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The TTen SSteps of the WHO/UNICEF Baby-FriendlyBaby-Friendly™™ Hospital Initiative Hospital Initiative

Launched in 1991, byLaunched in 1991, by

UNICEF and the World Health Organization UNICEF and the World Health Organization

To ensure that all To ensure that all hospitals, maternity facilities and hospitals, maternity facilities and

communitiescommunities become become

Centers of Breastfeeding SupportCenters of Breastfeeding Support

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The Baby Friendly - 10 Steps

Have a written breastfeeding policy that is routinely Have a written breastfeeding policy that is routinely

communicated to all health care staff.  communicated to all health care staff.  

Train all health care staff in skills necessary to implement Train all health care staff in skills necessary to implement

this policy.  this policy.  

Inform all pregnant women about the benefits and Inform all pregnant women about the benefits and

management of breastfeeding.management of breastfeeding.   

Help mothers initiate breastfeeding within one half-hour of Help mothers initiate breastfeeding within one half-hour of

birth.  birth.  

Show mothers how to breastfeed and maintain lactation, Show mothers how to breastfeed and maintain lactation,

even if they should be separated from their infants. even if they should be separated from their infants. 

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The Baby Friendly - 10 Steps

Give newborn infants no food or drink other than breastmilk, Give newborn infants no food or drink other than breastmilk,

unless medically indicated. unless medically indicated. 

Practice rooming in - that is, allow mothers and infants to Practice rooming in - that is, allow mothers and infants to

remain together 24 hours a day.  remain together 24 hours a day.  

Encourage breastfeeding on demand.  Encourage breastfeeding on demand.  

Give no artificial nipples or pacifiers (soothers) to Give no artificial nipples or pacifiers (soothers) to

breastfeeding infants.  breastfeeding infants.  

Foster the establishment of breastfeeding support groups Foster the establishment of breastfeeding support groups

and refer mothers to them on discharge from the hospital or and refer mothers to them on discharge from the hospital or

clinic. clinic.

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BFHI 10-Steps based on Research

If every baby were exclusively breastfed If every baby were exclusively breastfed

from Birth for from Birth for 6 months6 months, ,

an estimated 1.5 million lives world-wide an estimated 1.5 million lives world-wide

would be saved each year. would be saved each year.

Babies and Mother’s lives would be Babies and Mother’s lives would be

enhanced with implementing the 10-Steps enhanced with implementing the 10-Steps

because: because:

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Immediate postpartum breastfeeding helps Mother/ChildMother/Child bonding Breastmilk Alone is the perfect food for BabyBaby’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 MotherMother 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 FamilyFamily Environment Environment Benefits

BFHI 10-Steps based on ResearchWhy Why Breastfeed?Breastfeed?

an abbreviated listan abbreviated list

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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

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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

How Facilities can Support Exclusive Breastfeeding

Promoting BFHI

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Facilitate unrestricted breastfeeding 8-12 times per 24 hoursEnsure 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.” www.guideline.gov

How Facilities can Support Exclusive Breastfeeding

Promoting BFHI

Correct positioning (infant)Signs of correct latch-on (infant)Signs (in Mother and Infant) of milk transfer

Observe:

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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.

Baby-Friendly™ Defined

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Breastfeeding Committee for Canada

(BCC)

is the National Authority

for implementing the WHO/UNICEF

Baby-Friendly™ Hospital Initiative (BFHI)

in Canada

WHO/UNICEF BFHI™ in Canada

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How a Hospital, Maternity Facility, Birthing Center Becomes WHO/UNICEF Baby-Friendly™:

WHO/UNICEF BFHI™ in Canada

1. 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

Recognizes need to improve Plan actions to improve weak areas

When standards met , submit request to P/T

Committee

3. BFHI Pre-AssessmentP/T Committee Reviews (the

Approved) Tool and breastfeeding

handouts

5.External Assessment

Using BFHI Global CriteriaBreastfeeding Committee for Canada to

arrange External Assessment by 2-4

BFHI Assessors (takes 2 – 4 days)

Submit Action Plan & timetable to meet criteriaA Certificate of Commitment is issuedP/T Committee (or BCC) provides advice up to 4 years

Meets Baby-Friendly Hospital Certificate Awarded By BCC and the P/T Committee

7.Re-Assessment Every 5

years to Retain Baby-Friendly

Criteria

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References

UNICEF Global Action www.unicef.ca

BREASTFEEDING AND THE BABY-FRIENDLY INITIATIVE

http://www.unicef.org/programme/breastfeeding/baby.htm

CURRENT STATUS OF BABY-FRIENDLY HOSPITAL INITIATIVE List of Baby-Friendly

Hospitals

http://www.unicef.org/programme/breastfeeding/assets/statusbfhi.pdf

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™: http://www.geocities.com/hotsprings/falls/1136/webdoc30.htm

The Mother-friendly Childbirth Initiative, 10 questions to Ask, CIMS (Coalition

for Improving Maternity Services)

http://www.motherfriendly.org/resources/10Q/

Take an interactive quiz http://www.unicef.ca/eng/travail/breastFeeding/index.html

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How we can contributeSupportSupport 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 designationHelp 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! Thank you for listening! Kairan Athwal and Sylvia te BoekhorstKairan Athwal and Sylvia te Boekhorst