to improve
Complete BFHI Self-Appraisal Tool
Plan strategies to address weakness areas
May contact Provincial/Territorial Committee for advice
3. BFHI Pre-Assessment
P/T Committee Reviews (the Approved)
Tool and breastfeeding handouts
Plan actions to improve weak areas
5. External Assessment Using
BFHI Global Criteria
Breastfeeding Committee for Canada to
arrange External Assessment by 2-4 BFHI
Assessors (takes 2 – 4 days)
7. Re-Assessment Every 5 years

to Retain Baby-Friendly Criteria
4.  Recognizes need to improve

When standards met
, submit request to P/T Committee
6.  Submit Action Plan & timetable to
meet criteria
A Certificate of Commitment is issued
P/T Committee (or BCC) provides advice up to 4 years
 Meets Baby-Friendly Hospital 
Certificate Awarded
By BCC and the P/T Committee
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How we can contribute
Support
 World Breastfeeding Week is celebrated every
year – in Canada during the first week in October.
Join the celebration!
 The Breastfeeding Challenge is held in many
communities during World Breastfeeding Week.
Take the Challenge! http://www.babyfriendly.ca/
Help facilities work towards a BFHI designation
 Promote and support implementation of the best
practice principles of Baby-Friendly in all
hospitals and birthing centres.
Created by Kairan Athwal and Sylvia te Boekhorst as a student project for the
Douglas College Breastfeeding Course for Health Care Providers, Coquitlam BC.
Adapted with permission by Sandra Yates, August 3, 2010.
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References
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UNICEF Global Action
www.unicef.ca
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Breastfeeding And The Baby-friendly Initiative
http://www.unicef.org/programme/breastfeeding/baby.htm
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Canadian Facilities Designated As Baby-friendly
http://breastfeedingcanada.ca/html/bfi.html
http://www.unicef.org/programme/breastfeeding/assets/statusbfhi.pdf
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Annex 1, Evaluating adequacy of Support for breast-feeding in maternity hospitals, wards
and clinics, Infant Feeding The Physiological Basis, Supplement to Volume 67, 1989 of the
Bulleting of the WHO
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Assessment Flowchart. An Overview of the BFI process. (How a Hospital, Maternity
Facility, Birthing Center Becomes WHO/UNICEF Baby-Friendly)™
http://breastfeedingcanada.ca/html/bfi.html
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The Mother-friendly Childbirth Initiative, 10 questions to Ask, CIMS (Coalition for
Improving Maternity Services) http://www.motherfriendly.org/resources/10Q/
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The Breastfeeding Challenge. Quintessence Foundation
http://www.babyfriendly.ca/
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