1. The Ten Steps of the WHO/UNICEF Baby-Friendly™ Hospital Initiative
Launched in 1991, by UNICEF and the World Health Organization To ensure that all hospitals, maternity facilities and communities become Centers of Breastfeeding Support
A father watches as his wife breastfeeds their new baby in the maternity ward of the Singburi Hospital, Thailand Fathers are encouraged to learn about the benefits and become active supporters of breastfeeding. Thailand is one of 12 developing countries to take the lead in instituting the "ten steps" of baby-friendly practice in as many hospitals as possible. 

2. The Baby Friendly - 10 Steps
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.  
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. 
Ten steps to successful breastfeeding

3. The Baby Friendly - 10 Steps
Give newborn infants no food or drink other than breastmilk, unless medically indicated. 
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.
Ten steps to successful breastfeeding

4. BFHI 10-Steps based on Research
If every baby were exclusively breastfed from Birth for 6 months, an estimated 1.5 million lives world-wide would be saved each year.
Babies and Mother’s lives would be enhanced with implementing the 10-Steps because:

5. Why Breastfeed?
BFHI 10-Steps based on Research
Immediate postpartum breastfeeding helps Mother/Child bonding
Breastmilk Alone is the perfect food for Baby’s first 6-months
Nutrients, antibodies, Hormones, Antioxidants, other factors
Stimulates immune system – response to diseases & vaccination
Protects from diarrhea and acute respiratory infections
Health and emotional benefits for Mother
Sense of empowerment and satisfaction
Decreased blood loss postpartum
Delayed return to fertility
Decreased risk of breast and ovarian cancer
Provides social/economic benefits to the Family
Environment Benefits
an abbreviated list

6. Hospital, Maternity Units, Birthing Centers
WHY The BFHI Initiative?
Hospital, Maternity Units, Birthing Centers
Set a Powerful Example for New Mothers (and Fathers)
Can provide a “Good Start” to Breastfeeding basics
First Influence of the benefits of Breastfeeding
Can instill Confidence and Empowerment to Mothers (and Fathers) to continue Breastfeeding

7. Facilitate breastfeeding as soon as possible after birth
Promoting BFHI
How Facilities can Support Exclusive Breastfeeding
In L&D provide information on how medical intervention and labour interventions can affect newborns ability to breastfeed
Facilitate breastfeeding as soon as possible after birth
Provide continuous skin-to-skin contact
for at least the first 2 hours after birth or
until after the first breastfeeding
before routine tests – weighing & measuring
allow some medical tests to be performed while on the breast
Confirm that parents know to respond to early feeding readiness cues
Help mother choose a comfortable position

8. Facilitate unrestricted breastfeeding 8-12 times per 24 hours
Promoting BFHI
How Facilities can Support Exclusive Breastfeeding
Correct positioning (infant)
Signs of correct latch-on (infant)
Signs (in Mother and Infant) of milk transfer
Observe:
Facilitate unrestricted breastfeeding 8-12 times per 24 hours
Ensure breastfeeding “culture” is sustained
Refuse to accept, market, distribute or promote breastmilk substitutes, bottles and artificial nipples
Empower (educate) women to breastfeed their children exclusively for six months and to continue breastfeeding with complementary food, well into the second year and beyond
Some of the 24 Recommendations of the International Lactation Consultant Assn document “Evidence-based guidelines for breastfeeding management during the first fourteen days.”

9. Baby-Friendly™ designation is an International Standard
Baby-Friendly™ Defined
Baby-Friendly™ designation is an International Standard
Baby-Friendly™ maternity services have passed external assessment according to the Global BFHI Criteria.
Is not appropriately applied to other medical services, community activities, workplaces or commercial products.
'breastfeeding-friendly', 'mother-child friendly' or 'pro-breastfeeding' may be used for any other complementary efforts to help mothers to breastfeed.

10. Breastfeeding Committee for Canada (BCC)
WHO/UNICEF BFHI™ in Canada
Breastfeeding Committee for Canada (BCC)
is the National Authority for implementing the WHO/UNICEF Baby-Friendly™ Hospital Initiative (BFHI) in Canada

11. Decision: Doesn’t Meet or Meets
WHO/UNICEF BFHI™ in Canada
How a Hospital, Maternity Facility, Birthing Center Becomes WHO/UNICEF Baby-Friendly™:
Self-Appraisal process Form multidisciplinary committee
Complete BFHI Self-Appraisal Tool
Decision: Doesn’t Meet or Meets
 Recognizes need to improve Plan strategies to address weakness areas
May contact Provincial/Territorial Committee for advice
BFHI Pre-Assessment
P/T Committee Reviews (the Approved) Tool and breastfeeding handouts
 Recognizes need to improve Plan actions to improve weak areas
When standards met , submit request to P/T Committee
External Assessment Using BFHI Global Criteria
Breastfeeding Committee for Canada to arrange External Assessment by 2-4 BFHI Assessors (takes 2 – 4 days)
 Submit Action Plan & timetable to meet criteria A Certificate of Commitment is issued
P/T Committee (or BCC) provides advice up to 4 years
 Meets Baby-Friendly Hospital  Certificate Awarded By BCC and the P/T Committee
Re-Assessment Every 5 years  to Retain Baby-Friendly Criteria 

12. References
UNICEF Global Action BREASTFEEDING AND THE BABY-FRIENDLY INITIATIVE
CURRENT STATUS OF BABY-FRIENDLY HOSPITAL INITIATIVE List of Baby-Friendly Hospitals
Annex 1, Evaluating adequacy of Support for breast-feeding in maternity hospitals, wards and clinics, Infant Feeding The Physiological Basis, Supplement to Volume 67, 1989 of the Bulleting of the WHO
BREASTFEEDING COMMITTEE FOR CANADA Breastfeeding Position Statement, How a Hospital, Maternity Facility, Birthing Center Becomes WHO/UNICEF Baby-Friendly™:
The Mother-friendly Childbirth Initiative, 10 questions to Ask, CIMS (Coalition for Improving Maternity Services)
Take an interactive quiz

13. Help facilities work towards a BFHI designation
How we can contribute
Support
World Breastfeeding Week is celebrated every year, on the anniversary of the Innocenti Declaration. ( Aug 1- 7 ) UNICEF supports World Breastfeeding Week
Help facilities work towards a BFHI designation
Canada’s only Baby-Friendly Hospital is Brome-Missisquoi-Perkins Hospital in Cowansville, Quebec. Designated in July 1st, 1999 (as of March 2002)
Thank you for listening!
Kairan Athwal and Sylvia te Boekhorst