. 2011 Winter;20(1):28–35. doi: 10.1891/1058-1243.20.1.28

Table 2. The Ten Steps to Successful Breastfeeding.

The Baby-Friendly Hospital Initiative, which was established in 1991 by the World Health Organization and UNICEF, promotes, protects, and supports breastfeeding in hospital and birthing-center settings through the Ten Steps to Successful Breastfeeding. The steps for hospitals and birthing centers in the United States are the following:^*

1
Have a written breastfeeding policy that is routinely communicated to all health care staff.
2
Train all health care staff in skills necessary to implement this policy.
3
Inform all pregnant women about the benefits and management of breastfeeding.
4
Help mothers initiate breastfeeding within one hour of birth.^a
5
Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
6
Give newborn infants no food or drink other than breastmilk, unless medically indicated.
7
Practice “rooming in”—allow mothers and infants to remain together—24 hours a day.
8
Encourage breastfeeding on demand.
9
Give no pacifiers or artificial nipples to breastfeeding infants.
10
Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

Note. *Source: Turner-Maffei, C., & Cadwell, K. (Eds.). (2004). Overcoming barriers to implementing the Ten Steps to Successful Breastfeeding—Final report. Sandwich, MA: Baby-Friendly, USA. Retrieved from http://www.babyfriendlyusa.org/eng/docs/BFUSAreport_complete.pdf

^a United States Baby-Friendly time frame to initiate breastfeeding within 1 hour differs from the WHO’s original time frame of a half-hour because of U.S. hospital constraints.