6th Nordic Breastfeeding Conference
24-25th September 2015
The Baby-friendly Hospital Initiative for Neonatal Wards (Neo-BFHI)
Three Guiding Principles (apply to all Ten Steps)
Guiding Principle 1: Staff attitudes toward the mother must focus on the individual mother and her situation.
Guiding Principle 2: The facility must provide family-centered care, supported by the environment.
Guiding Principle 3: The health care system must ensure continuity of care from pregnancy to after the infant’s discharge.
Expanded Ten Steps to Successful Breastfeeding
Step 1. Have a written breastfeeding policy that is routinely communicated to all health care staff.
Step 2. Educate and train all staff in the specific knowledge and skills necessary to implement this policy.
Step 3. Inform hospitalized pregnant women at risk for preterm delivery or birth of a sick infant about the benefits of breastfeeding and the management of lactation and breastfeeding.
Step 4. Encourage early, continuous and prolonged mother-infant skin-to-skin contact/Kangaroo Mother Care.
Step 5. Show mothers how to initiate and maintain lactation, and establish early breastfeeding with infant stability as the only criterion.
Step 6. Give newborn infants no food or drink other than breast milk, unless medically indicated.
Step 7. Enable mothers and infants to remain together 24 hours a day.
Step 8. Encourage demand breastfeeding or, when needed, semi-demand feeding as a transitional strategy for preterm and sick infants.
Step 9. Use alternatives to bottle feeding at least until breastfeeding is well established, and use pacifiers and nipple shields only for justifiable reasons.
Step 10. Prepare parents for continued breastfeeding and ensure access to support services/groups after hospital discharge.
And compliance with: International Code of Marketing of Breast-milk Substitutes and relevant World Health Assembly resolutions
Or: www.ilca.org: Resources: Neo-BFHI
References: Nyqvist KH, Häggkvist AP, Hansen MN, Kylberg E, Frandsen AL, Maastrup R, Ezeonodo A, Hannula L, Koskinen K, Haiek LN. Expansion of the ten steps to successful breastfeeding into neonatal intensive care: expert group recommendations for three guiding principles. Journal of Human Lactation 2012;28(3):289-96.
Nyqvist KH, Häggkvist AP, Hansen MN, Kylberg E, Frandsen AL, Maastrup R, Ezeonodo A, Hannula L, Haiek LN. Expansion of the ten steps to successful breastfeeding into neonatal intensive care: expert group recommendations for three guiding principles. Journal of Human Lactation 2013;29(3):300-9.
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