The Baby Friendly Hospital Initiative (BFHI) was launched in 1991 by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), with the goal of protecting, promoting, and supporting breastfeeding in facilities that provide maternity services, ensuring that the facilities follow the WHO/UNICEF “Ten Steps to Successful Breastfeeding” (the Ten Steps) and adhere to the 1981 International Code of Marketing of Breast-milk Substitutes.
The BFHI was a key part of the 2002 WHO/UNICEF Global Strategy for Infant and Young Child Feeding, which seeks to improve the nutritional status, growth and development, health and survival of infants and young children through optimal feeding practices.
In 2009, the BFHI was updated to integrate Code implementation, mother-friendliness, care of pregnant women and mothers in the context of HIV, emergencies, and the expansion to other types of health facilities in the community. The BFHI has been shown to increase rates of exclusive breastfeeding.
Several studies indicated that the sustainability of breastfeeding was dependent on strong implementation of community support mechanisms (i.e., step 10 of the Ten Steps).
BFHI offered health benefits for infants and school-aged children, including reduced incidence of gastrointestinal disease and atopic eczema during the first year of life, and improved IQ and academic performance among 6.5-year-old, improved breastfeeding initiation, decreased use of prelacteal feeds, and higher rates of exclusive breastfeeding. A dose-response relationship exists between implementation of the Ten Steps and improved breastfeeding outcomes. BFHI remains highly relevant to current global health challenges and targets, such as the WHO target to increase rates of exclusive breastfeeding in children under six months of age to at least 50% by 2025
