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History of the Baby Friendly
Hospital Initiative
Just Imagine!
Imagine the unveiling of a new feeding system that could claim to
provide a baby with a nutritious, satisfying meal while it fulfilled all
daily requirements for vitamins: at the same time, regular doses would
protect the newborn against disease and infection and strengthen the
bond between mother and infant. The product would be available
everywhere, in exactly the quantities needed, and it would require no
packaging, storage, refrigeration or preparation. A mother who used the
new feeding system would find herself temporarily protected against
unplanned pregnancy, and her risk of cancer would be reduced. Imagine
the price its creators could demand!
Only Breastfeeding can make all those claims!
The baby friendly process
Breastfeeding is universally accepted as the best method
of feeding babies. But in the twentieth century breastmilk met with
competition from industrial substitutes and mothers were drawn to the
convenience of prepackaged foods. This "great scientific discovery led
to a decline in breastfeeding with formulae feeding being regarded as
"The Greatest Uncontrolled Experiment the World has ever known!"
Hospital practices were also cited for resulting in a
decline in breastfeeding. Such practices included mother and baby
separation, rigid feeding regimes, administering prelacteal e.g. glucose
water, uses of dummies, uses of analgesia or anaesthetics.
The consequences of a decrease in breastfeeding result
in an increase in morbidity (sickness) and mortality (death) of
children. According to the World Health Organization (WHO), every day
between 3000 and 4 000 infants die globally because the ability to
breastfeed their infants appropriately has been taken away from their
mothers, while thousands more succumb to infection and malnutrition.
The decline in breastfeeding was cause for concern and
worldwide effort to protect, promote and support breastfeeding, the Baby
Friendly Hospital Initiative (BFHI), was launched by James P Grant,
Executive Director of UNICEF, and Hiroshi Nakajima, Director-General of
WHO in 1991. This initiative was created to transform Health Care
policies by restoring breastfeeding as the natural and normal practice
for nurturing babies. BFHI is thus a strategy to encourage the
implementation of the "Ten Steps to Successful Breastfeeding". These
steps were contained in a joint WHO/UNICEF statement (1989) entitle:
"Protecting, promoting and supporting breastfeeding the special role of
Maternity Service" A slightly amended version of the Ten Steps was
adopted by the South African Health Matters Committee in 1990. Although
notification of this was officially circulated to hospitals and BFHI was
launched in South Africa during March 1993, it has become apparent that
many maternity personnel have remained unaware of the concept of
"Baby-Friendliness".
The aim of the WHO/UNICEF statement was to increase
awareness of the critical role of health services in the promotion of
breastfeeding and to give guidelines for appropriate information and
support to mothers. The BFHI strategy, whilst focusing on maternity care
services, involves the holistic care of mother and baby both within the
facility and beyond.
South Africa has accepted the BFHI challenge and
‘now is the time’ to ensure that health care personnel, families and
communities receive the information and support required for babies
in South Africa to receive the best start in life!
Questions and answers on
the assessment and designation of Baby Friendly Hospitals
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HEALTH KWAZULU-NATAL