Baby-Friendly

Hospital Initiative

R Dh@ker, Asst. Professor, RCN 1

 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.
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R Dh@ker, Asst. Professor, RCN
 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

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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

R Dh@ker, Asst. Professor, RCN 11

• 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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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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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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• 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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• 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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R Dh@ker, Asst. Professor, RCN
• 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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– Standardize institution support of
immunization

– Promotion of healthy growth and good

nutrition

– Widespread availability and adoption of

family planning

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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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 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
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