When you start breastfeeding, you need all the help you can get. Women who want the highest level of breastfeeding support available should try to give birth in a Baby-Friendly designated hospital or birth center. Why is that? Aren’t all hospital maternity wards the same?
No.
Research has shown that how a mother’s breastfeeding experience is managed during her hospital stay affects the chances that she will meet her breastfeeding goals. Baby-Friendly hospitals implement research-driven practices that result in better breastfeeding outcomes.
WHO & UNICEF Initiative
The Baby-Friendly Hospital Initiative was launched in 1991 by the World Health Organization (WHO) and UNICEF in an effort to increase breastfeeding rates worldwide. The US first facility to become Baby-Friendly was Evergreen Hospital Medical Center in Kirkland, Washington, in 1996. Today there are more than 600 Baby-Friendly designated facilities in the US. They are located in all 50 states, the District of Columbia and Puerto Rico.

To obtain this prestigious designation, a hospital or birth center must demonstrate that they are implementing the Ten Steps to Successful Breastfeeding. The process is detailed and rigorous. Although the WHO and UNICEF revised the Ten Steps in 2108, Baby-Friendly USA (BFUSA) states on their website that “BFUSA will be following the current/existing guidance until further notice.” BFUSA is the organization that confers designation on hospitals and birth centers in the US.
Ten Steps to Successful Breastfeeding
- Have a written breastfeeding policy that is routinely communicated to all health care staff.
- Train all health care staff in the skills necessary to implement this policy.
- Inform all pregnant women about the benefits and management of breastfeeding.
- Help mothers initiate breastfeeding within one hour of birth.
- Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
- Give infants no food or drink other than breast-milk, unless medically indicated.
- Practice rooming-in – allow mothers and infants to remain together 24 hours a day.
- Encourage breastfeeding on demand.
- Give no pacifiers or artificial nipples to breastfeeding infants.
- Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or birth center.
Hospitals that are Baby-Friendly provide 20 hours of breastfeeding education to the nurses who care for new moms and babies. Obstetricians, pediatricians, family practice doctors, and nurse practitioners receive training as well. In fact, every staff member that will come in contact with a breastfeeding mom will receive some training related to breastfeeding support.
Although it is not listed in the current Ten Steps, an additional requirement for designation is that hospitals must pay a fair market price for infant formula, bottles, nipples, and pacifiers. Furthermore, facilities are not allowed to distribute formula marketing packets to new mothers. Often referred to as “formula gift bags,” these were a powerful marketing tool that contained free samples of formula. Studies have shown women who received them had decreased breastfeeding duration rates.
Additionally, hospitals must allow moms and babies time for skin-to-skin contact after birth. Skin-to-skin not only helps babies initiate breastfeeding, it also helps them stabilize their vital signs, including temperature, heart rate, respiration, and blood sugar levels.
By having consistent policies and training in place, hospitals and birth centers are better able to provide breastfeeding mothers the care they need to be successful with their breastfeeding goals.
Baby-Friendly Designated Hospital — Sources
Baby-Friendly USA
Baby-Friendly USA
Journal of Human Lactation