Breastfeeding and the Baby Friendly Hospitals Initiative (BFHI): organization, response and outcome in Sweden and other countries

The Baby Friendly Hospitals Initiative (BFHI), organized as a global campaign by UNICEF and focusing mainly on the breastfeeding routines, attitudes and knowledge among staff and mothers at maternity centres, was introduced in Sweden in 1993. Four years later, all of the then 65 maternity centres had been designated “baby friendly” (BF). Concomitant with that, the 6-mo breastfeeding rate increased from about 50% to 73% on a national basis, presumably resulting from adherence to the “10 steps” and the development of a favourable breastfeeding climate. The BFHI has engaged practically all countries throughout the world with close to 20 000 maternity centres. On a global scale, about 30% of these maternity centres have been awarded BF status but with large variations between regions and countries; Europe and other industrialized areas being among the lowest.

Conclusion: Strong government support, an organized central lead group and support from the medical profession are necessary prerequisites for BFHI success, but continued work is necessary for sustaining attitudes and knowledge.