Since 1991, the Baby-Friendly Hospital Initiative (BFHI) has sought to motivate healthcare teams caring for newborns to provide the best support for successful breastfeeding, based on the Ten Steps.
The primary responsibility for monitoring the implementation of the code rests with governments. Enforcement is most effective when this responsibility is shared among the main government agencies involved throughout the various stages of product commercialization.
- National legislation on the Code should indicate which government agencies are in charge of overseeing this and how it should be done.
- Manufacturers and vendors of human milk substitutes should monitor their own marketing practices at all levels.
Having a written breastfeeding policy allows to:
- Make the various actors at the facilities agree to comply with practices that favor breastfeeding.
- Make the medical and nursing staff take ownership of the topic.
- Have recommendations applicable to specific environments.
- Monitor, evaluate and obtain data on breastfeeding practices and their effects, e.g., through audits.
- Exchange views within and outside the institution, involving more actors, sharing experiences and facilitating the replication of good practices.
The development of the breastfeeding policy varies broadly; it should include breastfeeding experts and avoid commercial links with products and companies regulated by the International Code of Human Milk Substitutes.
A committee including high-level representation from all stakeholders may be appointed to develop the policy. Once the necessary agreements are reached, the committee should continue to monitor the proper implementation of the policy.
Standards and policies to strengthen breastfeeding at birthing facilities should be written. This feature is important to sustain unanimity of criteria in practices.
Furthermore, the policy should consider the 10 steps set forth by the World Health Organization for successful breastfeeding, i.e.
- available for consultation by all personnel
- visibly displayed in all areas of the hospital
- written in the language(s) most frequently understood by patients and staff.
The hospitalization of premature, small and/or sick newborns poses multiple challenges to breastfeeding, including:
Nurturing care starts before birth, when mothers and other caregivers can start talking and singing to the foetus.
After birth, the baby can recognize the mother’s voice. Early bonding is facilitated by skin-to-skin contact, breastfeeding and the presence of a companion to support the baby mother. These also build the foundations for optimal nutrition, quality interactions and care.
The theme of Breastfeeding Week 2023 is “Let's make breastfeeding and work work”.