Dear Colleagues,

It’s been a year since we updated you on our plans for implementing the revised guidance for the Baby-Friendly Hospital Initiative (BFHI) provided by the WHO and UNICEF. At that time, we said that the process of evaluating and customizing the guidance for the US would take about two years. Since we are now midway through that process, we thought this would be a good time to provide another update.

The implementation and roll-out of the new guidance is extremely complex, as the WHO and UNICEF encouraged all countries to review and customize the international standards for national application. This requires a multi-pronged strategy with input from key stakeholder groups and multiple levels of review. Despite these complexities, this process presents a much-needed opportunity to fine-tune the initiative and to infuse the new BFHI with more flexibility and a more user-friendly approach to implementation.

Now, one year later, we are pleased to report that we’ve made tremendous progress and look forward to beginning implementation of the revised guidance in the US in early 2020.

Here’s what we’ve done so far:

  • Performed a detailed analysis of the implementation guidance and the underlying evidence document provided by the WHO and UNICEF.
  • Compared the new guidelines and standards with the existing US Guidelines and Evaluation Criteria (GEC) to ascertain if any immediate modifications could be rolled out.
  • Concluded that adjustments to the requirements for Step 9 were warranted and, therefore, published a revised version of the US GEC in July 2018.
  • Convened an expert panel in August 2018, consisting of individuals with widespread knowledge and experience in implementing the BFHI standards, to review the updated evidence and the new implementation guidance, and make recommendations on how to customize the global guidance for applicability to the US.
  • Presented the expert panel’s recommendations to the Clinical Committee of the BFUSA Board of Directors.
  • Developed a draft of the new US guidelines based on these recommendations and sent it back to the expert panel for review and comment.
  • Finished receiving comments from the expert panel in February 2019 and incorporated the feedback into a revised guidance document.
  • Sent the revised document to the BFUSA Clinical Committee, the expert panel, as well as to several key national professional health organizations for further input.

Here’s what will happen next:

  • We will reconvene the expert panel in July 2019 to review the comments received in the latest review stage and assist with finalizing the guidance, standards and evaluation criteria for the US.
  • BFUSA will then update all of the 4-D Pathway monitoring and assessment tools and brief key stakeholders prior to rolling out the final materials. We expect this process to unfold by April 2020. Please be assured that we will provide ample time for facilities to implement the new plans.

We are implementing this complicated process as carefully and objectively as possibly. While we consider our organization to be the overseers of a critically important public health initiative that will affect the health and lives of generations to come, we also see ourselves as the stewards of many voices and many diverse perspectives – and we do not take this responsibility lightly. We appreciate your patience and know the final product will be so much better because we’ve all taken the time to get it right.

Thank you for your support.

Sincerely,

Trish MacEnroe
Chief Executive Officer