WHO and UNICEF launched the Baby Friendly Initiative (BFHI) over thirty years ago; three years later, UNICEF UK Baby Friendly Initiative (BFI) was born. The original BFHI framework of Ten Steps was created to improve maternity and hospital practices that undermined breastfeeding, such as separating mothers and their newborns or routine formula supplements, as well as implementing the International Code of Breastmilk Substitutes in maternity settings, in order to eliminate conflicts of interest with the baby feeding industry (companies that manufacture or distribute infant formula/milks, baby foods, feeding bottles and teats) such as promotion of formula milk in healthcare settings, or direct contact by companies with parents.

The Baby Friendly Initiative has changed the face of maternity practices and midwifery training in the UK – breastfeeding initiation has gone up about 20% since UNICEF UK BFI was founded in 1994. In this country, BFI has grown beyond maternity settings to create standards for infant feeding support programmes in the community and for universities training the next generation of midwives and health visitors. The BFI standards were revised in 2012, based upon the twin pillars of breastfeeding and the UN Convention on the Rights of the Child.

BFI standards in the community call for the integration of several levels of breastfeeding care:

  • Routine care: all staff in the universal services (midwives, health visitors, support workers etc) are trained to BFI standard with sound, evidence-based, basic training in supporting breastfeeding and responsive infant feeding. 
  • Additional services: every area should have additional support available, such as trained, skilled peer supporters who can act as an “informed friend” for new mothers, and a network of local peer support groups where new parents can find social support alongside help with everyday breastfeeding issues.
  • Specialist services: every area should also have a referral pathway for specialist care for more complex breastfeeding problems; breastfeeding specialists should have extensive experience or training such as the IBCLC qualification or a recognised breastfeeding counsellor/supporter credential, and either be a registered health professional themselves, or co-lead the specialist service with a registered health professional.
WBTi poster on Integrated Services to Support Breastfeeding, 2019

A good example of how the BFI community standards work is Harrow. Read more HERE about how WBTi UK Steering Team member and specialist health visitor Alison Spiro led Harrow’s local community health services through BFI accreditation, to develop a well integrated services and become 

the only local authority in the UK where breastfeeding was the ‘normal’ way to feed babies”

UNICEF assessment

More recently, UNICEF UK BFI have produced Learning Outcomes for a wider range of health professions: medical students, paediatricians, pharmacists, paediatric/ children’s nurses, maternity support workers and nursery nurses. These will help to address the gaps in high level health professional training standards found in WBTI’s 2016 report. Every health professional who works with women, infants and children should understand the basics of lactation and breastfeeding management, prescribing during lactation, and how to refer parents on to local breastfeeding support.

#WBW2022 Webinar

On Wednesday 3 August, we will all have the chance to learn more about the Ten Steps of BFHI in a webinar produced by the Global Breastfeeding Collective, an alliance of NGOs from around the world led by WHO and UNICEF.

In addition, there will be sessions on the care of young breastfed infants who are small or with faltering growth (the MAMI Pathway) and on infant feeding in emergencies. 

The entire webinar runs from 7-9 AM BST and again from 4-6 PM BST, and will be recorded.

Register HERE

Our WBTi #WBW2022 blog will cover these additional topics later in the week.

See you there!

This image has an empty alt attribute; its file name is h-gray-2021-dorset.jpeg

Helen Gray MPhil IBCLC is Joint Coordinator of the WBTi UK Steering Group.

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