e-Library of Evidence for Nutrition Actions (eLENA)


An online library of evidence-informed guidelines for nutrition interventions and single point of reference for the latest nutrition guidelines, recommendations and related information.

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Implementation of the Baby-friendly Hospital Initiative

Intervention | Last updated: 9 August 2023


Breastfeeding has many health benefits for both the mother and infant. Breast milk contains all the nutrients an infant needs in the first six months of life. Breastfeeding protects against diarrhoea and common childhood illnesses such as pneumonia, and may also have longer-term health benefits for the mother and child, such as reducing the risk of overweight and obesity in childhood and adolescence.

To reduce infant mortality and ill health, WHO recommends that mothers begin breastfeeding their infants within one hour of birth – referred to as “early initiation of breastfeeding”. This ensures that the infant receives the colostrum (“first milk”), which is rich in protective and regulatory factors. Infants should also be exclusively breastfed for the first six months of life to achieve optimal growth, development and health, with continued breastfeeding up to two years of age or beyond.

The Baby-friendly Hospital Initiative is a global effort to implement practices that protect, promote and support breastfeeding. It aims to ensure that all maternity facilities become centres of breastfeeding support.

Since its launch by WHO and UNICEF in 1991, more than 150 countries have implemented the Baby-friendly Hospital Initiative. The Initiative has had a measurable and proven impact, increasing both early initiation of breastfeeding and the likelihood of infants being exclusively breastfed from birth until six months of age.

WHO Recommendations


One of the nine operational targets of the Global Strategy for Infant and Young Child Feeding is to ensure that every maternity facility practices the Ten Steps to Successful Breastfeeding. The Ten Steps have been updated in 2018 as described in Protecting, promoting, and supporting breastfeeding in facilities providing maternity and newborn services: the revised Baby-friendly Hospital Initiative 2018--Implementation guidance.



Evidence


Related Cochrane reviews


Interventions for promoting the initiation of breastfeeding

Balogun OO, O’Sullivan EJ, McFadden A, Ota E, Gavine A, Garner CD et al. Cochrane Database of Systematic Reviews. 2016; Issue 11. Art. No.: CD001688.


Early skin-to-skin contact for mothers and their healthy newborn infants

Moore ER, Bergman N, Anderson GC, Medley N.Cochrane Database of Systematic Reviews 2016, Issue 11. Art. No.: CD003519.

Summary of this review Alternate Text

Rooming-in for new mother and infant versus separate care for increasing the duration of breastfeeding

Jaafar SH, Ho JJ, Lee KS.Cochrane Database of Systematic Reviews 2016, Issue 8. Art. No.: CD006641.

Summary of this review Alternate Text

Other related systematic reviews


Impact of the Baby-friendly Hospital Initiative on breastfeeding and child health outcomes: a systematic review

Pérez-Escamilla R, Martinez JL, Segura-Pérez S. Matern Child Nutr. 2016;12(3):402-17.


Interventions to improve breastfeeding outcomes: a systematic review and meta-analysis

Sinha B, Chowdhury R, Sankar MJ, Martines J, Taneja S, Mazumder S, et al. Acta Paediatrica. 2015; 104:114–134.