The Baby-Friendly Hospital Initiative was launched globally in 1991 by WHO and UNICEF to promote breastfeeding and adopted 10 steps to support breastfeeding in hospitals, with over 152 countries now implementing the initiative. India established a national task force in 1992 to improve breastfeeding practices in hospitals and certify them as "Baby-Friendly" if they follow the 10 steps. The initiative has been shown to increase exclusive breastfeeding rates for the first six months.

1. Baby-Friendly
Hospital Initiative
1R Dh@ker, Asst. Professor, RCN

2. Introduction
• Baby friendly Hospital Initiative was launched
in 1992 in INDIA.
• The history Innocenti declaration on the
promoting, protection and support of
breastfeeding was produced and adapted by
participants at the WHO/ UNICEF policy
maker’s meeting on breast feeding in 1990s.
R Dh@ker, Asst. Professor, RCN
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3. Cont…introduction
• The GLOBAL initiative was co- sponsored by
the USAID and SIDA.
• The baby friendly hospital camping was
launched by the WHO/ UNICEF in mid 1991
in Ankara to boost the breastfeeding practices
and to counter the trends of bottle feeding
R Dh@ker, Asst. Professor, RCN 3

4. • 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.
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6. • The programme, launched in Kerala in March
1993, is hospital .
• Manoncourt said of the 1,372 baby friendly
hospitals in India 65 per cent are in Tamil Nadu
and Kerala.
• Dr Elsie Philip, state co-ordinator of BFHI, said
the rates of breast-feeding initiation within a day
is 92 per cent in Kerala (compared to 78.7
percent in Tamil Nadu and the national average
of 37.1 per cent)
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7. • Baby friendly hospital are required to adopted
breast feeding policy and follow the
“ ten step of Successful breastfeeding”
as recommended by code of practice of WHO/
UNICEF
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Cont…introduction

8. Have a written breastfeeding policy that is
routinely communicated to all health care staff.
Train all health care staff in skills necessary to
implement this policy.
Inform all pregnant women about the benefits and
management of breastfeeding.
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9. Cont…BHIF Policies
Help mothers initiate breastfeeding within one
half-hour of birth.
Show mothers how to breastfeed and maintain
lactation, even if they should be separated from
their infants.
Give newborn infants no food or drink other than
breast milk, unless medically indicated.
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10. Practice rooming in - that is, allow mothers and
infants to remain together 24 hours a day.
Encourage breastfeeding on demand.
Give no artificial nipples or pacifiers (soothers) to
breastfeeding infants.
Foster the establishment of breastfeeding support
groups and refer mothers to them on discharge from
the hospital or clinic.
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11. Ten steps to successful
breastfeeding
(revised 2018)- WHO
R Dh@ker, Asst. Professor, RCN 11

12. • Critical management procedures
– 1a. Comply fully with the International Code of
Marketing of Breast-milk Substitutes and relevant World
Health Assembly resolutions.
– 1b. Have a written infant feeding policy that is routinely
communicated to staff and parents.
– 1c. Establish ongoing monitoring and data-management
systems.
– 2. Ensure that staff have sufficient knowledge,
competence and skills to support breastfeeding.
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13. Ten steps to successful breastfeeding (revised 2018)- WHO
• Key clinical practices
– 3. Discuss the importance and management of
breastfeeding with pregnant women and their families.
– 4. Facilitate immediate and uninterrupted skin-to-skin
contact and support mothers to initiate breastfeeding as
soon as possible after birth.
– 5. Support mothers to initiate and maintain
breastfeeding and manage common difficulties.
– 6. Do not provide breastfed newborns any food or
fluids other than breast milk, unless medically
indicated.
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14. Ten steps to successful breastfeeding (revised 2018)- WHO
• Key clinical practices
– 7. Enable mothers and their infants to remain together
and to practise rooming-in 24 hours a day.
– 8. Support mothers to recognize and respond to their
infants’cues for feeding.
– 9. Counsel mothers on the use and risks of feeding
bottles, teats and pacifiers.
– 10. Coordinate discharge so that parents and their infants
have timely access to ongoing support and care.
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25. • Indian hospital are till in early stages of joining
this movement. The National BFHI task force
was formed, in 1992, towards the efforts to
improve the breastfeeding practices.
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26. • The task force comprising of Govt. of INDIA,
UNICEF, WHO and Professional Organization
( TNAI, BPNI, NNF, IMA, FOGSI, IAP, CMAI,
CHAI, IBFAN, ACASH) is working for
evaluation of breastfeeding practices in the
hospitals and appropriate certification as
“ Baby Friendly Hospital” .
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28. • The certificate needs re-recognition on every
two years to ensure the standard and quality for
successful breastfeeding.
• Beside promotion of breastfeeding, BFHI in
INDIA also proposed to provide:-
– Improved antenatal care
– Mother friendly delivery services.
– Diarrhea management
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29. – Standardize institution support of
immunization
– Promotion of healthy growth and good
nutrition
– Widespread availability and adoption of
family planning
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30. Cont…
• Govt. of India has made significantly efforts to
promote and protect breastfeeding by enacting a law
“The Infant Milk Substitutes, Feeding Bottles and
Infant Food Act,1992”.
• The act prohibits advertizing of infant milk
substitutes (IMS) and feeding bottles to public, free
sampling, hospital promotion and gifts of samples of
IMS to health workers.
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31. Abbreviation
• WHO
• UNICEF
• USAID
• SIDA
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WHO - World Health organization
UNICEF - United nation international
children’s emergency fund
USAID - United State agency for international
development
SIDA- Swedish international development
cooperation