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Baby Friendly Health Initiative (BFHI) Accreditation. Protecting, supporting and promoting breastfeeding in WA hospitals. © 2008. Department of Health, State of Western Australia. Delivering a Healthy WA.

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Baby Friendly HealthInitiative (BFHI) Accreditation

Protecting, supporting and promoting breastfeeding in WA hospitals

© 2008. Department of Health, State of Western Australia

Delivering a Healthy WA


Our hospital is applying for Baby Friendly Health Initiative (BFHI) accreditation. Each of us has a role to play in implementing the ten steps to successful breastfeeding.

bfhi is a world health organisation who united nations children s fund unicef global strategy
BFHI is a World Health Organisation (WHO) / United Nations Children’s Fund (UNICEF) global strategy

That promotes:

  • exclusive breastfeeding for 6 months.
  • timely introduction of adequate, safe and appropriate complementary food.
  • breastfeeding for 2 yrs and beyond, as mother and baby desire.




the baby friendly health initiative bfhi
The Baby Friendly Health Initiative (BFHI)
  • Was launched in 1991 by WHO/UNICEF.
  • It aims to give every baby the best start in life by creating a health care environment where breastfeeding is the norm.
bfhi goals
BFHI goals
  • Implement the “Ten steps to successful breastfeeding”.
  • End the practice of distribution of free and low cost supplies of infant formula to hospitals and maternity wards.
  • Compliance with the WHO International code of breast milk marketing.
compliance with the who international code of marketing of breast milk substitutes means
Compliance with the WHO international code of marketing of breast milk substitutes means;
  • NO advertising.
  • NO donations.
  • NO free samples.
  • NO promotion.
  • NO gifts.
  • NO pictures idealising formula feeding.
  • NO use of equipment sponsored or produced by formula companies.

Of formula

our goals
Our goals
  • For all staff to know how they can protect, promote and support breastfeeding in our hospital.
  • For all staff to be educated on the ten steps to successful breastfeeding.

Step one:

Have a written breastfeeding policy that is routinely communicated to all health care staff.

the policy should be on display
The policy should be on display
  • The policy is based on the 10 steps.
  • Everyone should know about it – if you don’t know ask a midwife.
  • It gives guidance on the initiation of breastfeeding.
  • It ensures consistent hospital practices.

Step two:

Train all health care staff in skills necessary to implement this policy.


Everyone should attend some form of training.

  • Formal training ensures consistent advice and management.
  • Improves initiation and duration of breastfeeding.

Step three:

Inform all pregnant women about the benefits and management of breastfeeding.

Information given to women about the benefits of breastfeeding motivates them to breastfeed.
  • Ensures mothers have made an informed choice.

Step four:

Place babies skin to skin contact with their mothers immediately following birth for at least an hour and encourage mothers to recognise when their babies are ready to breastfeed, offering help if needed.

babies placed skin to skin
Babies placed skin to skin
  • Cry less.
  • Keep warm.
  • Use less energy.
  • Start to develop their instinctive feeding behaviours.

Step five:

Show mothers how to breastfeed and how to maintain their lactation even if separated from their infants.

Expert advice and support improves the mother’s confidence.
  • Information and individual help on expressing breast milk maintains the milk supply of a mother if separated from her baby.

Step six:

Give newborn infants no food or drink other than breast milk, unless medically indicated.

other food or drink
Other food or drink
  • May interfere with newborn suckling.
  • Reduces the frequency of breastfeeding.
  • Reduces breast stimulation and therefore milk supply.
  • Is known to cause early cessation of breastfeeding.
  • Interferes with baby’s feeding behaviours.
  • May undermine the mother’s confidence.

Step seven:

Practice rooming-in, allow mothers and babies to remain together 24 hours a day.


Reduces the chances of cross infection.

  • Allows the mother to respond to her baby when they show readiness to feed.
  • Helps establish good milk flow and production.
  • Improves breastfeeding outcomes.

Step eight:

Encourage breastfeeding on demand.

Scheduled feeding leads to breastfeeding problems and may cause insufficient milk supply.
  • Feeding the baby whenever they are hungry helps produce and maintain the milk supply.
  • Frequency and length of feeds vary between infants and from day to day.

Step nine:

Give no artificial teats or dummies to breastfed infants.

Dummies reduce time spent suckling at the breast.
  • Dummies should not replace a breastfeed.
  • Cup or finger feeding is recommended if feeding at the breast is not possible.

Step ten:

Foster the establishment of breastfeeding support and refer mothers on discharge from the facility.

breast milk and breastfeeding baby benefits
Breast milk and breastfeeding baby benefits
  • Colostrum(first milk) is the baby’s first immunisation.
  • Important for the development of the digestive system.
  • Perfect for immature organs.
  • Is a living fluid that protects against infection and allergy.
  • Breastfed babies have less stomach, ear and chest illnesses.
  • Higher intelligence and better vision.
  • May protect against diabetes and heart disease in later life.
  • Reduces the risk of childhood obesity.
breastfeeding benefits for mums
Breastfeeding benefits for mums

May reduce the risk of osteoporosis, breast and ovarian cancers.

Promotes bonding.

Helps the uterus return to normal size.

Helps the return to pre-pregnancy weight.

breastfeeding benefits for the family
Requires no special equipment.

Reduces health care costs.

Protects the environment.

Is free.

Breastfeeding benefits for the family
who can help
Who can help?
  • Australian Breastfeeding Association. 24hr helpline, 1800 mum 2 mum= 1800 686 2 686
  • Midwives
  • Community Child Health Nurses.
  • Some hospitals have dedicated breastfeeding clinics.
  • Private Lactation Consultants (fees apply).
  • Mother’s groups (playgroups, coffee mornings etc).
  • You

Understand how the ‘Ten steps to successfully breastfeeding’ can affect your practice.


Know what to say


ask the midwives for help if a mother asks your advice.

Produced for WA Health: Women’s and Newborns’ Health Network

Music: Sovereign. Kevin MacLeod ( Licensed under Creative Commons “Attribution 3.0

Photographs: Families and staff from King Edward Memorial Hospital.

© 2008. Department of Health, State of Western Australia