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This bright spot was originally published in the 100 Million Healthier Lives Change Library and is brought to you through partnership with 100 Million Healthier Lives and the Institute for Healthcare Improvement.

Overview

Detailed Description

Baby-Friendly Hospital Initiative (BFHI) is a global initiative of the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) that encourages and recognizes hospitals and birthing centers that offer an optimal level of care for infant feeding and mother/baby bonding.

Expected Outcomes

Increased number and frequency of breastfeeding

Key Principles

Facility appraises current practice using the Self-Appraisal Tool and by studying the BFHI Guidelines and Criteria. After identifying deficiencies, the facility develops a plan of action to fill gaps and meet BFHI. Criteria Facility implements action plans and submits required documentation throughout the process.
Facility requests an external assessment. If external assessor determines the facility meets the Criteria, then they are designated.
Facility undergoes reassessment every three years.

*Please note, in the United States, the accrediting body for BFHI is Baby Friendly USA (BFUSA). In order to be designated, facilities must work through the 4-D Pathway as required by BFUSA. Please visit the BFUSA website for more information on the assessment process.

Cost Details

Dependent upon organization. BFUSA designation in the US does have required fees (see below). Fee Schedule

Key Steps for Implementation

Facility appraises current practice using the Self-Appraisal Tool and by studying the BFHI Guidelines and Criteria.

After identifying deficiencies, the facility develops a plan of action to fill gaps and meet BFHI. Criteria Facility implements action plans and submits required documentation throughout the process.

Facility requests an external assessment. If external assessor determines the facility meets the Criteria, then they are designated Facility undergoes reassessment every three years

*Please note, in the United States, the accrediting body for BFHI is Baby Friendly USA (BFUSA). In order to be designated, facilities must work through the 4-D Pathway as required by BFUSA. Please visit the BFUSA website for more information on the assessment process.

Partnerships

Please contact Baby-Friendly USA for further information.

Required Staffing (FTEs)

Variable depending upon the organization

Special Funding

Funding may be available through state or national programs offering assistance to facilities aiming to reach Baby-Friendly designation. North Carolina offers a Maternity Center Breastfeeding-Friendly Designation to help facilitate the adoption of incremental movement towards the Ten Steps to Successful Breastfeeding.

Training

Training Requirements QA During the Developmental Phase process, facilities receive a comprehensive set of tools to assist in implementing the Ten Steps to Successful Breastfeeding. Baby Friendly USA provides technical assistance to the facility to create a plan for achieving Baby Friendly guidelines. All plans are reviewed and feedback is provided by Baby-Friendly USA before the facility moves to the next phase. Plans are reviewed and feedback is provided before the facility moves to the next phase. Training for maternity care staff that emphasizes content and staff competency. Training should include, at minimum, all 15 sessions identified by UNICEF/WHO which has been estimated to take approximately 20 hours. Depending on prior knowledge and experience this may take shorter or longer to complete.

Types of Staff

Doctors
Nurses
Hospital administrators
Staff educated in lactation
Other hospital staff

Return on Investment Details

Facilities should involve community partners that reach pregnant and new moms.

Outcome Measures

Process Measures

Guidelines and Evaluation Criteria: Implementation of the 4-D Pathway, Implementation of the Ten Steps to Breastfeeding and the International Code of Marketing of Breast-milk Substitutes.

Increase the proportion of infants who are ever breastfed.
Increase the proportion of infants who are breastfed at 6 months.
Increase the proportion of infants who are breastfed at 1 year.
Increase the proportion of infants who are breastfed exclusively through 3 months.
Increase the proportion of infants who are breastfed exclusively through 6 months.
Reduce the proportion of breastfed newborns who receive formula supplementation within the first 2 days of life.
Increase the proportion of live births that occur in facilities that provide recommended care for lactating mothers and their babies.

Resources

Webpage of Ten Steps to Successful Breastfeeding

Bright Spot: Baby-Friendly Hospital Initiative (BFHI)