Baby-Friendly Initiative

BFI in Canada

In Canada, the Baby-Friendly Hospital Initiative (BFHI) is called the Baby-Friendly Initiative (BFI) reflecting the continuum of care from hospital to home. Publicly funded maternity hospitals, birthing centers and community health services with prenatal and postnatal care, such as public health units and community health centers, are eligible for BFI assessment and designation in Canada.

The BCC adapts the WHO/UNICEF international standards to the Canadian context. The Canadian BFI Implementation documents are available on the BCC website. As BFI is a continuous quality improvement program, the indicators are reviewed regularly following changes at the international or national level or when there is a need for clarification.

To become BFI designated, agencies must adhere to and fulfill the requirements of the 10 Steps as outlined by WHO/UNICEF (2018) and adapted by the Breastfeeding Committee for Canada for all healthcare institutions. This process is evaluated by a team of BFI assessors. 

Reference: WHO/UNICEF (2018). Implementation Guidance. Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: The revised Baby-Friendly Hospital Initiative. Geneva: WHO.

‘New’ BFI Implementation Guideline

BFI process and costs

BFI Assessment Process Summary

How to become an assessor

Learn more

The Baby-Friendly Hospital Initiative (BFHI) at the global level

WHO and UNICEF launched the BFHI in 1991, in an effort to motivate facilities providing maternity care to implement the Ten Steps for Successful Breastfeeding (the Ten Steps). The Ten Steps were developed by WHO and UNICEF in 1989, as a package of policies and procedures to support breastfeeding.

Facilities that document their full adherence to the Ten Steps, including compliance to the International Code of Marketing of Breastmilk Substitutes and the relevant resolutions from the World Health Assembly (WHA), can be designated as “Baby-Friendly”.

A global indicator of the percentage of births in BFHI designated hospitals has been part of the Global Monitoring Framework for Maternal, Infant and Young Child Nutrition reported at WHA meetings since 2015.

Almost all countries have implemented the BFHI to some point in time and to some extent. However, coverage within most countries has remained low. The 2018 WHO/UNICEF Guidance was published in an attempt to reinvigorate the BFHI and presents updated Ten Steps which now include the WHO Code within Step 1.

Global Strategy

Innocenti Declaration

WHO/UNICEF 2018 BFHI Guidance & Appendices



International Code

What is the Code?

The WHO International Code of Marketing of Breastmilk Substitutes, approved by the member states participating at the World Health Assembly (except the US), was approved in 1981 to protect breastfeeding by ensuring the ethical marketing of breastmilk substitutes by industry. 

The Code includes these ten important provisions: 

  • No advertising of products under the scope of the Code to the public.
  • No free samples to mothers.
  • No promotion of products in health care facilities, including the distribution of free or low cost supplies.
  • No company representatives to advise mothers.
  • No gifts or personal samples to health workers.
  • No words or pictures idealizing artificial feeding, including pictures of infants on the labels of products.
  • Information to health workers should be scientific and factual.
  • All information on use of breastmilk substitutes, including the labels, should explain the benefits of breastfeeding and all costs and hazards associated with artificial feeding.
  • Unsuitable products such as sweetened condensed milk should not be promoted for babies.
  • Products should be of a high quality and take into account the climatic and storage conditions of the country where they are used.

The Code