Typical Costs Incurred

Part of the planning process for any project is budgeting for anticipated expenses. The cost of becoming Baby-Friendly designated will vary depending on the specific decisions and needs of each facility. However, there are typically three types of costs incurred by all facilities.  Those include:

  • Staff and provider training expenses
  • The cost of purchasing breast milk substitutes (infant formula), bottles, nipples, pacifiers and other infant feeding supplies
  • Fees to Baby-Friendly USA, Inc.

The information below provides general considerations for the usual costs incurred by facilities and the time frames for when those costs are typically incurred.

Training Expenses

The section on Step 2 in the Guidelines and Evaluation Criteria outlines the requirements related to training staff and providers. Your facility can meet these requirements in a variety of ways and your expenses will vary depending on the approach you take.

To estimate your costs for meeting the training requirements outlined in Step 2, you will need to determine the number of staff members and providers who are required to participate in training. Also, identify any other positions your facility has chosen to train.

Mom and BabyConsider which of the following items apply to your facility’s situation:

  • Cost of a training program offered by a training vendor
  • Purchase of curriculum for in-house training or staff time to create a curriculum
  • Reimbursement of staff and providers who seek training on their own
  • Travel expenses for off-site training
  • Equipment and materials
  • Staff time to participate in training

Remember to consider on-going training costs for new staff members and providers that will join your facility.

Purchasing Breast Milk Substitutes and Infant Feeding Supplies

Baby-Friendly designated hospitals and birth centers uphold the International Code of Marketing of Breast-milk Substitutes (International Code). A key element of the International Code is ensuring that relationships with the manufacturers and distributors of breast milk substitutes are appropriate. Facilities may not receive gifts or free products from these manufacturers or distributors and must purchase all breast milk substitutes, bottles, nipples, and pacifiers at fair market price (FMP).

It is important to understand that the FMP for each item varies from one facility to another. Each facility must determine their unique FMP. A facility may not simply pay the same price paid by another facility.  More guidance on the methods for determining FMP for your facility is available through the BFUSA portal. However, before completing these calculations at a facility level, please have purchasing leadership assess if your facility is purchasing as a system or through a buying group. For example, these calculations may have already been completed by your system.

You can download this infant feeding supply estimation worksheet to better understand the infant formula and supply needs for your facility.

Baby-Friendly USA Fees

Fees paid by hospitals and birthing centers seeking the Baby-Friendly designation are the primary source of funding support for Baby-Friendly USA. Please see the Operating Structure and Changes page for information pertaining to the single campus enrollment policy.

4-D Pathway Fees

  • Each facility pays a “Phase Fee” as it moves through the 4-D Pathway. The Phase Fee assumes that a facility will complete each phase within twelve months. If a facility takes more than twelve months to complete a single phase, additional fees will apply. If a facility completes a phase in less than twelve months, it may move on by submitting the fee for the next phase.
  • There is no fee for the first phase (Discovery).
  • The Development, Dissemination and Designation Phase fees also include a portion of the on-site assessment fee.

Post-Designation Fees

  • There are two different types of post-designation annual fees:
  • In addition to the Re-Des phase fee in Year 5, facilities also pay the travel related expenses associated with their on-site assessment.
  • After the five year post-designation cycle is complete, facilities move back into the AQI Phase.
  • Post-designation fees are reviewed and subject to change annually.
Download 2020 Fees for Designated Facilities