Assessment and Accreditation of the Breastfeeding Friendly Hospitals

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In 2017, the WHO published a “WHO guideline Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services” 

Further in 2018, WHO updated the implementation guidance for countries implementing the BFHI.This provides strategic guidance to scale up to universal coverage and ensure sustainability. The guidance focuses on integrating the programme more fully in the health-care system, to ensure that all facilities in a country implement the Ten Steps. Among its nine principles is the one that calls for external assessment system to evaluate a hospital if they adhere to Ten Steps. The tools developed by BPNI help in assessment process through this BFHI-India -webportal. BPNI assists in accomplishing it and provide technical assistance for accreditation of "Breastfeeding Friendly Hospitals"
 
 WHO Guidance: Nine key principles

  1. Establish or strengthen a national breastfeeding coordination body.
  2. Integrate the Ten Steps into relevant national policy documents and professional standards of care.
  3. Ensure the competency of health professionals and managers in implementation of the Ten Steps. 
  4. Utilize external assessment systems to regularly evaluate adherence to the Ten Steps.
  5. Develop and implement incentives for compliance and/or sanctions for non-compliance with the Ten Steps. 
  6. Provide technical assistance to facilities that are making changes to adopt the Ten Steps.
  7. Monitor implementation of the initiative.
  8. Advocate for the BFHI to relevant audiences.
  9. Identify and allocate sufficient resources to ensure the ongoing funding of the initiative.

Ten steps to successful breastfeeding
WHO and UNICEF launched the Baby-friendly Hospital Initiative (BFHI) to help motivate facilities providing maternity and newborn services worldwide to implement the Ten Steps to Successful Breastfeeding. The Ten Steps summarize a package of policies and procedures that facilities providing maternity and newborn services should implement to support breastfeeding. WHO has called upon all facilities providing maternity and newborn services worldwide to implement the Ten Steps.

The implementation guidance for BFHI emphasizes strategies to scale up to universal coverage and ensure sustainability over time. The guidance focuses on integrating the programme more fully in the health-care system, to ensure that all facilities in a country implement the Ten Steps. Countries are called upon to fulfill nine key responsibilities through a national BFHI programme:

Critical management procedures:
1a. Comply fully with the International Code of Marketing of Breast-milk Substitutes and relevant World Health Assembly resolutions.

1b. Have a written infant feeding policy that is routinely communicated to staff and parents.

1c. Establish ongoing monitoring and data-management systems.

2. Ensure that staff have sufficient knowledge, competence and skills to support breastfeeding.

Key clinical practices:
3. Discuss the importance and management of breastfeeding with pregnant women and their families.

4. Facilitate immediate and uninterrupted skin-to-skin contact and support mothers to initiate breastfeeding as soon as possible after birth.

5. Support mothers to initiate and maintain breastfeeding and manage common difficulties.

6. Do not provide breastfed newborns any food or fluids other than breast milk, unless medically indicated.

7. Enable mothers and their infants to remain together and to practise rooming-in 24 hours a day.

8. Support mothers to recognize and respond to their infants’ cues for feeding.

9. Counsel mothers on the use and risks of feeding bottles, teats and pacifiers.

10. Coordinate discharge so that parents and their infants have timely access to ongoing support and care.