This publication and its contents has been superseded by a more recent version. It is here for reference purposes. Please follow this link to the most recent version.


Archived: Baby-Friendly Hospital Initiative

Revised, updated and expanded for integrated care

World Health Organization, UNICEF

Publication details

Publication date: 2009
Languages: English, Spanish
ISBN: English - 978 92 4 159495 0 (set), Spanish - 978 92 75 33229 0 [(Section 1 & 4) 33230 6 (Section 2) 33231 3 (Section 3)]


  • BFHI Section 1
    Background and implementation
  • BFHI Section 2
    Strengthening and sustaining the Baby-friendly Hospital Initiative: A course for decision-makers
  • BFHI Section 3
    Breastfeeding Promotion and Support in a Baby-friendly Hospital, a 20-hour course for maternity staff
  • BFHI Section 4
    Hospital self-appraisal and monitoring


The Baby-friendly Hospital Initiative (BFHI) is a global effort launched by WHO and UNICEF to implement practices that protect, promote and support breastfeeding. It was launched in 1991 in response to the Innocenti Declaration. The global BFHI materials have been revised, updated and expanded for integrated care. The materials reflect new research and experience, reinforce the International Code of Marketing of Breast-milk Substitutes, support mothers who are not breastfeeding, provide modules on HIV and infant feeding and mother-friendly care, and give more guidance for monitoring and reassessment.

The revised package of BFHI materials includes five sections: 1. Background and Implementation, 2. Strengthening and Sustaining the BFHI: A course for decision-makers, 3. Breastfeeding Promotion and Support in a Baby-friendly Hospital: a 20-hour course for maternity staff, 4. Hospital Self-Appraisal and Monitoring, and 5. External Assessment and Reassessment. Sections 1 to 4 are widely available while section 5 is for limited distribution.

Section 5. External Assessment and Reassessment, provides guidelines and tools for external assessors to use initially to assess whether hospitals meet the Global Criteria and thus fully comply with the Ten Steps, and then to reassess on a regular basis whether they continue to maintain the required standards. Section 5 is divided in three parts:

  • 5.1 Guide for Assessors
  • 5.2 Hospital External Assessment Tool
  • 5.3 Guidelines and Tool for External Reassessment

It also includes:

  • A set of PowerPoint Slides to use in training assessors
  • A BFHI Assessment Computer Tool to use in scoring and presenting assessment results

Section 5: External Assessment and Reassessment is not available for general distribution but will be provided for those needing it for assessment purposes. It is available to the regional and national UNICEF offices through the UNICEF Intranet and WHO offices to provide to the national authorities for BFHI. It is then made available to the assessors who conduct BFHI assessments and reassessments.

Related links