UPSC MainsMEDICAL-SCIENCE-PAPER-II20125 Marks
Q9.

Write briefly about 'Baby Friendly Hospital Initiative'. List all the ten steps of its policy.

How to Approach

This question requires a concise yet comprehensive answer detailing the Baby-Friendly Hospital Initiative (BFHI). The approach should involve defining BFHI, highlighting its importance in promoting breastfeeding, and then systematically listing and briefly explaining the ten steps. Focus on clarity and precision, as the question asks for a 'brief' account. Structure the answer with a clear introduction, a body listing the ten steps, and a concise conclusion emphasizing the initiative's impact.

Model Answer

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Introduction

The Baby-Friendly Hospital Initiative (BFHI), launched by UNICEF and the World Health Organization (WHO) in 1992, is a global program to encourage and support breastfeeding as the optimal way of feeding infants. It aims to create facilities that empower mothers to initiate breastfeeding within an hour of birth and to practice exclusive breastfeeding for the first six months of life. BFHI recognizes hospitals that demonstrate commitment to providing an environment that supports successful breastfeeding, contributing significantly to improved infant and maternal health outcomes globally. The initiative is based on evidence that breastfeeding is crucial for child survival and development.

The Ten Steps of the Baby-Friendly Hospital Initiative

The BFHI outlines ten specific practices for hospitals to implement to become ‘baby-friendly’. These steps are designed to support mothers in achieving their breastfeeding goals.

  1. Establish a breastfeeding policy: Hospitals must have a clearly written breastfeeding policy that is communicated to all healthcare staff.
  2. Train all staff: All healthcare staff involved in maternity and newborn care should receive regular training on breastfeeding practices and the BFHI.
  3. Inform pregnant women about the benefits of breastfeeding: Provide expectant mothers with information about the benefits of breastfeeding during antenatal care.
  4. Facilitate immediate initiation of breastfeeding: Assist mothers to initiate breastfeeding within the first hour after birth and provide support to continue.
  5. Support exclusive breastfeeding: Encourage exclusive breastfeeding for the first six months, with no other foods or liquids (except for medically indicated supplements).
  6. Support rooming-in: Allow mothers and babies to remain together 24 hours a day, promoting bonding and facilitating breastfeeding on demand.
  7. Encourage breastfeeding on demand: Advise mothers to feed their babies whenever they show signs of hunger, rather than on a fixed schedule.
  8. Avoid artificial teats or pacifiers: Discourage the use of artificial teats and pacifiers, as they can interfere with breastfeeding.
  9. Bring mothers together: Establish mother support groups to provide peer support and share experiences.
  10. Refer mothers to breastfeeding support groups: Provide mothers with information about local breastfeeding support groups and resources upon discharge.

Detailed Explanation of Key Steps

Several steps require further elaboration. For instance, Step 5 (Support exclusive breastfeeding) is crucial as colostrum, the first milk, is rich in antibodies and provides vital immunity to the newborn. Step 6 (Support rooming-in) is vital for early bonding and allows mothers to recognize feeding cues. Step 8 (Avoid artificial teats or pacifiers) is important because nipple confusion can occur, hindering successful breastfeeding.

Global Impact and Implementation

As of 2023 (knowledge cutoff), over 20,000 hospitals and birthing centers in over 150 countries have been designated as Baby-Friendly. Countries like Sweden and Iceland have achieved high rates of BFHI-designated facilities, correlating with high breastfeeding rates. Implementation varies across regions, with challenges in resource-limited settings often related to staff training and infrastructure.

Conclusion

The Baby-Friendly Hospital Initiative represents a significant global effort to promote breastfeeding and improve infant and maternal health. By adhering to the ten steps, hospitals can create a supportive environment that empowers mothers to successfully breastfeed, leading to reduced infant mortality and morbidity rates. Continued investment in BFHI implementation, particularly in underserved regions, is crucial for achieving the Sustainable Development Goals related to child health and nutrition.

Answer Length

This is a comprehensive model answer for learning purposes and may exceed the word limit. In the exam, always adhere to the prescribed word count.

Additional Resources

Key Definitions

Colostrum
The first milk produced by the mammary glands after giving birth. It is rich in antibodies, proteins, and nutrients, providing crucial immunity and nourishment to the newborn.
Nipple Confusion
A condition where an infant experiences difficulty latching onto the breast after being exposed to an artificial nipple, leading to decreased breastfeeding effectiveness.

Key Statistics

Globally, approximately 828 million children under 5 years of age are affected by stunting, and breastfeeding can prevent up to 13% of child deaths.

Source: UNICEF, 2023 (knowledge cutoff)

Exclusive breastfeeding for the first six months is associated with a 45% reduction in infant mortality due to diarrheal diseases and respiratory infections.

Source: WHO, 2022 (knowledge cutoff)

Examples

Sweden's BFHI Success

Sweden has a very high percentage of Baby-Friendly hospitals, and consequently, boasts one of the highest breastfeeding rates in the world, with over 98% of mothers initiating breastfeeding.

Frequently Asked Questions

What happens if a mother is unable to breastfeed?

The BFHI emphasizes supporting mothers in their chosen feeding method. If a mother is unable to breastfeed, healthcare professionals should provide guidance on safe and appropriate alternatives, such as formula feeding, while continuing to support her emotional well-being.

Topics Covered

PediatricsPublic HealthNutritionBreastfeedingInfant HealthHospital Policy