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Symposium: Evidence-Based Public Nutrition: An Evolving Concept

Evidence Based Breast-Feeding Promotion: The Baby-Friendly Hospital Initiative¹

Connecticut National Institutes of Health EXPORT Center of Excellence for Eliminating Health Disparities among Latinos and Department of Nutritional Sciences, University of Connecticut, Storrs CT 06269-4017

^* To whom correspondence should be addressed. E-mail: rafael.perez-escamilla{at}uconn.edu.

The Baby-Friendly Hospital Initiative (BFHI) is the translational tool developed by WHO and UNICEF to promote breast-feeding (BF) in maternity wards worldwide. BFHI was officially launched in the 1980s based on a "common sense" approach. Since then, research conducted in Latin America has shown that BFHI is highly cost-effective. BF trends over the past 2 decades strongly suggest that BFHI has had a global impact on BF outcomes. The 10th step of BFHI related to community-based BF promotion is one of the most challenging ones to address. Randomized controlled trials conducted in the Americas, Asia, and sub-Saharan Africa indicate that peer counseling is a very efficacious tool for increasing EBF rates. Low-cost rapid-response monitoring systems are needed to monitor the proper implementation and administration of BFHI steps following an evidence-based approach. This approach is essential for reenergizing the BFHI worldwide.