To increase the impact of BFHI on community breastfeeding practices, BFHI should focus on involving the family members with the mother throughout the implementation of the Ten Steps while encouraging maternal support groups and taking cultural differences into account.

No abstract

Four hundred eight providers and staff members who care for breastfeeding mothers and babies at Al-Zahraa University Hospital, Cairo, Egypt were randomly selected to assess their knowledge, attitudes, and practices regarding the Baby-Friendly Hospital Initiative. The majority of the participants scored above 50% on the knowledge and attitude questions, however, on the practice questions only 45.3% scored above 50%, similar to the result obtained 10 years prior. The results indicate that most attention should be focused on developing practice guidelines and monitoring outcomes since knowledge and attitude were found to be adequate. We would recommend self-appraisal of staff as a first step to others whose hospitals are in the process of implementing the Baby-Friendly Hospital Initiative.