A new initiative will now help mothers identify “breastfeeding-friendly” hospitals before they give birth.
The Breastfeeding Promotion Network of India(BPNI) in collaboration with Association of Healthcare Providers of India (AHPI), which comprises more than 12,000 private hospitals, has launched an accreditation programme that will enable hospitals to get a “breastfeeding-friendly” tag. This programme is called “Baby Friendly Hospital Initiative (BFHI)”.
The certification process involves two stages — the first stage includes self-assessment by a hospital, followed by an external assessment by an authorised appraiser who interviews doctors, nurses and patients as well as reviews different practices and training of staff. The accreditation process costs ₹17,000 per hospital.
Early initiation of breastfeeding continues to be low in the country. According to the National Family Health Survey-5 (2019-2021), while there were 88.6% institutional births, only 41.8% of infants were breastfed within the first one hour, which has improved only marginally from 41.6% during NFHS-4 (2015-2016). In fact, many States such as Maharashtra, Karnataka, Gujarat, Uttar Pradesh, Jharkhand and Chhattisgarh have shown a decline in the proportion of children breastfed within the first hour.
Provision of mother’s breast milk to infants within one hour of birth ensures that the infant receives the colostrum, or “first milk”, which is rich in protective factors, according to the WHO.
Lack of support and counselling for expectant mothers during pregnancy and at birth as well as aggressive promotion of baby foods are the reasons for poor early breastfeeding rates. A rise in caesarean sections is also known to negatively impact breastfeeding rates.
“During caesarean operations everyone is focused on recovery, wound surgery, infection control and breastfeeding within the golden hour is missed. Evidence shows that improving breastfeeding rates in hospitals reduces neonatal mortality and infant mortality rates. Therefore, it is important that we train our nurses, doctors and allied health staff. We will roll out our accreditation programme in phases and begin with 100-bed hospitals through our 19 chapters,” said Giridhar Gyani, Director General, AHPI.
The initiative is only for private hospitals and is based on the Ministry of Health and Family Welfare's MAA programme for government hospitals launched in 2016. The tools for this evaluation process have been developed in partnership with the Health Ministry and World Health Organisation. The BFHI programme is a worldwide programme of the WHO and UNICEF. Though India adopted it in 1993, it fizzled out by 1998 and is now being revived after more than two decades.
“The programme will evaluate hospitals on how well they counsel and support mothers in lactation, whether they have adequate skilled support persons and if they adhere to the law that bans promotion of infant formula, feeding bottles and infant food- Infant Milk Substitute Act, 1992 and Amendment Act 2003. Hospitals with the top grade will be accredited and others will be guided to improve their practices,” explained Arun Gupta, Central coordinator, BPNI.
Chennai's Bloom Healthcare has become the first hospital to be recognised as “breastfeeding-friendly” under this programme.