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BABY FRIENDLY HOSPITAL
INITIATIVES (BFHI)
Presented By:
Mohammad Aslam Shaiekh
MPH-3rd Batch
School of Health & Allied Sciences (SHAH)
Pokhara University (P.U)
17/5/2018 Aslam Aman_MPH
Introduction
• BFHI is a global movement, spearheaded by
WHO and UNICEF that aims to give every baby
the best start in life by creating a health care
environment where breastfeeding is the norm.
• Maternity wards and hospitals applying the
principles in the joint statement are being
designated baby friendly to call public attention to
their support for sound environment.
27/5/2018 Aslam Aman_MPH
Introduction
• The joint WHO/UNICEF statement on
breastfeeding and maternity services has
become the centerpiece of the BFHI.
37/5/2018 Aslam Aman_MPH
Goals of BFHI
1. To transform hospitals and maternity facilities
through implementation of the “ten steps”.
2. To end the practice of distribution of free and
low - cost supplies of breast milk substitutes
to maternity wards and hospitals.
47/5/2018 Aslam Aman_MPH
• BFHI has incorporated the International Code
of Marketing of Breast-milk Substitutes (1981)
and is aimed to protect and promote
breastfeeding.
• Since the launch of initiative, more than
20,000 hospitals in 156 countries in the world
have adopted it over the last 15 years.
57/5/2018 Aslam Aman_MPH
Key dates in the history of
breastfeeding and BFHI
1979 - Joint WHO/UNICEF meeting on Infant
and young Child Feeding, Geneva.
1981 – adoption on the International Code of
Marketing of Breast Milk Substitutes
 1989 – Protecting, promoting and supporting
breast feeding. The special role of maternity
services.
- convention on the right of child
 1990 – world summit for children
67/5/2018 Aslam Aman_MPH
1991 – Launching of baby friendly initiatives
2000 – WHO expert consultation on HIV and
Infant feeding
2001 – WHO consultation on the optimal duration
of exclusive breastfeeding
2002 – Endorsement of the Global strategy for
infant and young child feeding by WHO
2005 – Innocenti Declaration 2005
2007 – Revision of BFHI document
77/5/2018 Aslam Aman_MPH
National Scenario
• In Nepal BFHI activities were started in 1994
with the training of health workers from 22
hospitals all over the country till 1996.
• After training, these hospitals were assessed by
external and internal assessors in 1997-98
through Nepal Pediatric Society and seven of
the hospitals were certified as Baby Friendly
Hospitals.
87/5/2018 Aslam Aman_MPH
• These seven hospitals are:
• Tribhuvan University Teaching Hospital,
Maharajgunj, Kathmandu
• Maternity Hospital, Thapathali, Kathmandu
• Patan Hospital, Lalitpur
• Bhaktapur Hospital, Bhaktapur
• Hetauda Hospital, Makawanpur
• BP Koirala Institute of Health Science, Dharan
and
• Koshi Zonal Hospital, Bitratnagar
97/5/2018 Aslam Aman_MPH
Steps of BFHI
1. Have a written breast feeding policy that is routinely
communicated to all health care staff
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 breast feeding within a half
hour of birth
5. Show mothers how to breastfed and how to maintain
lactation, even if they should be separated from their
infants
107/5/2018 Aslam Aman_MPH
6. Give newborn infants no food or drink other
than breast milk unless medically indicated
7. Practice rooming in- allows mothers and
newborn to remain together 24 hours a day
Rooming –in. A hospital arrangement where a
mother/ baby pair stay in the same room day
and night, allowing unlimited contact
between mother and infant.
117/5/2018 Aslam Aman_MPH
8. Encourage breastfeeding on demand
• Earlier passage of meconium
• Lower maximal weight loss
• Breast milk flow established sooner
• Larger volume of milk intake on day 3
• Less incidence of jaundice
9. Give no artificial teats or pacifiers ( also called
dummies and soothers) to breastfeeding infants
10. Foster the establishment of breast feeding support
group and refer mothers to them on discharge from
hospital or clinic Supports can include.
127/5/2018 Aslam Aman_MPH
Summary and role of Baby-friendly
hospitals
AIM: To contribute to the provision of safe and
adequate nutrition for infants by:
• The protection and promotion of breastfeeding,
and
• Ensuring the proper use of breast-milk
substitutes, when these are necessary, on basis
of adequate information and through
appropriate marketing and distribution.
137/5/2018 Aslam Aman_MPH
Scope
Marketing, practices related, quality and
availability, and information concerning the
use of:
• breast-milk substitutes, including infant
formula
• other milk products, foods and beverages,
including bottle-fed complementary foods,
when intended for use as a partial or total
replacement of breast milk
• feeding bottles and teats 147/5/2018 Aslam Aman_MPH
Summary of the main points of the
International Code
• No advertising of breast-milk substitutes and
other products to the public
• No donations of breast-milk substitutes and
supplies to maternity hospitals
• No free samples to mothers
• No promotion in the health services
• No company personnel to advise mothers
• No gifts or personal samples to health workers
157/5/2018 Aslam Aman_MPH
• No use of space, equipment or education
materials sponsored or produced by companies
when teaching mothers about infant feeding.
• No pictures of infants, or other pictures idealizing
artificial feeding on the labels of the products.
• Information to health workers should be scientific
and factual.
• Information on artificial feeding, including that
on labels, should explain the benefits of
breastfeeding and the costs and dangers
associated with artificial feeding.
• Unsuitable products, such as sweetened
condensed milk, should not be promoted for
babies.
167/5/2018 Aslam Aman_MPH
Global Strategy on Infant and Young
Child Feeding (IYCF): Aim
• To improve – through optimal feeding – the
nutritional status, growth and development,
health, and thus the survival of infants and
young children.
177/5/2018 Aslam Aman_MPH
Further strengthening of BFHI
• The Global Strategy urges that hospital
routines and procedures remain fully
supportive of the successful initiation and
establishment of breastfeeding through the:
• Implementation of the Baby-friendly Hospital
Initiative
• Monitoring and reassessing already designated
facilities; and
• Expanding the Initiative to include clinics,
health center, and paediatric hospitals
187/5/2018 Aslam Aman_MPH
REFERENCES
1. Subedi N. Health prospect 2012, Baby
friendly hospital initiatives situation in
Nepal.2012;11 pp52-4.
2. World health organization nutrition baby
friendly hospital initiatives 2018.
3. https://www.slideshare.net/smaxy/bfhi-
65805827
197/5/2018 Aslam Aman_MPH
207/5/2018 Aslam Aman_MPH

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Baby Friendly Hospital Initiatives (BFHI)

  • 1. BABY FRIENDLY HOSPITAL INITIATIVES (BFHI) Presented By: Mohammad Aslam Shaiekh MPH-3rd Batch School of Health & Allied Sciences (SHAH) Pokhara University (P.U) 17/5/2018 Aslam Aman_MPH
  • 2. Introduction • BFHI is a global movement, spearheaded by WHO and UNICEF that aims to give every baby the best start in life by creating a health care environment where breastfeeding is the norm. • Maternity wards and hospitals applying the principles in the joint statement are being designated baby friendly to call public attention to their support for sound environment. 27/5/2018 Aslam Aman_MPH
  • 3. Introduction • The joint WHO/UNICEF statement on breastfeeding and maternity services has become the centerpiece of the BFHI. 37/5/2018 Aslam Aman_MPH
  • 4. Goals of BFHI 1. To transform hospitals and maternity facilities through implementation of the “ten steps”. 2. To end the practice of distribution of free and low - cost supplies of breast milk substitutes to maternity wards and hospitals. 47/5/2018 Aslam Aman_MPH
  • 5. • BFHI has incorporated the International Code of Marketing of Breast-milk Substitutes (1981) and is aimed to protect and promote breastfeeding. • Since the launch of initiative, more than 20,000 hospitals in 156 countries in the world have adopted it over the last 15 years. 57/5/2018 Aslam Aman_MPH
  • 6. Key dates in the history of breastfeeding and BFHI 1979 - Joint WHO/UNICEF meeting on Infant and young Child Feeding, Geneva. 1981 – adoption on the International Code of Marketing of Breast Milk Substitutes  1989 – Protecting, promoting and supporting breast feeding. The special role of maternity services. - convention on the right of child  1990 – world summit for children 67/5/2018 Aslam Aman_MPH
  • 7. 1991 – Launching of baby friendly initiatives 2000 – WHO expert consultation on HIV and Infant feeding 2001 – WHO consultation on the optimal duration of exclusive breastfeeding 2002 – Endorsement of the Global strategy for infant and young child feeding by WHO 2005 – Innocenti Declaration 2005 2007 – Revision of BFHI document 77/5/2018 Aslam Aman_MPH
  • 8. National Scenario • In Nepal BFHI activities were started in 1994 with the training of health workers from 22 hospitals all over the country till 1996. • After training, these hospitals were assessed by external and internal assessors in 1997-98 through Nepal Pediatric Society and seven of the hospitals were certified as Baby Friendly Hospitals. 87/5/2018 Aslam Aman_MPH
  • 9. • These seven hospitals are: • Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu • Maternity Hospital, Thapathali, Kathmandu • Patan Hospital, Lalitpur • Bhaktapur Hospital, Bhaktapur • Hetauda Hospital, Makawanpur • BP Koirala Institute of Health Science, Dharan and • Koshi Zonal Hospital, Bitratnagar 97/5/2018 Aslam Aman_MPH
  • 10. Steps of BFHI 1. Have a written breast feeding policy that is routinely communicated to all health care staff 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 breast feeding within a half hour of birth 5. Show mothers how to breastfed and how to maintain lactation, even if they should be separated from their infants 107/5/2018 Aslam Aman_MPH
  • 11. 6. Give newborn infants no food or drink other than breast milk unless medically indicated 7. Practice rooming in- allows mothers and newborn to remain together 24 hours a day Rooming –in. A hospital arrangement where a mother/ baby pair stay in the same room day and night, allowing unlimited contact between mother and infant. 117/5/2018 Aslam Aman_MPH
  • 12. 8. Encourage breastfeeding on demand • Earlier passage of meconium • Lower maximal weight loss • Breast milk flow established sooner • Larger volume of milk intake on day 3 • Less incidence of jaundice 9. Give no artificial teats or pacifiers ( also called dummies and soothers) to breastfeeding infants 10. Foster the establishment of breast feeding support group and refer mothers to them on discharge from hospital or clinic Supports can include. 127/5/2018 Aslam Aman_MPH
  • 13. Summary and role of Baby-friendly hospitals AIM: To contribute to the provision of safe and adequate nutrition for infants by: • The protection and promotion of breastfeeding, and • Ensuring the proper use of breast-milk substitutes, when these are necessary, on basis of adequate information and through appropriate marketing and distribution. 137/5/2018 Aslam Aman_MPH
  • 14. Scope Marketing, practices related, quality and availability, and information concerning the use of: • breast-milk substitutes, including infant formula • other milk products, foods and beverages, including bottle-fed complementary foods, when intended for use as a partial or total replacement of breast milk • feeding bottles and teats 147/5/2018 Aslam Aman_MPH
  • 15. Summary of the main points of the International Code • No advertising of breast-milk substitutes and other products to the public • No donations of breast-milk substitutes and supplies to maternity hospitals • No free samples to mothers • No promotion in the health services • No company personnel to advise mothers • No gifts or personal samples to health workers 157/5/2018 Aslam Aman_MPH
  • 16. • No use of space, equipment or education materials sponsored or produced by companies when teaching mothers about infant feeding. • No pictures of infants, or other pictures idealizing artificial feeding on the labels of the products. • Information to health workers should be scientific and factual. • Information on artificial feeding, including that on labels, should explain the benefits of breastfeeding and the costs and dangers associated with artificial feeding. • Unsuitable products, such as sweetened condensed milk, should not be promoted for babies. 167/5/2018 Aslam Aman_MPH
  • 17. Global Strategy on Infant and Young Child Feeding (IYCF): Aim • To improve – through optimal feeding – the nutritional status, growth and development, health, and thus the survival of infants and young children. 177/5/2018 Aslam Aman_MPH
  • 18. Further strengthening of BFHI • The Global Strategy urges that hospital routines and procedures remain fully supportive of the successful initiation and establishment of breastfeeding through the: • Implementation of the Baby-friendly Hospital Initiative • Monitoring and reassessing already designated facilities; and • Expanding the Initiative to include clinics, health center, and paediatric hospitals 187/5/2018 Aslam Aman_MPH
  • 19. REFERENCES 1. Subedi N. Health prospect 2012, Baby friendly hospital initiatives situation in Nepal.2012;11 pp52-4. 2. World health organization nutrition baby friendly hospital initiatives 2018. 3. https://www.slideshare.net/smaxy/bfhi- 65805827 197/5/2018 Aslam Aman_MPH