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What is The Baby Friendly Hospital Initiative?


The Baby Friendly Hospital Initiative (BFHI) is an international programme launched in 1991 by the World Health Organisation (WHO) and the United Nations Children's Fund (UNICEF) to ensure all maternity services become centres of breastfeeding support worldwide.

Breastfeeding lays the foundation for good health in infancy, childhood and adult life. Today more than 20,000 hospitals have been Baby Friendly Accredited in 156 countries worldwide. The BFHI programme encourages hospitals and health care facilities - particularly maternity wards - to adopt practices that fully protect, promote and support exclusive breastfeeding from birth.

The BFHI aims to improve exclusive breastfeeding rates and ensure evidenced-based best practice standards of care are offered by maternity services.

Baby friendly facilities work to see that all women, regardless of their feeding method, receive unbiased information, support and professional advice in their decision to feed their babies.

In New Zealand, all maternity services are required to achieve and maintain BFHI accreditation. The standards of care and services provided are audited by the New Zealand Breastfeeding Alliance (NZBA) every three years. Currently 99.85 percent of infants born in national maternity services are delivered in BFHI accredited facilities.

The BFHI has had a positive impact on New Zealand's maternity services, with annual breastfeeding rates showing nearly 80 percent of babies are exclusively breastfed on discharge from Baby Friendly hospitals.

The New Zealand Breastfeeding Alliance (NZBA) is the national authority for the implementation of the Baby Friendly Hospital Initiative (BFHI) in New Zealand.  The BFHI assessment of maternity facilities is carried out based on the World Health Organisation WHO/UNICEF Global Hospital Assessment Criteria, adapted for application in New Zealand.

Amendments and clarifications to the accreditation documents have been made to recognise the uniqueness of the New Zealand health system and to encourage consistent evidence-based culturally appropriate practice at all health care facilities, where initiation of breastfeeding occurs. The accreditation documents recognise:

  • The Treaty of Waitangi principles of protection, participation and partnership as an integral part of BFHI in Aotearoa New Zealand
  • New Zealand has a unique system where women choose their Lead Maternity Carer (LMC) for their antenatal, birth and post-natal care. The auditing tool was developed to assess the facility and staff employed by the facility. Self-employed LMCs utilising hospital facilities also have a key role in practising in-line with BFHI principles and promoting these in the community
  • Informed consent is an important part of the BFHI process with consultation with community service providers and consumers having been encouraged.

The accreditation documents are under review as part of aligning a Baby Friendly Aotearoa programme against the new WHO and UNICEF Ten Steps guidance (2018).  They will be in place from 1 January 2020 with a transition process in place for facilities undergoing audit in the next two years.