The Relaunched UNICEF and WHO Baby Friendly Hospital Initiative (BFHI): Practical Applications for Clinicians

Preconference Workshop
Sponsored by Academy of Breastfeeding Medicine (ABM)

Tuesday 15th Oct, 13.00 - 17.00

Venue: Scholars, Foster Building
University of Central Lancashire, Preston, PR1 2HE

Facilitated by:

  • Dr. Elien Rouw, MD, FABM, BOD Academy of Breastfeeding Medicine
  • Prof. Fiona Dykes, RM, MA, PhD, FHEA Maternal and Infant Nutrition and Nurture Group, UCLAN
  • Dr. Anita Pavicic Bosnjak, MD, PhD, IBCLC, University of Zagreb
  • Anna Byrom, RM, BSc, MAINN, UCLAN 


The WHO has reviewed the Baby Friendly Hospitals Initiative (BFHI) to include conducting twenty-two systematic reviews following Cochrane procedures plus qualitative syntheses using the GRADE-CERQual approach.  This has resulted in the development of the WHO (2017) Guideline: Protecting, Promoting and supporting breastfeeding in facilities providing newborn services.  This review underpins a revision of the 10 steps to successful breastfeeding; UNICEF/WHO 2018. Protecting, promoting and supporting Breastfeeding in facilities providing maternity and newborn services: the revised BFHI.   The revised Ten Steps now consist of critical management procedures to support breastfeeding (steps 1 and 2) and key clinical practices to support breastfeeding (steps 3-10).

Workshop Aims:

To facilitate an international group of experts in Breastfeeding medicine in:

  • Increasing their awareness of the changes to the BFHI, based on the 2017 Guideline and 2018 revised BFHI implementation document
  • Considering barriers to implementation of the revised BFHI
  • Considering facilitators to implementation of the revised BFHI
  • Focusing on ways of overcoming the barriers in their specific country context

Workshop Timetable:

13.00 - 13.15 Welcome and Introductions
13.15 - 14.00 PowerPoint Presentation by Fiona Dykes. The 2018 Revised Baby Friendly Hospital Initiative
14.00 - 15.00 Expert Group Work
15.00 - 15.30 Refreshment
15.30 - 17.00 Feedback and Discussion with the Four Facilitators as a Panel

Workshop Content:

There will be four groups of clinicians supported by one of the facilitators. Each group will be allocated several of the Ten Steps to Successful Breastfeeding. They will discuss the facilitators and challenges to implementation and strategies of overcoming challenges. Each group will then provide feedback followed by a general discussion.

The groups will consider facilitators and barriers to implementing the Ten Steps from a:

  1. societal (macro-level) level
  2. local hospital or community facility level (meso-level)
  3. mother/baby/family level (micro-level)

There is a possibility to participate in the development of a supplement of relevant, country-specific case studies in Breastfeeding Medicine (TBC).

Workshop Facilitators:

Dr. Elien Rouw, MD, FABM, BOD Academy of Breastfeeding Medicine
Elien Rouw is a Dutch physician, specialised on healthy infant care. Living in Germany since 1987, she has a practice for healthy child visits, with emphasis on the normal development of the child. One of the major themes is baby and infant nutrition, and she is specialised in this area, especially in breastfeeding, since 1982. She has served in the medical advisory board of two breastfeeding self-support groups and teaches health care workers on breastfeeding issues. She has co-authored a German book on breastfeeding for health care workers, “Stillen und Stillprobleme” and has written numerous articles about breastfeeding and normal child development. She has been an invited speaker at national and international conferences on the field of breastfeeding and human lactation, especially on the topic of growth and growth disturbances. She is member of the German National Breastfeeding Committee and Board Member of the Academy of Breastfeeding Medicine and organises a bi-annual Regional Meeting in Europe for this organisation. She also acts as a Liaison of the Academy to WABA.

Dr. Anita Pavicic Bosnjak, MD, PhD, IBCLC, University of Zagreb
Anita Pavicic Bosnjak is a neonatologist at the University Hospital Sveti Duh Zagreb, Croatia, and Assistant Professor at University of Zagreb, Faculty of Teacher Education. She completed her breastfeeding training at the Institute of Child Health, University College London in 1999 and earned her IBCLC certification in 2007. She has been actively involved in BFHI implementation and breastfeeding promotion programs in Croatia for more than 20 years. She is vice president of the Croatian National Breastfeeding Committee, the national coordinator of breastfeeding promotion program in neonatal intensive care units (Neo-BFHI) and head of the Croatian National Team of BFHI Assessors. She has years of experience in providing hospital care for term and preterm newborns. She also practices outpatient and inpatient Breastfeeding Medicine and serves as the head of the Lactation Clinic in her hospital. She has published several papers in peer-reviewed journals and co-authored a book about breastfeeding.

Fiona Dykes, RM, MA, PhD, FHEA - Maternal and Infant Nutrition and Nurture Group (MAINN), UCLAN
Fiona Dykes is Professor of Maternal and Infant Health and leads MAINN at the School of Community Health and Midwifery, University of Central Lancashire.  Fiona has a particular interest in the global, socio-cultural and political influences upon infant and young child feeding practices; her methodological expertise is in ethnography and other qualitative research methods.  Fiona is the Conference Convenor and Chair of the Scientific Review Committee for the MAINN Conference, a three day, international, peer reviewed event established in 2007 and held bi-annually in the UK and, more recently, on alternate years overseas (Sydney, Australia, Sweden and Florida).  Fiona is author of Breastfeeding in Hospital: Mothers, Midwives and the Production Line (Routledge) and co-author, with Dr Tanya Cassidy of Banking on Milk: An ethnography of donor human milk relations (Routledge). She is also joint editor of several books including Infant and Young Child Feeding: Challenges to implementing a Global Strategy (Wiley-Blackwell) and Ethnographic Research in Maternal and Child Health (Routledge).

Anna Byrom, RM, BSc, Maternal and Infant Nutrition and Nurture Group, UCLAN
Anna Byrom, RM, BSc, MSc, has worked in a variety of roles throughout maternity services and midwifery education around the UK. As a practising midwife she gained experience working in caseload, continuity models of care, supporting women and families across all areas of clinical practice. Before commencing her current role as a midwifery lecturer, in 2010, she worked as an infant feeding lead in the community and hospital. This role prompted her interest in research and she has recently submitted her PhD exploring the impact of the UNICEF UK Baby Friendly Initiative upon midwives and service users, with Professor Fiona Dykes and the Maternal and Infant Nutrition and Nurture Unit (MAINN) at the University of Central Lancashire, Preston. She is the Editor-in-Chief and new publisher of The Practising Midwife journal and online platform that supports the learning, sharing and caring needs for all midwives and maternity workers. She is passionate about supporting physiological processes, positive childbearing and early parenting experiences.

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Cost: $75

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