Why we should do this: what the evidence says

Maintain Baby Friendly Aotearoa (BFHI) accreditation as a contractual requirement for all private and public maternity facilities.

The BFHI has been effective in improving breastfeeding rates, both nationally and internationally. Globally, systemic reviews reveal the positive impacts of the BFHI, including improvements in breastfeeding initiation and duration (Pérez‐Escamilla et al 2016).

Ensure maternity services staff attain the necessary skills to implement the BFHI criteria for New Zealand Aotearoa. All maternity services staff, irrespective of designation, should receive orientation to the service’s breastfeeding policy when beginning employment and at each policy review.

All health workers who provide care during the antenatal and postnatal period and beyond have a key role to play in establishing and sustaining breastfeeding. Many health workers cannot fulfil this role effectively because they have not been trained to do so (World Health Organization and United Nations Children’s Fund 2020).

Investigate implementing Neo-BFHI into neonatal units to expand the current BFHI model. Expand the BFHI into paediatric wards and wider hospital facilities and ensure adequate specialty services are in place for breastfeeding parents, infants and children when admitted to a DHB setting.

Research demonstrates positive impacts for neonates, parents and facilities when Neo-BFHI steps are implemented. In addition, research indicates international readiness for expansion of baby‐friendly standards to neonatal settings (Maastrup et al 2019).

Where are we now?

  • The implementation of the BFHI in maternity services has produced a significant improvement in breastfeeding rates (Baby Friendly Aotearoa, 2020).
  • BFHI Documents for New Zealand Aotearoa were revised in 2020. Pae ora and te ao Māori have been integrated into the BFHI Documents 2020.
  • Annual breastfeeding data on discharge from all maternity services is collected online and reported back to the wider health sector.

Next steps and considerations

  • Updated WHO/UNICEF criteria, training tools and advice will be integrated into the BFHI programme.
  • Consider alignment of Baby Friendly Aotearoa with other health accreditation frameworks.


Baby Friendly Aotearoa. 2020. National infant feeding data at discharge for 2019. URL: (accessed 29 April 2020).

Pérez‐Escamilla R, Martinez J & Segura‐Pérez S. 2016. Impact of the Baby‐friendly Hospital Initiative on breastfeeding and child health outcomes: A systematic review. Maternal and Child Nutrition. 12(3): 402–17.

World Health Organization, United Nations Children’s Fund‎‎‎‎‎‎‎. 2020. Baby-friendly Hospital Initiative training course for maternity staff. Geneva: WHO.

Maastrup R, Haiek L, Neo‐BFHI Survey Group. 2019. Compliance with the “Baby‐friendly Hospital Initiative for Neonatal Wards” in 36 countries. Maternal and Child Nutrition. 15(2):e12690.