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Step 10 Resources

October 2019

As a Baby-Friendly Hospital facility, there are many resources at your disposal.  To assist you in achieving Step 10 of the Ten Steps to Successful Breastfeeding, I would like to highlight one of those resources.

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Produced by the World Health Organization and UNICEF, The Revised Baby-friendly Hospital Initiative 2018, provides much of what you'll need to achieve and maintain your BFHI designation. Within this document is Implementation Guidance. This quote comes from page 35:

"Clearly, facilities providing maternity and newborn services constitute only one of the many entry points for protecting, promoting, and supporting breastfeeding. Many other interventions are needed in antenatal care, postpartum care, communities and workplaces. It is critical that those working to improve policies and programmes in facilities providing maternity and newborn services integrate their work with those working in other areas.

"For example, health-professional education on breastfeeding is typically quite weak and needs to be strengthened. Training on BFHI standards will need to be integrated into broader pre-service breastfeeding education for health professionals. The WHO Model chapter for textbooks for medical students and allied health professionals provides standard information on breastfeeding (85). Development of a medical school curriculum on breastfeeding would not generally be the responsibility of a BFHI coordination body, but the contribution of the information on the BFHI standards for such a curriculum probably would.

"Similarly, while the BFHI coordination body would not be responsible for improving breastfeeding counselling in primary health-care facilities or antenatal clinics; it would need to ensure that national standards for antenatal care do provide mothers with adequate knowledge about breastfeeding before they enter the facility providing maternity and newborn services.

"The BFHI programme needs to work with existing programmes and initiatives to ensure that there are sufficient breastfeeding-support structures in the community to connect mothers to upon facility discharge, even though the programme itself does not carry out services in the community... Perz-Escamilla (2016) identified community support as a critical step for sustaining breastfeeding beyond the first few weeks of life (42).  Interventions to increase breastfeeding rates have been shown to be much more effective when health services interventions are combined with community interventions (92).

"The UNICEF-and WHO-led Global Breastfeeding Collective (93) has identified the linkage between health facilities and communities, and encourages community networks that protect, promote and support breastfeeding as a top priority. The national BFHI coordination body should foster the development of numerous types of community breastfeeding support through primary health-care centres, community health workers, home visitors, breastfeeding clinics, nurses/midwives, lactation consultants, peer counsellors, and mother-to-mother support groups.”

This and other documents can be downloaded freely at the WHO website. Please use these documents to better achieve the BFHI designation and to protect, provide, and support breastfeeding.


Kathy Parkes, MSN-Ed, RN, IBCLC, FILCA CHC

Professional Development Educator



Implementation guidance: protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services - the revised Baby-friendly Hospital Initiative. Geneva: World Health Organization; 2018. License: CC-B IGO.Y-NC-SA 3.0


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