History of the Baby Friendly Hospital Initiative

Just Imagine!

Imagine the unveiling of a new feeding system that could claim to provide a baby with a nutritious, satisfying meal while it fulfilled all daily requirements for vitamins: at the same time, regular doses would protect the newborn against disease and infection and strengthen the bond between mother and infant. The product would be available everywhere, in exactly the quantities needed, and it would require no packaging, storage, refrigeration or preparation. A mother who used the new feeding system would find herself temporarily protected against unplanned pregnancy, and her risk of cancer would be reduced. Imagine the price its creators could demand!

Only Breastfeeding can make all those claims!

The baby friendly process

Breastfeeding is universally accepted as the best method of feeding babies. But in the twentieth century breastmilk met with competition from industrial substitutes and mothers were drawn to the convenience of prepackaged foods. This "great scientific discovery led to a decline in breastfeeding with formulae feeding being regarded as "The Greatest Uncontrolled Experiment the World has ever known!"

Hospital practices were also cited for resulting in a decline in breastfeeding. Such practices included mother and baby separation, rigid feeding regimes, administering prelacteal e.g. glucose water, uses of dummies, uses of analgesia or anaesthetics.

The consequences of a decrease in breastfeeding result in an increase in morbidity (sickness) and mortality (death) of children. According to the World Health Organization (WHO), every day between 3000 and 4 000 infants die globally because the ability to breastfeed their infants appropriately has been taken away from their mothers, while thousands more succumb to infection and malnutrition.

The decline in breastfeeding was cause for concern and worldwide effort to protect, promote and support breastfeeding, the Baby Friendly Hospital Initiative (BFHI), was launched by James P Grant, Executive Director of UNICEF, and Hiroshi Nakajima, Director-General of WHO in 1991. This initiative was created to transform Health Care policies by restoring breastfeeding as the natural and normal practice for nurturing babies. BFHI is thus a strategy to encourage the implementation of the "Ten Steps to Successful Breastfeeding". These steps were contained in a joint WHO/UNICEF statement (1989) entitle: "Protecting, promoting and supporting breastfeeding the special role of Maternity Service" A slightly amended version of the Ten Steps was adopted by the South African Health Matters Committee in 1990. Although notification of this was officially circulated to hospitals and BFHI was launched in South Africa during March 1993, it has become apparent that many maternity personnel have remained unaware of the concept of "Baby-Friendliness".

The aim of the WHO/UNICEF statement was to increase awareness of the critical role of health services in the promotion of breastfeeding and to give guidelines for appropriate information and support to mothers. The BFHI strategy, whilst focusing on maternity care services, involves the holistic care of mother and baby both within the facility and beyond.

Quick Links