Must adapt and develop to succeed

Breast feeding is unparalleled in providing an infant with ideal nourishment, protection from infections, and much more.1 2 Despite this, there is still a strong culture for bottle feeding in Britain.3 The global baby friendly hospital initiative, known in Britain as the baby friendly initiative, was launched jointly by UNICEF and the World Health Organisation in 1991. The objective was to reverse the negative impact that many maternity hospital practices have on establishing breast feeding. The “ten steps” (see box) are intended as a standard for good practice.4 The “Baby Friendly Initiative Golden Award” is given to hospitals that complete the 10 steps and achieve a 75% rate of breast feeding on discharge, and the British “Baby Friendly Initiative Award” to hospitals that achieve a 50% breast feeding rate on discharge. By December 1996 there were only three baby friendly hospitals in Britain and another 10 that had a certificate of commitment (for achieving steps 1, 7, and 10).