Step 1) “Have a written breastfeeding policy that is routinely communicated to all health-care staff”-this should include a breastfeeding policy to cover all of the 10 steps to successful breastfeeding and have this policy on display in the areas that are used by mother’s and baby’s. The unit must also prevent the promotion of formula milk, dummies and bottles in the unit and show conformity to this policy at all times (unicef, 2008).
Step 2) “Train all health-care staff in the skills necessary to implement the breastfeeding policy”-this should involve all new members of staff being shown the breastfeeding policy in the first week of their employment and then being fully trained within the first 6 months of their employment and that all staff receive compulsory training and be able to answer correctly when questioned the basic breastfeeding policy (unicef, 2008).
Step 3) “Inform all pregnant women about the benefits and management of breastfeeding”-this should involve giving the expectant mother all the relevant information on breastfeeding before the 32nd week of their pregnancy, including positioning and attachment, skin to skin contact and the importance of skin to skin, and why it is important to avoid dummies and formula milk etc.
This step also insists that pregnant women should not be taught how to prepare a formula feed in antenatal classes and that all paperwork, leaflets, posters etc should not have anything on them that may promote formula feeding and dummies (unicef, 2008).
Step 4) “Help mothers initiate breastfeeding soon after birth”-this should involve skin to skin contact between mother and baby as soon after the delivery as possible and then to provide support to encourage breastfeeding when the baby shows signs of wanting to feed (unicef, 2008).
Step 5) “Show mothers how to breastfeed and how to maintain lactation, even if they should be separated from their infants”-all mothers should be asked if they need help with additional breastfeeding six hours after delivery and should also be shown how to express their milk by hand (unicef, 2008).
Step 6) “Give newborn infants no food or drink other than breastmilk other than medically indicated”-unless the mother has made an informed choice or there is a medical reason that prevents the baby from breastfeeding (unicef, 2008).
Step 7) “Practice rooming-in: allow mothers and infants to remain together 24 hours a day”-unless there is a medical reason that separates the mother from the baby (unicef, 2008).
Step 8) “Encourage breastfeeding on demand” –unless there is a medical reason that requires regular feeding, the mother should not restricted on how long or how many times she feeds her baby (unicef, 2008).
Step 9) “Give no artificial teats or dummies to breastfeeding infants”-until breastfeeding is successful (unicef, 2008).
Step 10) “foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital”-this should involve giving mothers all contact details of all support group in the mother housing area for her to use as she needs (unicef, 2008).
Baby Friendly Initiative in Wales
According to the Infant Feeding Survey in 2005 the initial breastfeeding rates in Wales were 67% but unfortunately because this is the first Infant feeding survey that counted Wales separately to England there is no previous statistics to compare too but it is thought that the number of mothers breastfeeding in Wales have risen by 7% since 2000.
A breastfeeding plan was developed in 2001 to promote breastfeeding in Wales and in 2003 a breastfeeding co-ordinator and a breastfeeding strategy group was introduced to identify the areas that need support to promote breastfeeding (Bolling et al, 2005).
According to the Welsh Assembly approximately 47% of babies in Wales are born in a credited Baby Friendly Initiative unit and the number of units are on the increase. Some of the units that have achieved the Unicef Baby Friendly awards in Wales are Aberdare General, Caerphilly Birthing centre, Nevill Hall, Prince Charles, Royal Gwent, Royal Glamorgan as well as several other units in Wales.
Conclusion
There are many steps in place in Wales to promote breastfeeding from birth, and many organisations including UNICEF-Baby Friendly Initiative, World Health Organisation (WHO) and the Welsh Assembly Government are working closely together to ensure that mother’s are receiving the best possible support and advice on breastfeeding. Many of the Welsh hospital and maternity units have already gained the accreditation from the UNICEF Baby Friendly Initiative and the number of mother’s that are breastfeeding appears to be on the increase in Wales.
References
UNICEF (2008). Baby Friendly Initiative [online]. Available at:
Bolling.K & Grant.C & Hamlyn.B &Thornton.A (2007). The Infant Feeding Survey 2005 [online]. Available from: (accessed on 15th October 2008).
Cadwell.K & Turner-Maffei.C (2008). Continuity of Care in Breastfeeding-Best Practice in the Maternity Setting. Jones & Bartlett. Sudbury.
Welsh Assembly Government (2008). Baby Friendly Initiative in Wales [online]. Available from: (Accessed on 30th October 2008 & 3rd November 2008).
Welsh Assembly Government (2008). New role to promote UNICEF Baby Friendly Initiative appointed [online]. Available from:
(Accessed on 30th October 2008 & 3rd November 2008)
Welsh Assembly Government (2008). Proposals for National Programme to Support Breastfeeding in Wales [online]. Available from: (Accessed on 30th October 2008 & 3rd November 2008)
