Review Background

The protection, promotion, and support of breastfeeding has become a global health priority since the Innocenti Declaration was signed by 30 countries in 1990.1 The Baby-Friendly Hospital Initiative (BFHI) was launched the following year by the World Health Organization (WHO) and UNICEF to increase breastfeeding rates by promoting worldwide adop-tion of the Ten Steps for Successful Breastfeeding2 (Table 1) and compliance with the International Code of Marketing of Breast-milk Substitutes (referred to herein as the “Code”).3 By 2009, more than 20,000 maternity facilities in 156 countries around the world had been designated Baby-Friendly, and many countries had established BFHI coordinating groups or other infant feeding authorities to support implementation of the BFHI at the regional or national levels.4 Several coun-tries have now expanded the BFHI to include criteria for Baby-Friendly designation of community health services (initiated by the UNICEF UK Baby-Friendly Initiative5), as well as specialty-care areas such as neonatal intensive care6 and pediatric units.8 In 2009, the WHO/UNICEF’s original 445195 JHLXXX10.1177/089033441244519 5Semenic et al.Journal of Human Lactatio