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Implementation of the Ten Steps to Successful Breastfeeding Saves Lives ONLINE FIRST

Joan Younger Meek, MD1; Lawrence Noble, MD2
[+] Author Affiliations
1Department of Clinical Sciences, Florida State University College of Medicine, Tallahassee
2Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
JAMA Pediatr. Published online August 22, 2016. doi:10.1001/jamapediatrics.2016.2015
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This Viewpoint discusses the Ten Steps to Successful Breastfeeding component of the Baby-Friendly Hospital Initiative, intended to optimize newborn care and health in the immediate postpartum period.

The Baby-Friendly Hospital Initiative (BFHI), developed in 1991 by the World Health Organization and the United Nations Children’s Fund to improve maternity care practices and breastfeeding rates, has been implemented globally in more than 152 countries. The core tenets of the BFHI are the Ten Steps to Successful Breastfeeding, which have been endorsed by the American Academy of Pediatrics. A recent meta-analysis of studies evaluating the BFHI found that implementation of the BFHI increased exclusive breastfeeding by 49% (95% CI, 33%-68%) and any breastfeeding by 66% (95% CI, 34%-107%).1 The meta-analysis reviewed 29 studies that found that the BFHI and its elements of hospital support increased breastfeeding in the first hour (relative risk = 1.11; 95% CI, 1.06-1.16), 51 studies that found that it increased exclusive breastfeeding in the first 5 months (relative risk = 1.46; 95% CI, 1.37-1.56), and 47 studies that found that it increased any breastfeeding in the first 6 months (relative risk = 1.40; 95% CI, 1.30-1.52).

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