The Baby-Friendly Hospital Initiative was launched in 1992 in India based on the WHO/UNICEF declaration from the 1990s to promote breastfeeding. It has since expanded to over 152 countries. Hospitals that adopt the Initiative must follow the Ten Steps to Successful Breastfeeding, such as keeping mothers and infants together, avoiding artificial nipples, and promoting breastfeeding within 30 minutes of birth. Kerala has a high rate of compliance with the Initiative's policies and a 92% breastfeeding initiation rate within one day of birth, higher than the national average.

1. Baby-Friendly
Hospital Initiative
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2. Introduction
• Baby friendly Hospital Initiative was launched
in 1992 in INDIA.
• The 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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Cont…introduction
• 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

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• 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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• 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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Cont…introduction
• 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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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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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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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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Ten steps to successful
breastfeeding
(revised 2018)- WHO

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• Critical management procedures
– 1a. Comply fully with the International Code of
Marketing of Breast-milk Substitutes and relevantWorld
Health Assemblyresolutions.
– 1b. Have a written infant feeding policy that isroutinely
communicated to staff and parents.
– 1c. Establish ongoing monitoring anddata-management
systems.
– 2. Ensure that staff have sufficient knowledge,
competence and skills to supportbreastfeeding.

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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 foodor
fluids other than breast milk, unless medically
indicated.

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Ten steps to successful breastfeeding (revised 2018)- WHO
• Key clinical practices
– 7. Enable mothers and their infants to remaintogether
and to practise rooming-in 24 hours aday.
– 8. Support mothers to recognize and respond totheir
infants’ cues forfeeding.
– 9. Counsel mothers on the use and risks offeeding
bottles, teats and pacifiers.
– 10. Coordinate discharge so that parents and their infants
have timely access to ongoing support andcare.

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25. Thank you