Budget Considerations

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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 thee types of costs incurred by all facilities.  Those include:

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

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.  Facilities can meet these requirements in a variety of ways, and expenses will vary depending on the decisions made by each facility.

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.

Consider 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.

Click here for an infant feeding supply estimation worksheet.  It offers one approach that maybe helpful in estimating the infant formula and supply needs for your facility.

Baby-Friendly USA Fees

Click here for the most current fee schedule.

General Guidance

Typical Time Frames for Costs

Discovery Phase (D1)

Development Phase (D2)

Dissemination Phase (D3)

  • Staff training expenses
  • Fees paid to BFUSA (Click here)

Designation Phase (D4)

  • Ongoing staff training expenses, as needed
  • Purchase of breast milk substitutes (infant formula) and infant feeding supplies at FMP for a minimum of 3 months prior to the on-site assessment
  • Fees Paid to BFUSA (Click here)
  • Travel expenses for the on-site assessment (NOTE: facilities requiring revisits will incur additional expenses)

Annual Quality Improvement (AQI) (Post Designation)

  • Ongoing staff training expenses, as needed
  • Ongoing purchase of breast milk substitutes and infant feeding supplies at FMP
  • Fees paid to BFUSA (To Be Determined)


  • Ongoing staff training expenses, as needed
  • Ongoing purchase of breast milk substitutes and infant feeding supplies at FMP
  • Fees paid to BFUSA (To Be Determined)
  • Travel expenses for the on-site assessment (every 5 years) (NOTE: Facilities requiring revisits will incur additional expenses)

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