INTRODUCTION:

The first few hours and days of a newborn’s life are a critical window for establishing
lactation and providing mothers with the support they need to breastfeed successfully.
Although, breastfeeding is the biological norm, health professionals may perform
inappropriate procedures that interfere with the initiation of breastfeeding such as separation
of the mother and infant.
The Baby Friendly Hospital Initiative (BFHI) has been implemented in almost all countries in
the world, with varying degrees of success. The programme has characteristically been
implemented as a vertical intervention focused on designating facilities that volunteer to take
part in the programme and can document their full adherence to the “Ten steps”.
The BFHI focuses on protecting, promoting and supporting breast-feeding in facilities
providing maternity and newborn services. It is understood that many other interventions are
needed to ensure adequate support for breast feeding, including in antenatal care, postpartum
care, communities and workplaces as well as adequate maternity protection and code
legislation. It is critical that the BFHI programme is integrated with all other aspects of
breast-feeding protection, promotion and support.
The baby friendly hospital campaign was launched by the WHO/UNICEF, in mid-1991 in
Ankara to boost the breast-feeding practices and to counter the trends of bottle feeding. BFHI
was launched in 1992 in India as a part of ‘Innocent declaration’ on breast-feeding.
 BREAST-FEEDING:
Breastfeeding is one of the most effective ways to ensure child health and survival. Breast
milk is the ideal food for infant. It is safe, clean and contains antibodies which help protect
against many common childhood illnesses. Breastmilk provides all the energy and nutrients
that the infant needs for the first months of life.
Definition of breastfeeding: breastfeeding is the feeding of an infant or young child with
breast milk directly from female human breasts i.e., via lactation not from a baby bottle or
other container.
Benefits of breast feeding:
1. Reduction in infant mortality due to infectious disease.
2. Reduced risk of infection (gastrointestinal, respiratory, ear etc)
3. Reduce the risk of overweight and obesity in childhood & later in life.
4. Improved intelligence and cognitive outcomes.
5. Improve infant gut health.
6. Improve appetite regulation.
7. Reduced risk of developing non-communicable diseases, such as diabetes and
cardiovascular diseases.
8. Fewer dental malocclusions.

 GOALS OF BFHI WORLDWIDE:

1. To improve the nutritional status, growth & development, health & survival of infants
and young children through optimal feeding practice.

[1]
 2. To support exclusive breastfeeding for six months followed by timely, adequate, safe
and appropriate complementary feeding.
3. To support maternal nutrition through social and community support initiatives.

 TEN STEPS FOR SUCCESSFUL BREASTFEEDING:

The following ten steps are recognized as minimum global criteria for attaining the status of a
Baby Friendly Hospital.
Step 1: have a written breastfeeding policy that is routinely communicated to all health staff.
Step 2: train health care staff in skills necessary to implement this policy.
Step 3: inform all pregnant women about the benefits and management of breastfeeding.
Step 4: helps mothers to initiate breastfeeding within half hour of birth.
Step 5: show mothers how to breastfeed and how to maintain lactation, even if they are
separated from their infants.
Step 6: give newborn infants no food or drink other than breast milk, unless medically
indicated.
Step 7: practice rooming in and allow mothers and infants to remain together round the clock.
Step 8: encourage breastfeeding on demand.
Step 9: give no artificial feeds or pacifiers to breastfeeding babies.
Step 10: foster the establishment of breastfeeding support groups and refer mothers to them
on discharge from the hospital or clinic.

 PROCEDURE FOR RECOGNITION OF A HOSPITAL AS BABY FRIENDLY:

The BFHI movement is active in India under a national task force comprising of government
of India, UNICEF, WHO and a large number of professional bodies and voluntary
organization. A number of regional workshops have been organized on lactation management
and for training of BFHI assessors. The following three steps are followed for recognition of
a hospital as baby friendly.
1. A hospital that conducts a minimum of 250 deliveries per year can seek the
recognition. After implementation of ten global steps for promotion of breastfeeding,
a duly completed self-assessment form and registration form are sent to the BFHI
secretariat.
2. The hospital or nursing home meeting all the ten criteria are visited by an assessor for
on-the-spot checks and to interview the mothers and health care staff. The assessor
sends his report and observations to the BFHI secretariat which is reviewed by the
Review Committee for final recommendation.
3. The hospitals fulfilling the national BFHI requirements are recognized as “Baby-
Friendly”. The national task force organizes a public ceremony for presentation of
BFHI recognition certificate and a logo-plaque.

[2]
Some other initiative in India by Baby Friendly Hospital is-
 Improve antenatal care
 Mother friendly delivery services
 Standardized institutional support of immunization
 Diarrhoea management
 Promotion of healthy growth and good nutrition
 Widespread availability and adoption of family planning.

[3]
CONCLUSION:

Breastfeeding is a vital component of realizing every child’s right to the highest

attainable standard of health, while respecting every mother’s right to make an
informed decision about how to feed her baby, based on complete evidence-based
information, free from commercial interests, and the necessary support to enable her
to carry out her decision. Indian hospitals are still in early stages of joining this
movement. The National BFHI task force was formed in 1992, towards the efforts to
improve the breastfeeding practices. The task comprises of Government of India,
UNICEF, WHO and professional organizations (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’.

[4]
BIBLIOGRAPHY:

 Sharma Rimple. Essentials of paediatric nursing. Second edition. New Delhi.

Jaypee brothers’ medical publishers (P) Ltd. 2017. Page no.100-101.
 Singh Meharban. Kalia Raman. Textbook of pediatric nursing. First edition.
Greater Noida; UP. Magic international Pvt. Ltd. 2019. Page no.233-234.
 Dutta Parul. Pediatric nursing. Fourth edition. Faridabad; Haryana. Jaypee
brothers’ medical publishers (P) Ltd. 2018. Page no. 23-24.
 https://www.unicef.org/media/95191/file/Baby-friendly-hospital-initiative-
implementation-guidance-2018.pdf

[5]