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

Abstract

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.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

Fig. 1

References

  1. 1.

    Section on B. Breastfeeding and the use of human milk. Pediatrics. 2012;129:e827–41.

    Article  Google Scholar 

  2. 2.

    Atchan M, Davis D, Foureur M. An historical document analysis of the introduction of the Baby Friendly Hospital Initiative into the Australian setting. Women Birth. 2017;30:51–62.

    Article  PubMed  Google Scholar 

  3. 3.

    Wright A, Schanler R. The resurgence of breastfeeding at the end of the second millennium. J Nutr. 2001;131:421S–5.

    Article  PubMed  CAS  Google Scholar 

  4. 4.

    WHO Guidelines Approved by the Guidelines Review Committee. Baby-Friendly Hospital initiative: revised, updated and expanded for integrated care. Geneva: World Health Organization and UNICEF; 2009.

  5. 5.

    USA. B-F. Guidelines and evaluation criteria for facilities seeking baby-friendly designation. 2016. https://d14abeop4cfxkt.cloudfront.net/cms/files/386/files/original/GEC2016.pdf. Accessed 30 Sept 2017.

  6. 6.

    Saadeh RJ. The Baby-Friendly Hospital Initiative 20 years on: facts, progress, and the way forward. J Hum Lact. 2012;28:272–275.

    Article  PubMed  Google Scholar 

  7. 7.

    Feldman-Winter L, Ustianov J, Anastasio J, Butts-Dion S, Heinrich P, Merewood A, et al. Best fed Beginnings: a nationwide quality improvement initiative to increase breastfeeding. Pediatrics. 2017;140:3121.

  8. 8.

    Labbok MH. Global baby-friendly hospital initiative monitoring data: update and discussion. Breastfeed Med. 2012;7:210–22.

    Article  PubMed  Google Scholar 

  9. 9.

    Meek JY, Noble L. Implementation of the Ten steps to successful breastfeeding saves lives. JAMA Pediatr. 2016;170:925–6.

    Article  PubMed  Google Scholar 

  10. 10.

    Bass JL, Gartley T, Kleinman R. Unintended consequences of current breastfeeding initiatives. JAMA Pediatr. 2016;170:923–924.

    Article  PubMed  Google Scholar 

  11. 11.

    Goldsmith JP. Hospitals should balance skin-to-skin contact with safe sleep policies. AAP News. 2013;34.

  12. 12.

    Flaherman V, Von Kohorn I. Interventions intended to support breastfeeding: updated assessment of benefits and harms. JAMA. 2016;316:1685–1687.

    Article  PubMed  Google Scholar 

  13. 13.

    Vallenas C, Savage F. Evidence for the ten steps to successful breastfeeding. 1998. http://apps.who.int/iris/bitstream/10665/43633/1/9241591544_eng.pdf. Accessed 30 Sept 2017.

  14. 14.

    Semenic S, Childerhose JE, Lauziere J, Groleau D. Barriers, facilitators, and recommendations related to implementing the Baby-Friendly Initiative (BFI): an integrative review. J Hum Lact. 2012;28:317–34.

    Article  PubMed  Google Scholar 

  15. 15.

    Lubold AM. The effect of family policies and public health initiatives on breastfeeding initiation among 18 high-income countries: a qualitative comparative analysis research design. Int Breastfeed J. 2017;12:34.

    Article  PubMed  PubMed Central  Google Scholar 

  16. 16.

    Feldman-Winter L. Evidence-based interventions to support breastfeeding. Pediatr Clin North Am. 2013;60:169–87.

    Article  PubMed  Google Scholar 

  17. 17.

    U.S. Department of Health and Human Services. The surgeon general’s call to action to support breastfeeding. In: Office of the Surgeon Genera, editor. Rockville, MD, 2011.

  18. 18.

    Patnode CD, Henninger ML, Senger CA, Perdue LA, Whitlock EP. Primary care interventions to support breastfeeding: updated evidence report and systematic review for the us preventive services task force. JAMA. 2016;316:1694–705.

    Article  PubMed  Google Scholar 

  19. 19.

    Kramer MS, Chalmers B, Hodnett ED, Sevkovskaya Z, Dzikovich I, Shapiro S, et al. Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus. JAMA. 2001;285:413–20.

    Article  PubMed  CAS  Google Scholar 

  20. 20.

    Atchan M, Davis D, Foureur M. The impact of the Baby Friendly Health Initiative in the Australian health care system: a critical narrative review of the evidence. Breastfeed Rev. 2013;21:15–22.

    PubMed  Google Scholar 

  21. 21.

    Merten S, Dratva J, Ackermann-Liebrich U. Do baby-friendly hospitals influence breastfeeding duration on a national level? Pediatrics. 2005;116:e702–8.

    Article  PubMed  Google Scholar 

  22. 22.

    Schmied V, Gribble K, Sheehan A, Taylor C, Dykes FC. Ten steps or climbing a mountain: a study of Australian health professionals’ perceptions of implementing the baby friendly health initiative to protect, promote and support breastfeeding. BMC Health Serv Res. 2011;11:208.

    Article  PubMed  PubMed Central  Google Scholar 

  23. 23.

    Walsh AD, Pincombe J, Henderson A. An examination of maternity staff attitudes towards implementing Baby Friendly Health Initiative (BFHI) accreditation in Australia. Matern Child Health J. 2011;15:597–609.

    Article  PubMed  Google Scholar 

  24. 24.

    Heymann J, Raub A, Earle A. Breastfeeding policy: a globally comparative analysis. Bull World Health Organ. 2013;91:398–406.

    Article  PubMed  PubMed Central  Google Scholar 

  25. 25.

    Gatti L. Maternal perceptions of insufficient milk supply in breastfeeding. J Nurs Scholarsh. 2008;40:355–63.

    Article  PubMed  PubMed Central  Google Scholar 

  26. 26.

    Robert E, Coppieters Y, Swennen B, Dramaix M. The reasons for early weaning, perceived insufficient breast milk, and maternal dissatisfaction: comparative studies in two belgian regions. Int Sch Res Not. 2014;2014:678564.

    PubMed  PubMed Central  Google Scholar 

  27. 27.

    Anstey EH, Chen J, Elam-Evans LD, Perrine CG. Racial and geographic differences in breastfeeding - united states, 2011-2015. MMWR Morb Mortal Wkly Rep. 2017;66:723–7.

    Article  PubMed  PubMed Central  Google Scholar 

  28. 28.

    Hawke BA, Dennison BA, Hisgen S. Improving hospital breastfeeding policies in New York State: development of the model hospital breastfeeding policy. Breastfeed Med. 2013;8:3–7.

    Article  PubMed  PubMed Central  Google Scholar 

  29. 29.

    Schanler RJ, O’Connor KG, Lawrence RA. Pediatricians’ practices and attitudes regarding breastfeeding promotion. Pediatrics. 1999;103:E35.

    Article  PubMed  CAS  Google Scholar 

  30. 30.

    Feldman-Winter LB, Schanler RJ, O’Connor KG, Lawrence RA. Pediatricians and the promotion and support of breastfeeding. Arch Pediatr & Adolesc Med. 2008;162:1142–9.

    Article  Google Scholar 

  31. 31.

    Feldman-Winter L, Szucs K, Milano A, Gottschlich E, Sisk B, Schanler RJ. National trends in pediatricians’ practices and attitudes about breastfeeding: 1995 to 2014. Pediatrics. 2017;140:1229.

  32. 32.

    Meek JY. Pediatrician competency in breastfeeding support has room for improvement. Pediatrics. 2017;140:2509.

  33. 33.

    Fairbank L, O’Meara S, Renfrew MJ, Woolridge M, Sowden AJ, Lister-Sharp D. A systematic review to evaluate the effectiveness of interventions to promote the initiation of breastfeeding. Health Technol Assess. 2000;4:1–171.

    PubMed  CAS  Google Scholar 

  34. 34.

    Meedya S, Fernandez R, Fahy K. Effect of educational and support interventions on long-term breastfeeding rates in primiparous women: a systematic review and meta-analysis. JBI Database Syst Rev Implement Rep. 2017;15:2307–2332.

    Article  Google Scholar 

  35. 35.

    Wouk K, Tully KP, Labbok MH. Systematic review of evidence for baby-friendly hospital initiative step 3. J Hum Lact. 2017;33:50–82.

    Article  PubMed  Google Scholar 

  36. 36.

    Lumbiganon P, Martis R, Laopaiboon M, Festin MR, Ho JJ, Hakimi M. Antenatal breastfeeding education for increasing breastfeeding duration. Cochrane Database Syst Rev. 2016;12:CD006425.

    PubMed  Google Scholar 

  37. 37.

    Munn AC, Newman SD, Mueller M, Phillips SM, Taylor SN. The impact in the united states of the baby-friendly hospital initiative on early infant health and breastfeeding outcomes. Breastfeed Med. 2016;11:222–30.

    Article  PubMed  PubMed Central  Google Scholar 

  38. 38.

    Chung M, Raman G, Trikalinos T, Lau J, Ip S. Interventions in primary care to promote breastfeeding: an evidence review for the U.S. Preventive Services Task Force. Ann Intern Med. 2008;149:565–82.

    Article  PubMed  Google Scholar 

  39. 39.

    de Jager E, Broadbent J, Fuller-Tyszkiewicz M, Nagle C, McPhie S, Skouteris H. A longitudinal study of the effect of psychosocial factors on exclusive breastfeeding duration. Midwifery. 2015;31:103–11.

    Article  PubMed  Google Scholar 

  40. 40.

    McFadden A, Gavine A, Renfrew MJ, Wade A, Buchanan P, Taylor JL, et al. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev. 2017;2:CD001141.

    PubMed  Google Scholar 

  41. 41.

    Hinsliff-Smith K, Spencer R, Walsh D. Realities, difficulties, and outcomes for mothers choosing to breastfeed: primigravid mothers experiences in the early postpartum period (6–8 weeks). Midwifery. 2014;30:e14–9.

    Article  PubMed  Google Scholar 

  42. 42.

    Tully KP, Ball HL. Maternal accounts of their breast-feeding intent and early challenges after caesarean childbirth. Midwifery. 2014;30:712–9.

    Article  PubMed  Google Scholar 

  43. 43.

    Roll CL, Cheater F. Expectant parents’ views of factors influencing infant feeding decisions in the antenatal period: a systematic review. Int J Nurs Stud. 2016;60:145–55.

    Article  PubMed  Google Scholar 

  44. 44.

    Labarere J, Gelbert-Baudino N, Ayral AS, Duc C, Berchotteau M, Bouchon N, et al. Efficacy of breastfeeding support provided by trained clinicians during an early, routine, preventive visit: a prospective, randomized, open trial of 226 mother-infant pairs. Pediatrics. 2005;115:e139–46.

    Article  PubMed  Google Scholar 

  45. 45.

    Ryan AS, Zhou W. Lower breastfeeding rates persist among the special supplemental nutrition program for women, infants, and children participants, 1978-2003. Pediatrics. 2006;117:1136–46.

    Article  PubMed  Google Scholar 

  46. 46.

    Francescon J, Haile ZT, Kling D, Chertok I. Association between wic enrollment and exclusive breastfeeding at 3 months postpartum among low-income mothers. J Am Osteopath Assoc. 2016;116:770–9.

    Article  PubMed  Google Scholar 

  47. 47.

    Hedberg IC. Barriers to breastfeeding in the WIC population. MCN Am J Matern Child Nurs. 2013;38:244–9.

    Article  PubMed  Google Scholar 

  48. 48.

    Jacobson LT, Twumasi-Ankrah P, Redmond ML, Ablah E, Hines RB, Johnston J, et al. Characteristics associated with breastfeeding behaviors among urban versus rural women enrolled in the Kansas WIC program. Matern Child Health J. 2015;19:828–39.

    Article  PubMed  Google Scholar 

  49. 49.

    Ahluwalia IB, Tessaro I, Grummer-Strawn LM, MacGowan C, Benton-Davis S. Georgia’s breastfeeding promotion program for low-income women. Pediatrics. 2000;105:E85.

    Article  PubMed  CAS  Google Scholar 

  50. 50.

    Schultz DJ, Byker Shanks C, Houghtaling B. The impact of the 2009 special supplemental nutrition program for women, infants, and children food package revisions on participants: a systematic review. J Acad Nutr Diet. 2015;115:1832–46.

    Article  PubMed  Google Scholar 

  51. 51.

    Balogun OO, O’Sullivan EJ, McFadden A, Ota E, Gavine A, Garner CD, et al. Interventions for promoting the initiation of breastfeeding. Cochrane Database Syst Rev. 2016;11:CD001688.

    PubMed  Google Scholar 

  52. 52.

    Moore ER, Bergman N, Anderson GC, Medley N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2016;11:CD003519.

    PubMed  Google Scholar 

  53. 53.

    Feldman-Winter L, Goldsmith JP, Committee On F, Newborn, Task Force On Sudden Infant Death Syndrome. Safe sleep and skin-to-skin care in the neonatal period for healthy term newborns. Pediatrics. 2016;138:e20161889.

  54. 54.

    Crenshaw J. Care practice #6: no separation of mother and baby, with unlimited opportunities for breastfeeding. J Perinat Educ. 2007;16:39–43.

    Article  PubMed  PubMed Central  Google Scholar 

  55. 55.

    Davanzo R, De Cunto A, Paviotti G, Travan L, Inglese S, Brovedani P, et al. Making the first days of life safer: preventing sudden unexpected postnatal collapse while promoting breastfeeding. J Hum Lact. 2015;31:47–52.

    Article  PubMed  Google Scholar 

  56. 56.

    Jaafar SH, Ho JJ, Lee KS. Rooming-in for new mother and infant versus separate care for increasing the duration of breastfeeding. Cochrane Database Syst Rev. 2016;CD006641.

  57. 57.

    Rodriguez-Alarcon J, Melchor JC, Linares A, Aranguren G, Quintanilla M, Fernandez-Llebrez L, et al. Early neonatal sudden death or near death syndrome. Epidemiol Study 29 cases Acta Paediatr. 1994;83:704–8.

    CAS  Google Scholar 

  58. 58.

    Espagne S, Hamon I, Thiebaugeorges O, Hascoet JM. [Sudden death of neonates in the delivery room]. Arch Pediatr. 2004;11:436–9.

    Article  PubMed  CAS  Google Scholar 

  59. 59.

    Branger B, Savagner C, Roze JC, Winer N. Pediatres des Maternites des P-d-l-L. [Eleven cases of early neonatal sudden death ou near death of full term and healthy neonates in maternity wards]. J Gynecol Obstet Biol Reprod. 2007;36:671–9.

    Article  CAS  Google Scholar 

  60. 60.

    Dageville C, Pignol J, De Smet S. Very early neonatal apparent life-threatening events and sudden unexpected deaths: incidence and risk factors. Acta Paediatr. 2008;97:866–9.

    Article  PubMed  CAS  Google Scholar 

  61. 61.

    Ottaviani G. Sudden infant and perinatal unexplained death: are we moving forward yet? Cardiovasc Pathol. 2011;20:302–6.

    Article  PubMed  Google Scholar 

  62. 62.

    Poets A, Steinfeldt R, Poets CF. Sudden deaths and severe apparent life-threatening events in term infants within 24 h of birth. Pediatrics. 2011;127:e869–73.

    Article  PubMed  Google Scholar 

  63. 63.

    Becher JC, Bhushan SS, Lyon AJ. Unexpected collapse in apparently healthy newborns--a prospective national study of a missing cohort of neonatal deaths and near-death events. Arch Dis Child Fetal Neonatal Ed. 2012;97:F30–4.

    Article  PubMed  Google Scholar 

  64. 64.

    Poets A, Urschitz MS, Steinfeldt R, Poets CF. Risk factors for early sudden deaths and severe apparent life-threatening events. Arch Dis Child Fetal Neonatal Ed. 2012;97:F395–7.

    Article  PubMed  Google Scholar 

  65. 65.

    Feldman K. The unexpected: sudden infant death in the postnatal period. Paediatr Child Health. 2013;18:360.

    PubMed  PubMed Central  Google Scholar 

  66. 66.

    Lutz TL, Elliott EJ, Jeffery HE. Sudden unexplained early neonatal death or collapse: a national surveillance study. Pediatr Res. 2016;80:493–8.

    Article  PubMed  Google Scholar 

  67. 67.

    Andres V, Garcia P, Rimet Y, Nicaise C, Simeoni U. Apparent life-threatening events in presumably healthy newborns during early skin-to-skin contact. Pediatrics. 2011;127:e1073–6.

    Article  PubMed  Google Scholar 

  68. 68.

    Ferrarello D, Carmichael T. Sudden unexpected postnatal collapse of the newborn. Nurs Women’s Health. 2016;20:268–75.

    Article  Google Scholar 

  69. 69.

    Hays S, Feit P, Barre P, Cottin X, Huin N, Fichtner C, et al. [Respiratory arrest in the delivery room while lying in the prone position on the mothers’ chest in 11 full term healthy neonates]. Arch Pediatr. 2006;13:1067–8.

    Article  PubMed  CAS  Google Scholar 

  70. 70.

    Task Force On Sudden Infant Death Syndrome. SIDS and other sleep-related infant deaths: updated 2016 recommendations for a safe infant sleeping environment. Pediatrics. 2016;138:e20162938.

  71. 71.

    Kramer MS, Kakuma R. Optimal duration of exclusive breastfeeding. Cochrane Database Syst Rev. 2012;CD003517.

  72. 72.

    Flaherman VJ, Aby J, Burgos AE, Lee KA, Cabana MD, Newman TB. Effect of early limited formula on duration and exclusivity of breastfeeding in at-risk infants: an RCT. Pediatrics. 2013;131:1059–65.

    Article  PubMed  PubMed Central  Google Scholar 

  73. 73.

    Stranak Z, Feyereislova S, Cerna M, Kollarova J, Feyereisl J. Limited Amount of formula may facilitate breastfeeding: randomized, controlled trial to compare standard clinical practice versus limited supplemental Feeding. PLoS ONE. 2016;11:e0150053.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  74. 74.

    Schubiger G, Schwarz U, Tönz O. UNICEF/WHO baby-friendly hospital initiative: does the use of bottles and pacifiers in the neonatal nursery prevent successful breastfeeding? Eur J Pediatr. 2012;156:874–7.

    Article  Google Scholar 

  75. 75.

    Howard CR, Howard FM, Lanphear B, Eberly S, deBlieck EA, Oakes D, et al. Randomized clinical trial of pacifier use and bottle-feeding or cupfeeding and their effect on breastfeeding. Pediatrics. 2003;111:511–8.

    Article  PubMed  Google Scholar 

  76. 76.

    Smith HA, Becker GE. Early additional food and fluids for healthy breastfed full-term infants. Cochrane Database Syst Rev. 2016;CD006462.

  77. 77.

    Nelson EA, Yu LM, Williams S, International Child Care Practices Study Group M. International Child Care Practices study: breastfeeding and pacifier use. J Hum Lact. 2005;21:289–95.

    Article  PubMed  CAS  Google Scholar 

  78. 78.

    Hauck FR, Omojokun OO, Siadaty MS. Do pacifiers reduce the risk of sudden infant death syndrome? A meta-analysis. Pediatrics. 2005;116:e716–23.

    Article  PubMed  Google Scholar 

  79. 79.

    Lubbe W, Ten Ham-Baloyi W. When is the use of pacifiers justifiable in the baby-friendly hospital initiative context? A clinician’s guide. BMC Pregnancy Childbirth. 2017;17:130.

    Article  PubMed  PubMed Central  Google Scholar 

  80. 80.

    Jenik AG, Vain NE, Gorestein AN, Jacobi NE. Pacifier, Breastfeeding Trial G. Does the recommendation to use a pacifier influence the prevalence of breastfeeding? J Pediatr. 2009;155:350–354. e351

    Article  PubMed  Google Scholar 

  81. 81.

    Pincombe J, Baghurst P, Antoniou G, Peat B, Henderson A, Reddin E. Baby Friendly Hospital Initiative practices and breast feeding duration in a cohort of first-time mothers in Adelaide, Australia. Midwifery. 2008;24:55–61.

    Article  PubMed  Google Scholar 

  82. 82.

    Karabulut E, Yalcin SS, Ozdemir-Geyik P, Karaagaoglu E. Effect of pacifier use on exclusive and any breastfeeding: a meta-analysis. Turk J Pediatr. 2009;51:35–43.

    PubMed  Google Scholar 

  83. 83.

    O’Connor NR, Tanabe KO, Siadaty MS, Hauck FR. Pacifiers and breastfeeding: a systematic review. Arch Pediatr & Adolesc Med. 2009;163:378–82.

    Article  Google Scholar 

  84. 84.

    Jaafar SH, Ho JJ, Jahanfar S, Angolkar M. Effect of restricted pacifier use in breastfeeding term infants for increasing duration of breastfeeding. Cochrane Database Syst Rev. 2016:CD007202.

  85. 85.

    Bartick MC, Nickel NC, Hanley LE. Evidence for the baby-friendly hospital initiative to support breastfeeding. JAMA. 2017;317:770–1.

    Article  PubMed  Google Scholar 

  86. 86.

    Martens PJ. What do Kramer’s Baby-Friendly Hospital Initiative PROBIT studies tell us? A review of a decade of research. J Hum Lact. 2012;28:335–42.

    Article  PubMed  Google Scholar 

  87. 87.

    Merewood A, Mehta SD, Chamberlain LB, Philipp BL, Bauchner H. Breastfeeding rates in US Baby-Friendly hospitals: results of a national survey. Pediatrics. 2005;116:628–34.

    Article  PubMed  Google Scholar 

  88. 88.

    Philipp BL, Merewood A, Miller LW, Chawla N, Murphy-Smith MM, Gomes JS, et al. Baby-Friendly Hospital initiative improves breastfeeding initiation rates in a US hospital setting. Pediatrics. 2001;108:677–81.

    Article  PubMed  CAS  Google Scholar 

  89. 89.

    Yotebieng M, Labbok M, Soeters HM, Chalachala JL, Lapika B, Vitta BS, et al. Ten steps to successful breastfeeding programme to promote early initiation and exclusive breastfeeding in DR Congo: a cluster-randomised controlled trial. Lancet Glob Health. 2015;3:e546–55.

    Article  PubMed  Google Scholar 

  90. 90.

    DelliFraine J, Langabeer J 2nd, Williams JF, Gong AK, Delgado RI, Gill SL. Cost comparison of baby friendly and non-baby friendly hospitals in the United States. Pediatrics. 2011;127:e989–94.

    Article  PubMed  Google Scholar 

  91. 91.

    Brodribb W, Kruske S, Miller YD. Baby-friendly hospital accreditation, in-hospital care practices, and breastfeeding. Pediatrics. 2013;131:685–92.

    Article  PubMed  Google Scholar 

  92. 92.

    Hawkins SS, Stern AD, Baum CF, Gillman MW. Evaluating the impact of the Baby-Friendly Hospital Initiative on breast-feeding rates: a multi-state analysis. Public Health Nutr. 2015;18:189–97.

    Article  PubMed  Google Scholar 

  93. 93.

    Hawkins SS, Stern AD, Baum CF, Gillman MW. Compliance with the Baby-Friendly Hospital Initiative and impact on breastfeeding rates. Arch Dis Child Fetal Neonatal Ed. 2014;99:F138–43.

    Article  PubMed  Google Scholar 

  94. 94.

    Howe-Heyman A, Lutenbacher M. The Baby-Friendly Hospital Initiative as an Intervention to Improve Breastfeeding Rates: A Review of the Literature. J Midwifery Women’s Health. 2016;61:77–102.

    Article  Google Scholar 

  95. 95.

    Ibanez G, de Reynal de Saint Michel C, Denantes M, Saurel-Cubizolles MJ, Ringa V, Magnier AM. Systematic review and meta-analysis of randomized controlled trials evaluating primary care-based interventions to promote breastfeeding in low-income women. Fam Pract. 2012;29:245–54.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

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

Author information

Affiliations

Authors

Corresponding author

Correspondence to Enrique Gomez-Pomar.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Gomez-Pomar, E., Blubaugh, R. The Baby Friendly Hospital Initiative and the ten steps for successful breastfeeding. a critical review of the literature. J Perinatol 38, 623–632 (2018). https://doi.org/10.1038/s41372-018-0068-0

Download citation

Further reading