UPSC MainsMEDICAL-SCIENCE-PAPER-II202410 Marks
Q8.

Write in brief the ten steps of Baby-friendly Hospital Initiative (revised 2018).

How to Approach

This question requires a direct and systematic response outlining the ten steps of the Baby-Friendly Hospital Initiative (BFHI). The answer should be structured as a list, detailing each step with clarity and conciseness. Focus on the revised 2018 guidelines, highlighting any significant changes. A brief explanation of the initiative's overall goal would be beneficial. Avoid overly detailed explanations of the rationale behind each step; focus on *what* the steps are.

Model Answer

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Introduction

The Baby-Friendly Hospital Initiative (BFHI), launched by UNICEF and the World Health Organization (WHO) in 1992, aims to enable mothers to make informed decisions about the optimal way to feed their babies. It promotes exclusive breastfeeding for the first six months of life and continued breastfeeding with complementary foods up to two years or beyond. The initiative assesses hospitals based on ten evidence-based practices designed to support successful breastfeeding. The BFHI was revised in 2018 to strengthen its impact and address contemporary challenges in infant feeding. This answer details the ten steps of the revised BFHI (2018).

The Ten Steps of the Baby-Friendly Hospital Initiative (Revised 2018)

The ten steps are designed to support mothers in achieving their breastfeeding goals. They are:

  1. 1. Develop a written breastfeeding policy that is comprehensively implemented and regularly reviewed. This policy should be communicated to all healthcare staff.
  2. 2. Train all healthcare staff in skills necessary to implement this policy. This includes doctors, nurses, midwives, and support staff. Training should be ongoing and updated regularly.
  3. 3. Inform all pregnant women about the benefits of breastfeeding. This information should be provided during antenatal care and include practical advice on how to initiate and maintain breastfeeding.
  4. 4. Facilitate immediate and uninterrupted skin-to-skin contact between mothers and babies immediately after birth. This practice helps regulate the baby’s temperature, heart rate, and breathing, and encourages early breastfeeding.
  5. 5. Support mothers to initiate breastfeeding within the first hour after birth. Early initiation promotes successful breastfeeding and provides colostrum, which is rich in antibodies.
  6. 6. Encourage exclusive breastfeeding for the first six months of life. This means the baby receives only breast milk, without any other foods or liquids, unless medically indicated.
  7. 7. Facilitate rooming-in, allowing mothers and babies to remain together 24 hours a day. This promotes bonding and allows mothers to respond to their baby’s feeding cues.
  8. 8. Encourage breastfeeding on demand. Mothers should feed their babies whenever they show signs of hunger, rather than on a fixed schedule.
  9. 9. Provide no artificial teats or pacifiers to breastfeeding infants. These can interfere with breastfeeding and lead to nipple confusion.
  10. 10. Support mothers in their transition back home and refer them to breastfeeding support groups or services. This ensures continued support after discharge from the hospital.

The revised 2018 guidelines place greater emphasis on the importance of skilled support for mothers, particularly those facing challenges with breastfeeding. They also highlight the need for hospitals to monitor their progress and continuously improve their practices.

The BFHI is not merely about technical skills; it’s about creating a supportive environment where mothers feel empowered to make the best choices for their babies. Successful implementation requires a commitment from all levels of the healthcare system.

Conclusion

The Baby-Friendly Hospital Initiative remains a cornerstone of global efforts to promote breastfeeding and improve infant health. The ten steps, revised in 2018, provide a clear framework for hospitals to create a supportive environment for breastfeeding mothers. Continued investment in training, monitoring, and support services is crucial to ensure the widespread adoption and sustained success of this vital initiative, ultimately contributing to improved maternal and child health outcomes globally.

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, vitamins, and minerals, providing essential immune protection for the newborn.
Nipple Confusion
A condition where an infant experiences difficulty latching onto the breast after being exposed to artificial nipples or pacifiers, leading to decreased breastfeeding success.

Key Statistics

Globally, only 44% of infants are exclusively breastfed for the first six months (UNICEF, 2023).

Source: UNICEF. (2023). Breastfeeding.

Exclusive breastfeeding for the first six months is associated with a 45% reduction in infant mortality due to diarrhea and pneumonia (Lancet, 2016).

Source: Lancet. (2016). Breastfeeding and infant mortality.

Examples

Kerala's BFHI Success

Kerala, India, has demonstrated significant success in implementing the BFHI, resulting in increased rates of exclusive breastfeeding and reduced infant mortality rates. This was achieved through dedicated training programs for healthcare professionals and community-level support groups.

Frequently Asked Questions

What is the role of skin-to-skin contact?

Skin-to-skin contact immediately after birth helps stabilize the baby’s vital signs, promotes bonding, encourages early breastfeeding, and regulates the baby’s temperature.

Topics Covered

MedicinePediatricsPublic HealthBreastfeedingChild HealthHospital Initiative