Session 1.

BFHI: A key component of quality maternal and newborn care

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© WHO/ Yoshi Shimizu

Session 1. Objectives BFHI: A key component of quality maternal and newborn care

After completing this session, participants will be able to:

• describe the importance of exclusive and continued breastfeeding;
• discuss the WHO/UNICEF Global Strategy for Infant and Young Child Feeding;
• outline the Baby-friendly Hospital Initiative (BFHI);
• list the Ten steps to successful breastfeeding (ten Steps);
• outline how this course improves capacity building.

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Exclusive and continued breastfeeding

Left: © UNICEF/UN041252/ Pirozzi

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Right top: © UNICEF/UN0281006/ Vishwanathan

Right Bottom: © UNICEF/UN0321734/ Mejía

To enable mothers/parents/caregivers to establish and sustain exclusive breastfeeding for six months, WHO and UNICEF recommend:

immediate and uninterrupted skin-to-skin contact from birth and initiation of breastfeeding within the first hour of life;

exclusive breastfeeding – the infant only receives breast milk, and no other foods or fluids;

breastfeeding responsively – that is, as early and often, and as long as the baby wants, day and night;

counselling mothers on the risks and use of feeding bottles, teats or pacifiers.

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Goal of Global Strategy

• Improve the nutritional status, growth and development, health, and survival of infants and young children through optimal feeding practices.
• Support exclusive breastfeeding for six months, followed by timely, adequate, safe, and appropriate complementary feeding.
• Breastfeeding should continue for up to two years and beyond.
• Support maternal nutrition through social and community support initiatives.

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Ten Steps to successful breastfeeding: 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.

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Ten steps to successful 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.

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Ten steps to successful breastfeeding: key clinical practices

7. Enable mothers and their infants to remain together, and to practice rooming-in 24 hours per 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.

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BFHI Maternity Staff Course: Structure and expectations

Structure

22 hours

3 days

Lecture, hands-on practice Clinical sessions

Expectations

Knowledge + Practice

Interaction

Problem-solving

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© WHO/ Yoshi Shimizu

Let’s discuss: Your local and national context

Global Breastfeeding Scorecard

Please find your country’s information

https://www.who.int/publications/i/item/WHO-NMH-NHD-19.22

Discussion questions

What did you learn about your own country’s situation?

How does this reflect your local context?

What are areas of success?

What are areas of improvement?

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Let’s discuss: Your local and national context

Breastfeeding rates

Early initiation in < 1 hour

Exclusive: 0-6 months

Continued at 1 year

Continued at 2 years

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Let’s discuss: Your local and national context

Enabling environment and reporting:

Please include information from the listed topics on the Breastfeeding Scorecard for your country.

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Let’s discuss: Your local and national context

Resources

Global Breastfeeding Scorecard

https://www.who.int/publications/i/item/WHO-NMH-NHD-19.22

WBTi

http://worldbreastfeedingtrends.org/

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