Protection, Promotion and Support of Healthy Maternal, Infant and Young Child Feeding

BFHI training materials for 2006 and beyond

Preliminary version for country implementation

Baby-friendly hospitals became an Initiative of UNICEF and WHO in 1991, following the Innocenti Declaration of 1990. The original 18-hour course was developed in support of the Baby-friendly Hospital Initiative (BFHI) in 1993. This course assisted many health facilities to implement supportive practices and to move towards a Baby-friendly designation.

Baby-Friendly practices continues to be an important component of infant feeding strategies. There is new information on the critical importance of breastfeeding and the practices to support it, particularly in emergencies and the HIV pandemic. There is increased recognition of the importance of competency-based education and the need for participants to understand what they can and cannot do as a result of this training. The BFHI materials and the course have been updated and revised based on a decade of accumulated knowledge and experience and the new developments.

A new approach is offered for country implementation considerations and alternatives, and the Code of Marketing section has been updated (Section 1: Background and Implementation). In addition, significant changes are seen in the training materials (Section 3: Breastfeeding Promotion and Support in a Baby-friendly Hospital - a 20-hour course for maternity staff) and assessment tools (Section 3: Hospital Self-Appraisal and Monitoring). The changes in the training materials expand their use, and include supportive practices during labour and birth, skin-to-skin contact, preparation for discharge, HIV considerations, and working towards Baby-Friendly status.

The current BFHI package includes:

Section 1: Background and Implementation provides guidance on the revised processes and expansion options at the country, health facility, and community level, recognizing that the Initiative has expanded and must be mainstreamed to some extent for sustainability, and includes:

1. Country Level Implementation
2. Hospital Level Implementation
3. The Global Criteria for BFHI
4. Compliance with the International Code of Marketing of Breast milk Substitutes
5. Baby-Friendly Expansion and Integration Options
6. Resources, References and Websites

Section 2: Strengthening and sustaining the Baby-friendly Hospital Initiative: A course for decision-makers was adapted from WHO course "Promoting breast-feeding in health facilities a short course for administrators and policy-makers". This can be used to orient hospital decisions-makers (directors, administrators, key managers, etc.) and policy-makers to the Initiative and the positive impacts it can have and to gain their commitment to promoting and sustaining "Baby-friendly". There is a Course Guide and eight Session Plans with handouts and PowerPoint Slides. Two alternative session plans and materials for use in settings with high HIV prevalence have been included.

Section 3: Breastfeeding Promotion and Support in a Baby-friendly Hospital is a 20-hour course for maternity staff that can be used by facilities to strengthen the knowledge and skills of their staff towards successful implementation of the Ten Steps to Successful Breastfeeding. This section includes:

1. Guidelines for Course Facilitators including a Course Planning Checklist
2. Outlines of Course Session
3. PowerPoint Slides for the Course

Section 4: Hospital Self-Appraisal and Monitoring provides tools that can be used by managers and staff initially to determine whether their facilities are ready to apply for external assessment and once their facilities are designated Baby-Friendly, to monitor continued adherence to the Ten Steps. This section includes:

1. Hospital Self-Appraisal Tool
2. Guidelines and Tool for Monitoring

While these materials are now ready for Country-level implementation, comments are most welcome. To contact UNICEF, send an e-mail to pdpimas@unicef.org (with subject: nutrition). Contact WHO at nutrition@who.int or visit the WHO Website.

02 January, 2009