The Baby-Friendly Hospital Initiative (BFHI) was started in 1991 by the World Health Organization (WHO) 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. Globally the Baby-Friendly Hospital Initiative engages in global efforts that protect, promote, and support breastfeeding; within each hospital, BFHI 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.

Based on results from the 2nd Global Nutrition Policy Review 2016-17 (GNPR2), 86% of countries have implemented the BFHI, this is equal to 152 countries around the globe. Approximately 10% of all births worldwide and 18% of US births occur in Hospitals designated as Baby-Friendly.

In MA there are 18 Baby-Friendly facilities and almost 40% of births occur at a Baby-Friendly Hospitals (April 2019).


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.


For more information about the BFHI:

National Implementation of the Baby-friendly Hospital Initiative 2017; WHO/NMH/NHD/17.4;jsessionid=0703DD9285351663CE6BD8CA6B202F60?sequence=1

The Baby-Friendly Hospital Initiative from WHO –

Baby-Friendly USA Web Site-

Information from UNICEF on the global baby friendly initiative


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