When the revitalized BFHI guidelines were released in 2018, national committees began adapting the localized guidance around the world. In July, Baby-Friendly USA released updated guidelines to reflect the 10 Steps to Successful Breastfeeding as well as the evaluation criteria for accreditation beginning in June 2023. The guidelines also included the material found in the Competency Verification Toolkit from 2020, so these documents reflect a full and extensive revision of the materials that hospitals rely on throughout their BFHI accreditation journey.
The 115 page document brings together all 10 Steps with the links to the global guidance as well as details specific to the United States, in a format that integrates evaluation criteria and competencies, as well as the rationale for each of the 10 Steps. While the guidance applies only to facilities in the United States, it is worth a look even if that is not where you practice.
As those who have been following the rollout globally will know, the foundations of the 10 Steps and BFHI have seen few changes in this latest revision. Best practices in care remain rooted in the same principles that they were when BFHI was launched in the early 1990s: babies (and their parents) need fundamentally the same things as they did then.
The revitalization however brought a great deal of evidence into the review that has both confirmed and deepened the understanding of why and how BFHI works. What is not always so obvious is that the revitalized BFHI also draws on the fields of change management, quality improvement, and adult learning principles.
The emphasis in the new BFHI on adult learning principles and particularly measuring competencies is among the largest changes for staff, management, and those who create and deliver training for them.
BFHI and the role of professional development within it are much richer in the revitalized BFHI. It challenges us to move beyond the clinical skills we are familiar with and to think about how staff and management create an enabling environment for the 10 Steps to be implemented consistently for every family we meet.
Michelle Pensa Branco MPH IBCLC
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Last Updated: September 2018