BFHI
Promotes Optimal Infant Feeding Practices Globally| WHO and UNICEF launched the Baby-Friendly Hospital Initiative (BFHI) in response to the declining breastfeeding rates in many parts of the world reflected in high infant mortality and morbidity rates largely due to malnutrition, infections of the respiratory tract and diarrhoeal disease. |
| BFHI promotes optimal infant feeding practices
in hospitals throughout the world by providing comprehensive guidelines to
make hospitals centres of support for breastfeeding. It also establishes the
necessary political and technical support for breastfeeding promotion
activities, draws on the experience of breastfeeding mothers for
mother-to-mother support groups and the skills of health professionals and
research to challenge prevailing medical practice. Central to the BFHI is the International Code of Marketing of Breastmilk Substitutes adopted in 1981 by the World Health Assembly and subsequent WHA resolutions, which call upon breastmilk substitute manufacturers and distributors not to provide free or low-cost supplies to any part of the health care system. Hospitals must meet the BFHI Global Criteria for each of the Ten Steps to Successful Breast-Feeding to achieve accreditation as a Baby- Friendly Hospital. The appraisal is a rigorous process carried out by a team of trained assessors from outside the facility, who report the results of the assessment to a national authority that decides the issue of designation and certification. Since the launching of BFHI in 1991, 14,584 maternity facilities in 128 countries have been designated Baby-Friendly and the effects of the initiative are being measured by the rate and duration of exclusive breastfeeding, by the changes in practise and policy of the health care system, and ultimately by lowered infant mortality and morbidity rates and maternal health, as well as health care costs. According to the WHO and UNICEF for example, a year after the Baby-Friendly Hospital Initiative (BFHI) was launched in Chile in 1991, 25% of infants were exclusively breastfed for the first six months of their lives as opposed to the original 4%. By 1996 it had risen to 45%.
Another key factor is the financial pressure exerted by infant formula manufacturers on hospitals via the "Tours De Lait" (each of the 4 main brands of infant formula being distributed quarterly in their turn and manufacturers paying large sums of money to the hospital proportionate to the number of deliveries per year) which makes full implementation of BFHI impossible at present.
Recently a new task force was formed under the auspices of the National Board of Public Health (Folkhälsoinstitutet) and a re-evaluation of hospitals is under way. Breastfeeding-friendly policies are also being introduced in primary care facilities.
Baby Milk Action Update 24, February 1999.
For more information contact INFACT Canada at 416 595-9819. References: Global Overview of the WHO/UNICEF Baby-Friendly Hospital Initiative R. Saadeh, World Health Organization, Geneva, Switzerland. Protecting, Promoting and Supporting Breastfeeding - The special role of maternity services, a joint WHO/UNICEF Statement. Baby Milk Action Update 24, February 1999 Country reports - IBFAN Regions. |
In Cuba, six years after the introduction of BFHI an
estimated 98 % of newborns were exclusively breastfed when they left the
maternity ward - an increase of 35%, and about 72% of these infants were
exclusively breastfed through four months of age, an increase of 47%. All 44
hospitals handling over 1,000 deliveries a year and 42 per cent of smaller
hospitals in the country are Baby-Friendly.