The Baby-Friendly Hospital Initiative

Hospitals and birthing centers around the world are officially becoming “baby-friendly” by adopting standards that support and encourage breastfeeding.


Here’s everything you need to know—from what it means to deliver in a “baby-friendly” facility, to how to have a successful start to breastfeeding, whether your facility is designated as “baby-friendly” or not.

In 1991 the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) launched the Baby-Friendly Hospital Initiative (BFHI), a global strategy aimed to increase the numbers of babies worldwide who are exclusively breastfed. Since then more than 20,000 maternity facilities in 150 countries have received the Baby-Friendly designation. In the United States alone, more than 500 hospitals and birthing centers now carry this designation.

What make a hospital “baby-friendly”?

To receive and maintain the Baby-Friendly designation, hospitals must adhere to the Ten Steps to Successful Breastfeeding and the International Code of Marketing of Breast-Milk Substitutes. The Ten Steps consist of evidence-based practices that have been shown to increase breastfeeding initiation and duration—like helping mothers initiate breastfeeding within the first hour of birth, practicing “rooming in,” where mothers and babies are kept together 24 hours a day, and withholding pacifiers and breast milk substitutes, unless medically necessary. The Code protects breastfeeding and prohibits aggressive baby formula marketing practices that often discourage mothers from achieving their own breastfeeding goals. A Baby-Friendly facility will not send parents and babies home with formula samples or formula advertisements and coupons.

The Ten Steps to Promoting Successful Breastfeeding in Hospitals

  1. Have a written breastfeeding policy that is routinely communicated to all healthcare staff.
  2. Train all health care staff in the skills necessary to implement this policy.
  3. Inform all pregnant women about the benefits and management of breastfeeding.
  4. Help mothers initiate breastfeeding within one hour of birth.
  5. Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
  6. Give infants no food or drink other than breast milk, unless medically indicated.
  7. Practice rooming in — allow mothers and infants to remain together 24 hours a day.
  8. Encourage breastfeeding on demand.
  9. Give no pacifiers or artificial nipples to breastfeeding infants.
  10. Foster the establishment of breastfeeding support groups and refer mothers to them upon discharge from the hospital or birth center.

What if my hospital isn’t “Baby-Friendly”?

If your hospital or birthing center does not yet have the Baby-Friendly designation, you can pave your own way to successful breastfeeding. Regardless of where you deliver, you can have a Baby-Friendly experience – if that what you’re looking for – by following the Ten Steps to Successful Breastfeeding on your own. For example, you can let your nurse know that you’d like to put your baby skin-to-skin as soon as possible after birth, initiate breastfeeding within one hour of birth, spend 24 hours a day with your baby, and hold off on pacifiers and artificial nipples until breastfeeding has been fully established (around four weeks).

The Baby-Friendly Hospital Initiative gives special recognition to hospitals that provide mothers with the information, confidence and skills necessary to successfully initiate and continue breastfeeding their babies or safely feed them formula.

For more information or to find a Baby-Friendly facility, please visit Baby Friendly USA.