Baby-Friendly Hospital Initiative Movement in Healthcare Settings: What are the Practical Solutions?
Abstract
Introduction: Implementation of the Baby-Friendly Hospital Initiative (BFHI) in all healthcare facilities is valuable to protect, promote and support breastfeeding and the well-being of young children. Besides prioritizing patient care, the BFHI movement in healthcare settings supports well-being, job satisfaction and productivity of healthcare providers working in those workplaces. Saskatchewan, Canada, has 70 healthcare settings, out of which only one healthcare facility implements the WHO’s ‘Ten steps to successful breastfeeding’ and has a BFHI accreditation. This preliminary study aimed at exploring facilitators and barriers surrounding the successful implementation of BFHI in healthcare settings of Saskatchewan and identifying practical solutions and recommendations to overcome challenges surrounding the successful implementation of BFHI in these healthcare settings.
Methods: A sequential qualitative descriptive design was employed. During Phase I, facilitators and barriers surrounding BFHI implementation were explored using a semi-structured interview guide with 26 multidisciplinary healthcare providers and breastfeeding mothers in a range of urban and rural settings in Saskatchewan, Canada. Phase II involved the identification of practical solutions and BFHI recommendations to support the implementation of BFHI in Saskatchewan in consultation with patient partners, healthcare providers, and policymakers.
Results: The barriers to the successful implementation of the BFHI include the absence of clearly stated policies on breastfeeding, a lack of uniform understanding of BFHI, insufficient support and resources, disagreements/lack of collaboration among healthcare professionals, maternal circumstances, and hospital routines and practices. The strategies for successful implementation of BFHI include healthcare providers’ leadership, teamwork/collaboration, adequate staffing and financial resources, education, mentoring and skills training opportunities for healthcare professionals, continuous monitoring of the BFHI steps, compliance with every step of BFHI, a mother-centred approach, and regulation on marketing and sale of breastmilk.
Conclusion: The role of multi-layered interventions, interdisciplinary collaboration and partnership-based approach is critical in minimizing barriers and promoting the successful implementation of BFHI in all healthcare settings.
Notes
References:
Burnham, L., Gambari, A., Beliveau, P., Ustianov, J., Parker, M. G., & Merewood, A. (2021). Perspectives of nurses in Mississippi on implementation of the Baby-Friendly Hospital Initiative. Journal of Obstetric, Gynecologic & Neonatal Nursing. https://doi.org/10.1016/j.jogn.2021.02.010
Fan, Y. W., Fan, H. S. L., Shing, J. S. Y., Ip, H. L., Fong, D. Y. T., & Lok, K. Y. W. (2025). Impact of baby-friendly hospital initiatives on breastfeeding outcomes: Systematic review and meta-analysis. Women and Birth, 38(2), 101881. https://doi.org/10.1016/j.wombi.2025.101881
Hirani, S. A. (2023). Baby-friendly initiatives to promote, protect and support breastfeeding practices of immigrant mothers: a qualitative study in Saskatchewan, Canada. Science Talks. https://doi.org/10.1016/j.sctalk.2022.100113
Hirani, S. A. A. (2024). Barriers affecting breastfeeding practices of refugee mothers: A critical ethnography in Saskatchewan, Canada. International Journal of Environmental Research and Public Health, 21(4), 398; https://doi.org/10.3390/ijerph21040398
Hirani, S. A., & Wagner, J. (2022). Impact of COVID-19 on women who are refugees and mothering: A critical ethnographic study. Global Qualitative Nursing Research. DOI: https://doi.org/10.1177/23333936221121335
Sigma Membership
Phi Gamma (Virtual)
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Descriptive/Correlational
Research Approach
Qualitative Research
Keywords:
Health Equity or Social Determinants of Health, Policy/Advocacy, Workforce, Breastfeeding, Policies, Healthcare Settings
Recommended Citation
Hirani, Shela, "Baby-Friendly Hospital Initiative Movement in Healthcare Settings: What are the Practical Solutions?" (2026). Creating Healthy Work Environments (CHWE). 18.
https://www.sigmarepository.org/chwe/2026/presentations_2026/18
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Washington, DC, USA
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-04-23
Baby-Friendly Hospital Initiative Movement in Healthcare Settings: What are the Practical Solutions?
Washington, DC, USA
Introduction: Implementation of the Baby-Friendly Hospital Initiative (BFHI) in all healthcare facilities is valuable to protect, promote and support breastfeeding and the well-being of young children. Besides prioritizing patient care, the BFHI movement in healthcare settings supports well-being, job satisfaction and productivity of healthcare providers working in those workplaces. Saskatchewan, Canada, has 70 healthcare settings, out of which only one healthcare facility implements the WHO’s ‘Ten steps to successful breastfeeding’ and has a BFHI accreditation. This preliminary study aimed at exploring facilitators and barriers surrounding the successful implementation of BFHI in healthcare settings of Saskatchewan and identifying practical solutions and recommendations to overcome challenges surrounding the successful implementation of BFHI in these healthcare settings.
Methods: A sequential qualitative descriptive design was employed. During Phase I, facilitators and barriers surrounding BFHI implementation were explored using a semi-structured interview guide with 26 multidisciplinary healthcare providers and breastfeeding mothers in a range of urban and rural settings in Saskatchewan, Canada. Phase II involved the identification of practical solutions and BFHI recommendations to support the implementation of BFHI in Saskatchewan in consultation with patient partners, healthcare providers, and policymakers.
Results: The barriers to the successful implementation of the BFHI include the absence of clearly stated policies on breastfeeding, a lack of uniform understanding of BFHI, insufficient support and resources, disagreements/lack of collaboration among healthcare professionals, maternal circumstances, and hospital routines and practices. The strategies for successful implementation of BFHI include healthcare providers’ leadership, teamwork/collaboration, adequate staffing and financial resources, education, mentoring and skills training opportunities for healthcare professionals, continuous monitoring of the BFHI steps, compliance with every step of BFHI, a mother-centred approach, and regulation on marketing and sale of breastmilk.
Conclusion: The role of multi-layered interventions, interdisciplinary collaboration and partnership-based approach is critical in minimizing barriers and promoting the successful implementation of BFHI in all healthcare settings.
Description
In this presentation, facilitators and barriers surrounding the successful implementation of the Baby-friendly Hospital Initiative (BFHI) movement in healthcare settings will be discussed, and practical solutions for the successful implementation of BFHI in these healthcare settings will be shared. The role of multi-layered interventions, interdisciplinary collaboration and partnership-based approach in minimizing barriers and promoting the successful implementation of BFHI will be highlighted.