Background:

The Baby-Friendly Hospital Initiative is a WHO-UNICEF evidence-based initiative aiming to improve quality of care in maternity facilities through global implementation of the Ten Steps to Successful Breastfeeding as standards of perinatal care. Although each step is evidence-based, all Ten Steps are intended to work synergistically. Step 1b requires maternity facilities to adopt an infant feeding policy that supports breastfeeding.

Key Information:

This protocol updates the Academy of Breastfeeding Medicine’s 2018 Model Maternity Policy Supportive of Breastfeeding and gives readers the most recent evidence basis. It includes a model policy that can be adapted to local needs. Its strength lies in the synergy of all its components. The importance of protecting families from the harmful influence of the commercial milk formula industry is stressed. The policy includes recommendations to verify health workers’ competencies to adequately support breastfeeding, to offer prenatal education on breastfeeding to mothers and families, guidance for respectful and patient-centered care during childbirth, and immediate and postnatal support for mother and child. Safety issues are considered. Tools for implementation are included.

Recommendations:

Maternity facilities must have a policy that protects and supports breastfeeding. It should include all the Ten Steps, which must be implemented as a whole package. External assessments are recommended to ensure compliance with requirements. Continuous monitoring of practices should be routine. Ensuring that health workers who deal directly with mothers and infants have the competencies needed to protect and support breastfeeding through counseling and person-centered care is strongly recommended.

About ABM Protocols

A central goal of the Academy of Breastfeeding Medicine (ABM) is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. The ABM empowers health professionals to provide safe, inclusive, patient-centered, and evidence-based care. Pregnant and breastfeeding women and others who are pregnant and lactating identify with a broad spectrum of genders, pronouns, and terms for feeding and parenting. There are two reasons ABM’s use of gender-inclusive language may be transitional or inconsistent across protocols. First, gender-inclusive language is nuanced and evolving across languages, cultures, and countries. Second, foundational research has not adequately described the experiences of gender-diverse individuals. Therefore, ABM advocates for, and will strive to use, language that is as inclusive and accurate as possible within this framework.

For more explanation, please read ABM Position Statements on Infant Feeding and Lactation-Related Language and Gender and Breastfeeding As a Basic Human Right.