Friendly Hospital Initiative
& Position Statement > Baby- Friendly Hospital Initiative
milk, beyond doubt, is unparalleled in nutritional value. The
protection it provides to infants against diseases, and financial
and social implications it has for a poor and over populated
country like ours cannot be over-emphasised. Nurses as important
members of health care team, play a pivotal role in collaborating
and implementing the Baby-Friendly Hospital Initiative (BFHI)
policy of quality infant and mother care.
hospitals create an environment, which supports women in their
desire to breastfeed. Staff at baby -friendly facilities provide
assistance to breastfeeding mothers and implement policies which
safeguard the breastfeeding relationship. Besides, it encompasses
the entire spectrum from prenatal planning and training, for
promotion and support of breastfeeding, to actual breastfeeding
practices. While breastfeeding is integrated with Maternal and
Child Nursing specialities, it is imperative that breastfeeding
practices in child survival be given due emphasis.
Trained Nurses’ Association of India therefore, emphasises the
promotion of breastfeeding as a key strategy for child survival,
as well as reproductive health. In terms of actual practice
the TNAI advocates focusing on training in correct breastfeeding
practices which includes the re-establishment’ of a breastfeeding
Trained Nurses’ Association of India accepts the concept and
the definition of Baby–Friendly Hospital as framed by the UNICEF/WHO
and National task Force as given in the foregoing para and believes
that in order to be Baby-Friendly, all hospitals must fulfil
the criteria for following the ten steps to successful breastfeeding.
Each facility providing maternity services and care for new
born infants should have the following:
1. A written breastfeeding policy that is routinely communicated
to all health care staff.
Step 2. Training all health care staff in skills necessary
to implement this policy.
Step 3. Informing all pregnant women about the benefits
and management of breastfeeding.
Step 4. Helping mothers initiate breastfeeding within
a half an hour of birth.
Step 5. Showing mothers how to breastfeed and how to
maintain lactation, even if they should be separated from their
Step 6. Giving newborn infants no food or drink other
than breast milk.
Step 7. Practising rooming-in, allow mothers and infants
to remain together –24 hours a day.
Step 8. Encouraging breastfeeding on demand.
Step 9. Giving no artificial teats or pacifiers (also
called dummies or soothers) to breastfeeding infants.
10. Fostering the establishment of
breastfeeding support groups and refer mothers to them on discharge
from hospital or clinic.
Trained Nurses’ Association of India acknowledges that to establish
Baby-Friendly Networks, there is a need to harmonise its efforts
with other maternal and child health care groups, the local
hospitals, nursing homes and maternity centres, the community
and above all with the government.
TNAI through its Branches all over the country, can work towards
establishing centres for conducting training programmes on B.F.H.I.
and collaborate with governmental and non-governmental organizations
to enable hospitals and maternity centres to become Baby-Friendly.
TNAI urges its State Branches to adopt the following plan of
action to achieve the objectives of Baby-Friendly Hospital Initiative.
The plan should also include Training in Ten Steps to successful
the role of Nurses and nursing in relation to a mother-child
care facility (hospital, nursing home, work place) and B.F.H.I.
plan, of that institution or community.
in national and international committees or bodies established
to identify, encourage and recognize institutions following
in the joint effort of the Baby Friendly Hospital Initiative
National Task Force, comprising Government of India, UNICEF,
WHO and professional organizations, viz., Indian Medical
Association (IMA), Federation of Obstetric and Gynaecological
Societies of India (FOGSI), Indian Academy of Paediatrics,
National Neonatalogy Forum (IAPNNF) Breastfeeding Promotion
Network of India (BPNI) Christian Medical Association of
India (CMAI), Catholic Hospital Association of India (CHAI),
International Baby Food Action Network (IBFAN), Association
for Consumer Action on Safety and Health (ACASH).
towards bringing about necessary changes in nursing education
to ensure adequate preparation of Nurses/ ANMs to enable
them to carry out their responsibilities effectively in
Baby-Friendly facilities. All Nurses in Speciality of Maternal
Health and Paediatrics must be trained in the ten steps
to successful breastfeeding as advocated by the UNICEF.
special preparation for the Nursing Supervisors and Head
Nurses to assume results-oriented leadership roles in protecting,
promoting and supporting breastfeeding.
and participate in training of assessors. Ensure that Nurses
trained as assessors must have in-depth knowledge of lactation
management, and are well versed with the International Code
of Marketing of Breast Milk Substitutes, and the Infant
Milk Substitutes, Feeding Bottles and Infant Food.
and participate in research to determine additional baby-and
mother-friendly practices, in the existing M.C.H. facilities,
community and work places. Also to conduct research into
issues related to policies and action.
to bring about necessary changes in general education of
schools, for creating awareness and right attitudes about
the importance of breastfeeding and to re-establishing the
type of training that should be given to non-professional
members, who are directly or indirectly involved in maternal