Review Article | Published:

The Baby Friendly Hospital Initiative and the ten steps for successful breastfeeding. a critical review of the literature

Journal of Perinatologyvolume 38pages623632 (2018) | Download Citation


There is no doubt regarding the multiple benefits of breastfeeding for infants and society in general. Therefore, the World Health Organization (WHO) in a conjoint effort with United Nations International Children’s Emergency Fund (UNICEF) developed the “Ten Steps to Successful Breastfeeding” in 1992, which became the backbone of the Baby Friendly Hospital Initiative (BFHI). Following this development, many hospitals and countries intensified their position towards creating a “breastfeeding oriented” practice. Over the past two decades, the interest increased in the BFHI and the Ten Steps. However, alongside the implementation of the initiative, extensive research continues to evaluate the benefits and dangers of the suggested practices. Hence, it is our intention to make a critical evaluation of the current BFHI and the Ten Steps recommendations in consideration of the importance of providing an evidence-based breastfeeding supported environment for our mothers and infants.

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We sincerely thank the comments and critical review of the manuscript done by Dr. Henrietta Bada.

Author information


  1. Division of Neonatology, Department of Pediatrics, University of Kentucky, Lexington, KY, 40506, USA

    • Enrique Gomez-Pomar
  2. Neonatal Intensive Care Unit Medical Director, Rush Foundation Hospital, Meridian, MS, 39301, USA

    • Robert Blubaugh


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The authors declare that they have no conflict of interest.

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Correspondence to Enrique Gomez-Pomar.

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