Frequently Asked Questions

What are your BFHI top tips?

We recommend all staff have a clear understanding of the Baby Friendly Hospital Initiative (BFHI) standards, and have access to the most recent version of the BFHI Documents for Aotearoa New Zealand.

  • Get the senior management and the quality team involved. Their support is vital.

  • Ensure your breastfeeding data is being collated accurately.

  • Know your clientele - consultation with Maori, and cultures that are represented by over 5 percent of your women is required.

  • Ensure you can confidently identify the staff education categories and course requirements for each level.

  • Don't let any member of your clinical staff escape a practical skills review.

  • Audit using the Baby Friendly assessment tool and provide feedback to the staff. It's important to keep everyone informed of the results, and repeat the process at regular intervals.

  • Be flexible, especially when providing breastfeeding education to staff. Make sure you offer a variety of modules to cater for the different learning styles of your staff.

  • Ensure that you and your key workers are consistent in your messages and expectations when communicating with staff.

  • Include all Lead Maternity Carers (LMCs) in your education programme - it is wonderful to have their practises wholeheartedly supporting the facility breastfeeding policy.

  • Pass the steps, but more importantly, if necessary, change your internal culture. Women receive the best care when all support staff truly believe in the BFHI.

Is BFHI easy to achieve and maintain without a BFHI co-ordinator?

Whilst it is possible and has been achieved by smaller facilities, having a designated person (with allocated time) will enable the process to proceed more smoothly.

Achieving Baby Friendly accreditation requires a significant change in practice and culture within the facility, and this is easier to achieve and sustain if a strategic approach is taken. This person can co-ordinate the necessary changes and actions. Education and audit are the keys to achieving this change, both of which can be time consuming.

It's important to take the time to appropriately implement best practice standards of the BFHI. Better informed and supported mothers are much less likely to have the common problems such as sore nipples, engorgement, unsettled babies and babies that won't latch, which take up hours of staff time.

What happens if a facility does not pass the assessment process?

The maternity facility will have six months following receipt of the report to fulfil the requirements. Any additional time required will incur costs for the facility.

Occasionally, after the facility meets the standards, the New Zealand Breastfeeding Alliance (NZBA) Board may give a 'provisional pass' which means the maternity facility must undergo a further review at the time of the Annual BFHI Survey. The cost of this visit is covered by the facility.

If the service is unable to meet the standards required for BFHI accreditation within the allocated six month timeframe, the designation as a BFHI facility is withdrawn. The certificate must be removed from view and the NZBA will notify the Ministry of Health.

What is the most likely reason a facility will not pass the assessment?

Non-compliance is more likely to be for Step Two (Staff Education), Step Five (Breastfeeding Management) and Step 7 (Rooming In). Step Five requires maternal interviewing which highlights staff practice within the facility.

Who do we contact about reassessment?

The date for reassessment is three to four (for those facilities that have been accredited for the fourth time) years from the date on the BFHI certificate. The NZBA will contact the facility and offer a pre-assessment discussion/visit. During this visit the audit process and any issues are discussed.

The request for assessment is initiated by the maternity facility by way of the BFHI Assessment Request form and completion of Part 3 of the BFHI Documents for Aotearoa New Zealand by the manager or the BFHI Co-ordinator.

For further advice contact NZBA at