The Baby Friendly Hospital Initiative (BFHI)

The Baby Friendly Hospital Initiative (BFHI) is a worldwide programme launched in 1991 by UNICEF and the World Health Organisation, following the Innocenti Declaration of 1990.
The Baby Friendly Hospital Initiative (BFHI)


The Initiative is a global effort for improving the role of maternity services to enable mothers to breastfeed their babies. It ensures that all maternities, whether in a hospital or as a free standing unit become places where there is support for breastfeeding. It aims at improving care of pregnant women, mothers and newborn infants at health facilities that provide services for protecting, promoting and supporting breastfeeding, in accordance with the International Code of Marketing of Breastmilk Substitutes.

To be designated ‘Baby Friendly’ a maternity facility must implement ‘The Ten Steps to Successful Breastfeeding’ and not accept free or low-cost breastmilk substitutes or other infant care aids provided by formula companies. This is a Global criteria that applies to all countries worldwide.

The internationally defined term ‘Baby Friendly’ may be used only by maternity services that have passed external assessment according to the Global Criteria for the BFHI.

Between 1991 and 2005 approximately 15,000 facilities in 134 countries worldwide have been accredited as Baby Friendly. By 2010 it is estimated that more than 20,000 facilities in over 140 countries will have achieved Baby Friendly status. In many countries, where hospitals have been designated as Baby Friendly, it has been recognised that more mothers are initiating breastfeeding and breastfeeding their infants for longer and that child health has improved.

The Sangre Grande Hospital has been accredited as a Baby Friendly Hospital.  This is the only institution, public or private, in Trinidad and Tobago, to have achieved this international recognition.

The criteria for a hospital’s Baby Friendly accreditation include:

  1. Have a written breastfeeding policy that is routinely communicated to all health care staff.
  2. Train all health care staff in skills necessary to implement this policy.
  3. Inform all pregnant women about the benefits and management of breastfeeding.
  4. Help mothers initiate breastfeeding within one half-hour of birth.
  5. Show mothers how to breastfeed and maintain lactation, even if they should be separated from their infants.
  6. Give newborn infants no food or drink other than breastmilk, unless medically indicated.
  7. Practice rooming in – that is, allow mothers and infants to remain together 24 hours a day.
  8. Encourage breastfeeding on demand.
  9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.
  10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.


The New interpretation of Step 4 in the revised BFHI Global Criteria (2006)

Place babies in skin-to-skin contact with their mothers immediately following birth for at least an hour and encourage mothers to recognise  when their babies are ready to breastfeed, offering help if needed.

The BFHI also restricts use by the hospital of free or low cost formula or other infant care aids provided by formula companies.

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