25/1

Health care practices

After completing this session participants will

be able to:
• list the Ten Steps to Successful Breastfeeding
• describe the health care practices summarized
by ‘The Ten Steps to Successful Breastfeeding’
• explain why the Baby-friendly Hospital Initiative
(BFHI) is important in areas with a high HIV
prevalence
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Step one

Have a written breastfeeding policy that is

routinely communicated to all health staff
 25/3

Step two

Train all health care staff in skills necessary

to implement this policy
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Step three

Inform all pregnant women about the

benefits and management of breastfeeding
25/525/5
 25/6

Step four

Help mothers initiate breastfeeding within a

half-hour of birth
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25/8
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Step five

Show mothers how to breastfeed and how to

maintain lactation, even if they should be
separated from their infants
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25/11
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Step six

Give newborn infants no food or drink other

than breast milk, unless medically indicated
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Stomach capacity of the newborn

and a 1-year-old child

Newborn stomach capacity 1-year old stomach capacity

10 X
bigger
 25/16

Step seven

Practice rooming-in: allow mothers and

infants to remain together 24 hours a day
25/17
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Step eight

Encourage breastfeeding on demand

25/19
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Step nine

Give no artificial teats or pacifiers* to

breastfeeding infants

* also called dummies and soothers

25/21
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Step ten

Foster the establishment of breastfeeding

support groups and refer mothers to them
on discharge from hospital or clinic
 25/23
25/23
 25/24

Effect of trained peer counsellors on

the duration of exclusive breastfeeding
80%
70%
70%
60%
50%
Percentage

Exclusively
40% breastfeeding
5 month old
30% infants
20%
10% 6%

0%
Project area Control

Adapted from Haider R, Kabir I, Huttly S and Ashworth A. Training peer counselors to
promote and support exclusive breastfeeding in Bangladesh. J Hum Lact, 2002;18(1):7-12.