Discussions with the WHO and UNICEF Regarding the Future of the Global Baby-Friendly Hospital Initiative

Dear Colleagues,

We are writing as a collaboration of five organizations that formed to provide unified feedback to the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) in the wake of proposed changes to the Global Baby-Friendly Hospital Initiative (BFHI).

We want to make sure all stakeholders in our networks are informed about the changes WHO and UNICEF have proposed, the concerns we have expressed, and the modifications to the proposals we have recommended. We are also pleased to share with you that WHO and UNICEF have already made some of our recommended changes.


On October 11 of last year the WHO and UNICEF released their draft revised BFHI Operational Guidance titled “Protection, promotion, and support of breastfeeding in facilities providing maternity and newborn services: The revised Baby-friendly Hospital Initiative 2017.”

This document was open for public comment for two weeks and more than 300 individuals and organizations provided feedback during this brief period. As a result of extensive concerns expressed by many stakeholders about the magnitude of the changes proposed and the extremely short timeframe for review and feedback, the WHO and UNICEF decided to delay publication of the proposed BFHI Operational Guidance until there could be further consultations with our five global breastfeeding organizations. Our organizations formed a collaborative, developed a list of 10 key concerns, and have been working closely together since then to provide consolidated and constructive feedback to the WHO and UNICEF on the proposed changes. We are pleased to report that there has been some progress on addressing our concerns.

Areas of Concern

Our collaboration agrees with WHO and UNICEF that the BFHI should be updated, revitalized and include broad and robust components to more effectively guide safe implementation of practices. While we are not included in all discussions underway, our latest information suggests that some critical issues remain:

  1. The proposal still includes the development of individual national criteria. It now includes global standards and recommends that the national criteria be based on them. While this adopts part of our recommendation (maintaining strong global standards), we still believe this approach will allow for wide variation of practices and inconsistent standards throughout the world, undermining global indicators. Global standards are the foundation of the BFHI and they are essential to monitoring the global effort to improve breastfeeding rates. To achieve global standards of practice, there is a need for standardized, model training courses, many of which already exist, and may need only minor adaptation for the revised BFHI.
  2. The proposal includes support for BFHI designation as a key strategy for maternity care practice improvement, however it continues to be optional. We believe optional designation weakens one of the most effective strategies used to achieve sustainable improvements in the quality of maternity care and breastfeeding rates, as evidenced by research and its success in many countries.
  3. The basis for the proposed changes to the Ten Steps is a 136-page review of the evidence released by the WHO on November 3 of last year – after the public comment period for the draft Operational Guidance closed – in a similarly-named document, “Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services.” While each of the Steps was reviewed individually, the review did not address the efficacy of the BFHI program as a whole, which is commonly a key component of program evaluation. Since the GRADE protocol used to create this document only considers randomized controlled trials (RCTs) as appropriate evidence, a significant body of evidence was not examined. This does not equate to lack of or negative evidence. This led initially to the proposed elimination of Step 9, which has now been reinstated, though it does not yet caution against risks of using bottles and pacifiers. While the WHO process for evaluating the evidence on specific topics may have been rigorous and appropriate for addressing narrowly defined quantifiable questions most appropriate for medically related topics, it was not the most appropriate method for examining the evidence related to the socio-cultural and ethical complexities of the BFHI. This method failed to portray the reality that those working and researching in this field have experienced over the past 30 years. It appears that other types of protocols are utilized by the WHO, such as for the newly released Intrapartum Care for Positive Childbirth Experience, which includes all types of quantitative research, for example observational studies, and is not limited to RCTs.
  4. Recent communication from WHO and UNICEF indicates agreement that the order, number and subject matter of each of the original Ten Steps to Successful Breastfeeding will be retained. There will be some modifications to the language and interpretation of the Steps. Most of the changes are improvements and reflect current evidence. We support this action as it enables the Steps to evolve with the evidence. However, the proposed new language for Step 9 remains a concern.
  5. The proposed changes are likely to soften and disrupt ongoing productive and beneficial BFHI work occurring in all corners of the world.

What We Have Done

Our collaborative has sent numerous letters and documents to the WHO and UNICEF and has had many discussions with representatives of these organizations. We also sent a detailed memorandum to Member States’ Representatives to the Executive Board of the World Health Assembly (WHA) prior to their January meeting in Geneva. Several of our members in attendance at the meeting met face-to-face with WHA representatives, and WHO and UNICEF leaders to express our concerns.

WHO and UNICEF, based on an evaluation of the evidence and information submitted by the collaborative, appear to have made significant changes to the proposed initial draft, including the retention of the order, number, and subject matter of each of the original Ten Steps. However, significant gaps in the alignment of our thinking with WHO and UNICEF remain.

We urge the continued delay of publication of the proposed Operational Guidance to allow time for additional conversation and improvements. The WHO and UNICEF’s original plan was to launch the new guidelines in November 2017. According to a recent communication, a new publication date may be late March 2018.

What You Can Do

If you support a continued, comprehensive global review of these issues focused on what’s best for mothers, babies and families, it is critical to let WHO (nutrition@who.int), UNICEF (nutrition@unicef.org) and your WHA representatives hear your concerns immediately. The Operational Guidance could be included in a WHA resolution at the May 2018 meeting to be brought to the table for agreement by Member States. The 2017 WHA delegates list can be found here and may be helpful in identifying and locating your own delegates.

You may wish to emphasize some or all of the following points and recommendations that we continue to advocate for in our discussions:

  1. Retain global: guidelines, criteria, streamlined monitoring tools, streamlined assessment tools, and scoring systems.
  2. Retain standardized model training courses, which can be used or adapted globally.
  3. Continue accreditation based on external assessment, inclusive of mother interviews, and conducted by knowledgeable individuals, as part of the process.
  4. Welcome the indication by WHO and UNICEF that they will maintain the metrics hospitals must achieve at the current 80% standard.
  5. Welcome the indication by WHO and UNICEF to retain the order, number and subject matter of each of the original Ten Steps.
  6. Welcome that the Code and internal monitoring is proposed to be incorporated into Step 1 on infant feeding policies.
  7. Advocate for revised language for the re-introduced Step 9, to clarify facility responsibility for minimizing the use of bottles, teats and pacifiers.  Include language about risks, and the advisability of using only when medically necessary or parents are appropriately educated.
  8. Continue safe and respectful birth practices as a component of the BFHI.
  9. Use empowering language throughout the Operational Guidance document.
  10. Keep the BFHI about healthy term infants. Adopt a separate set of standards pertaining to breastfeeding support for preterm and sick infants, such as the NEO BFHI Baby-Friendly Hospital Initiative for Neonatal Wards which was initially developed by the Nordic-Quebec Working Group.
  11. Include a discussion of the ethical issues related to doing randomized trials on infant and young child feeding including those specific to breastfeeding.
  12. Incorporate a robust discussion regarding the interrelationship between each of the 10 Steps and how they work together as a comprehensive breastfeeding support program.

We appreciate the opportunity to communicate with WHO and UNICEF on this important matter and look forward to continuing to do so in an open and transparent manner. Together, we can strengthen the foundation that supports breastfeeding around the world.

Thank you for your support.



Trish MacEnroe
Baby-Friendly Hospital Initiative Network of Industrialized Nations, Central and Eastern European Nations and Independent States (BFHI Network)

Elisabeth Sterken
Co-chair IBFAN Global Council
International Baby Food Action Network (IBFAN)

Michele Griswold
International Lactation Consultant Association (ILCA)

Ann Calandro
La Leche League International (LLLI)

Felicity Savage
World Alliance for Breastfeeding Action


Additional translations of this communication are available in French, Italian, and Spanish.

Editor’s Note: The International Lactation Consultant Association would like to applaud the important advocacy efforts of our representatives, Kathleen Marinelli, Joan Dodgson, and Linda Smith, who have worked within this collaborative.


Discussions avec l’OMS et l’UNICEF au sujet de l’avenir de l’Initiative des Hôpitaux Amis des bébés au niveau international

Chères collègues,

Nous vous écrivons au nom d’un collectif de cinq organisations qui s’est développé en vue de fournir à l’Organisation mondiale de la santé (OMS) et à l’UNICEF une rétroaction unifiée sur les changements proposés à l’Initiative des hôpitaux amis des bébés (IHAB) au niveau international.

Nous voulons nous assurer que les membres de nos organisations respectives soient informés correctement sur les changements que l’OMS et l’UNICEF ont proposés, sur les préoccupations que nous avons exprimées, et sur les modifications aux propositions que nous avons recommandées. Nous sommes aussi heureuses de vous informer que l’OMS et l’UNICEF ont déjà accepté quelques-unes de nos recommandations.


Le 11 octobre dernier, l’OMS et l’UNICEF ont mis en ligne une révision proposée des Lignes directrices pour l’Initiative des Hôpitaux Amis des bébés (IHAB), sous le titre anglais “Protection, promotion, and support of breastfeeding in facilities providing maternity and newborn services: The revised Baby-friendly Hospital Initiative 2017”.

Ce document était disponible pour consultation publique pour une période de deux semaines. Malgré cette courte période de consultation, plus de 300 individus et organisations ont envoyé des commentaires. Suite aux nombreuses préoccupations exprimées sur l’ampleur des révisions proposées et le temps extrêmement court pour en prendre connaissance et y réagir, l’OMS et l’UNICEF ont décidé de retarder la publication des Lignes directrices proposées en vue de permettre de plus amples consultations avec nos cinq organisations. Depuis ce temps, nos organisations ont formé un collectif, produit une liste de 10 préoccupations clés et travaillé en étroite collaboration, en vue de fournir à l’OMS et l’UNICEF une rétroaction constructive et unifiée quant aux changements proposés.

Sujets de préoccupations qui persistent

Notre collectif est d’accord avec l’OMS et l’UNICEF que l’IHAB a besoin d’être mise à jour, revitalisée et qu’il faut y inclure des éléments solides et à plus large portée en vue de guider l’implantation sécuritaire des pratiques. Cependant, comme notre collectif n’est pas inclus dans toutes les discussions en cours, nos dernières informations suggèrent que certaines questions préoccupantes ne sont pas réglées :

  1. Les changements proposés recommandent toujours aux états-membres de développer leurs propres standards nationaux, même si des critères internationaux seront maintenant proposés comme base au développement des critères nationaux. Nous avions recommandé de maintenir des critères globaux forts, ce qui est fait. Par contre, nous croyons que l’approche de développement de critères nationaux apportera une grande variation dans les pratiques et des standards inégaux à travers le monde, affaiblissant ainsi les critères internationaux. Les standards internationaux sont la fondation même de l’IHAB; ils sont essentiels à la surveillance des efforts globaux visant l’amélioration des taux d’allaitement. Pour atteindre des standards internationaux, il faut aussi un modèle d’éducation continue standardisé; plusieurs de ces cours de formation continue existent et peuvent nécessiter seulement des adaptations mineures.
  2. Les changements proposés soutiennent que la certification IHAB est une stratégie clé pour l’amélioration des pratiques mais qu’elle demeure optionnelle. Nous croyons que ceci affaiblira l’une des stratégies reconnues les plus efficaces pour améliorer de façon durable la qualité des soins périnatals et augmenter les taux d’allaitement, tel que démontré par les recherches et l’expérience terrain dans plusieurs pays.
  3. Une communication récente de l’OMS et de l’UNICEF indique que la structure des Dix conditions pour le succès de l’allaitement, leur ordre original ainsi que l’objet de chacune d’elles seront retenus. Plusieurs changements de langage et d’interprétation sont à prévoir en vue de refléter les plus récentes données probantes. Nous soutenons cette décision qui permettra l’évolution des conditions selon les évidences scientifiques. Cependant, le libellé proposé pour la condition 9 pose encore un problème.
  4. Les changements proposés aux Dix conditions sont basés sur une revue des données probantes de 136 pages publiée par l’OMS le 3 novembre 2017-après la période de consultation publique sur les Lignes directrices- dans un document portant un nom similaire “Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services”. Dans cette revue des évidences scientifiques, les Dix conditions ont été étudiées individuellement mais l’efficacité de l’IHAB comme un tout n’a pas été considérée; pourtant, ceci fait généralement partie de l’évaluation d’un programme. Le protocole  GRADE utilisé pour cette recherche de données probantes ne considère que les études randomisées contrôlées (RCTs) comme évidence scientifique acceptable. En conséquence, un large éventail de la littérature scientifique n’a pas examiné, ce qui n’équivaut pas à un manque d’évidence ni à des données scientifiques négatives. C’est entre autres ce processus qui a conduit à la proposition initiale d’éliminer la Condition 9 qui a, depuis, été réinscrite dans les Dix conditions; cependant actuellement, la condition 9 n’inclut pas de mention des risques associés à l’utilisation des biberons et des sucettes. Même si ce protocole est  rigoureux et approprié pour l’étude d’une question quantifiable définie précisément, par exemple une question médicale pointue, ce n’est pas la méthode la plus appropriée pour évaluer les évidences scientifiques liées aux aspects socio-culturels et éthiques complexes de l’IHAB. Le protocole GRADE utilisé pour étudier les données probantes liées à l’IHAB ne dépeint pas la réalité de ceux et celles qui travaillent et font de la recherche dans ce domaine depuis plus de trente ans. Il semble que l’OMS utilise d’ailleurs d’autres protocoles de revue de la littérature qui incluent aussi d’autres types de recherches quantitatives en plus des RCTs,  par exemple des études observationnelles, comme c’est le cas pour le document récemment publié Intrapartum Care for Positive Childbirth Experience.
  5. Les changements proposés vont fort probablement miner le travail productif et bénéfique effectué actuellement en regard de l’IHAB dans tous les coins du monde.

Ce que nous avons fait

Notre collectif a eu de nombreuses discussions avec les représentants de l’OMS et de l’UNICEF et leur a fait parvenir plusieurs lettres et documents. Nous avons aussi envoyé un mémorandum aux membres du Comité exécutif de l’Assemblée mondiale de la santé avant leur rencontre à Genève en janvier dernier. Des membres de notre collectif, présents sur place, ont aussi rencontré individuellement plusieurs délégués de même que les responsables de l’IHAB de l’OMS et de l’UNICEF, en vue de leur expliquer de vive voix nos préoccupations.

Suite à l’évaluation des données probantes et des informations que notre collectif leur a soumises, l’OMS et l’UNICEF semblent avoir apporté de nombreux changements au canevas proposé initialement, incluant la structure, l’ordre et l’objet des Dix conditions. Cependant, on constate qu’encore actuellement, la vision de l’OMS-UNICEF et la nôtre ne concordent pas entièrement.

Nous demandons de retarder la publication des Lignes directrices actuellement proposées en vue de poursuivre le travail pour bonifier ce document. L’OMS et UNICEF planifiaient de publier ce document en novembre 2017. Selon la lettre que nous avons reçue, la publication pourrait avoir lieu en mars 2018.

Ce que vous pouvez faire

Si vous êtes d’accord qu’une révision globale, continue et inclusive de ces préoccupations, doit être poursuivie, centrée sur ce qu’il y a de meilleur pour les mères et les bébés, il est important que l’OMS (nutrition@who.int), l’UNICEF (nutrition@unicef.org) et vos délégués nationaux à l’Assemblée mondiale de la santé (AMS) vous entendent immédiatement. Les nouvelles Lignes directrices pourraient faire l’objet d’une résolution demandant le vote des délégués à l’AMS en mai 2018. La liste des délégués des états-membres de 2017 se trouve sur ce site web afin de vous permettre d’identifier et de rejoindre vos propres délégués.

Vous désirerez peut-être alors discuter avec eux de l’un ou de tous les points et recommandations sur lesquels nous continuons à insister lors de nos discussions, à savoir:

  1. Garder au niveau international : lignes directrices, critères, outils simplifiés pour le monitoring, méthodes et outils d’évaluation et de compilation.
  2. Conserver un modèle standardisé de formation continue qui peut être utilisé tel quel ou adapté au niveau international.
  3. Considérer l’évaluation externe comme partie prenante du processus de certification, incluant les entrevues de mères menées par des individus ayant les compétences pour le faire.
  4. Accueillir favorablement l’intention de l’OMS/UNICEF de conserver les pourcentages de passage à 80% pour les établissements de santé.
  5. Accueillir favorablement l’indication que l’OMS/UNICEF gardera la structure et l’ordre des Dix conditions, de même que l’objet de chacune d’entre elles.
  6. Accueillir favorablement le fait que le Code et la surveillance (monitoring) seront intégrés dans la condition 1 sur les politiques d’alimentation de l’enfant.
  7. Militer pour un langage approprié pour la condition 9 qui a été réinscrite aux Dix conditions. Clarifier ainsi le rôle des établissements de santé pour minimiser l’utilisation de biberons, de suces et de sucettes. Utiliser un langage spécifiant les risques liés à ces produits et l’opportunité de leur utilisation sur indication médicale  seulement ou après que les parents aient été informés de façon appropriée.
  8. Conserver comme critères évaluables dans l’IHAB, les pratiques respectueuses et sécuritaires au moment de la naissance.
  9. Utiliser dans tout le document des Lignes directrices un langage visant l’empowerment des personnes.
  10. Inclure uniquement les bébés à terme et en santé dans l’IHAB. Adopter des standards différents et à part de l’évaluation régulière, pour le soutien à l’allaitement des bébés prématurés et/ou malades, par exemple le NEO BFHI, un guide sur l’Initiative des hôpitaux amis des bébés appliquée aux unités de soins intensifs néonataux, développé à l’origine par le Nordic-Quebec Working Group.
  11. Inclure dans les Lignes directrices une solide discussion sur les aspects éthiques liés aux études randomisées en ce qui concerne la nutrition des nourrissons et des jeunes enfants, incluant spécifiquement celles en regard de l’allaitement.
  12. Insérer dans les Lignes directrices une explication détaillée des interrelations entre les Dix conditions et comment l’IHAB fonctionne comme un programme intégré de soins et services.

Nous saluons l’opportunité de travailler avec l’OMS et l’UNICEF à cet important changement et espérons de continuer ainsi dans la transparence et l’ouverture. Ensemble, nous pouvons solidifier les fondations qui soutiennent l’allaitement internationalement.

Merci de votre soutien.


Acceptez nos salutations respectueuses,

Trish MacEnroe, coordonnatrice, Baby-Friendly Hospital Initiative Network of Industrialized Nations, Central and Eastern European Nations and Independent States (BFHI Network)

Elizabeth Sterken, vice-présidente, International Baby Food Action Network (IBFAN)

Michele Griswold, présidente, Association internationale des consultantes en lactation (ILCA)

Ann Calandro, présidente, La Ligue La Leche International (LLLI)

Felicity Savage, présidente, World Alliance for Breastfeeding Action (WABA)


Traduction libre par Louise Dumas, Comité canadien pour l’allaitement; texte original en anglais “Discussions with the WHO and UNICEF Regarding the Future of the Global Baby-Friendly Hospital Initiative”.

Des traductions supplémentaires de cette communication sont disponibles en anglais, italien et espagnol.

Note de la rédaction: L’International Lactation Consultant Association aimerait féliciter les représentants de nos représentants, Kathleen Marinelli, Joan Dodgson et Linda Smith, qui ont travaillé dans le cadre de ce projet de collaboration.


Negociaciones con la OMS y con UNICEF sobre el futuro de la IHAN (Hospital Amigo de los Niños y las Niñas) a Nivel Internacional

Estimados colegas:

Os escribimos en nombre de la alianza formada por nuestras 5 organizaciones al objeto de ofrecer, a la Organización Mundial de la Salud (OMS) y el Fondo de las Naciones Unidas para la Infancia (UNICEF), una respuesta unificada ante las propuestas de cambios a nivel Global para la IHAN (Iniciativa Hospital amigo de los niños y las niñas o (en España) Iniciativa para la Humanización de la Asistencia al Nacimiento y la Lactancia).

Es nuestro deseo hacer llegar, dentro de nuestras redes, a todas las partes interesadas, la información de los cambios que OMS y UNICEF han propuesto, así cómo las preocupaciones que nuestra alianza les ha expresado junto a las modificaciones que hemos propuesto.


El 11 de octubre del pasado año, OMS y UNICF hicieron público un documento preliminar de la Guía Operativa IHAN titulado: “Protection, promotion, and support of breastfeeding in facilities providing maternity and newborn services: The revised Baby-friendly Hospital Initiative 2017.” (sólo publicado en inglés)

Este documento estuvo abierto a comentario público durante 2 semanas y, en tan corto espacio de tiempo, obtuvo comentarios de más de 300 individuos y organizaciones. Como resultado de la importante inquietud, expresada por muchas de las partes implicadas, sobre la magnitud de los cambios propuestos y sobre la extrema brevedad del tiempo concedido para hacer revisiones y propuestas, OMS y UNICEF decidieron retrasar la publicación de la Revisión de la Guía Operacional para la IHAN hasta que pudieran tener lugar consultas de mayor profundidad con nuestras 5 organizaciones (de ámbito mundial). Nuestras organizaciones formaron una alianza y hemos estado trabajando unidas desde entonces, con el propósito de ofrecer una respuesta conjunta, consolidada y constructiva sobre los cambios propuestos, a la OMS y el UNICEF. Nos satisface poder comunicar en este punto que, de alguna manera, la respuesta a nuestras preocupaciones está realizando progresos.

Motivos de preocupación

Estamos de acuerdo con que la IHAN debe ser actualizada, revitalizada e incluir componentes sólidos que aseguren de forma más efectiva su implementación. Aunque no estamos incluidas en todas las discusiones que están teniendo lugar, nuestras últimas informaciones sugieren la persistencia de algunos puntos críticos.

  1. La propuesta aún incluye el desarrollo de criterios nacionales individuales. Aunque ahora incluye los Criterios Globales y recomienda que los criterios nacionales se basen en ellos. A pesar de que parte de nuestras recomendaciones son adoptadas (mantener unos Criterios Globales Fuertes), creemos no obstante que este enfoque abre la posibilidad a una amplia variabilidad de prácticas y a la inconsistencia de estándares a nivel mundial, y socava los indicadores globales. Los Criterios Globales son la base fundacional de la IHAN y son esenciales en la monitorización de los esfuerzos que a nivel global se realizan para mejorar las tasas de lactancia materna. Para conseguir estándares de práctica globales, son necesarios cursos modelo de formación estandarizados, muchos de los cuales ya existen y necesitarían tan sólo pequeñas adaptaciones a la IHAN revisada.
  2. La propuesta incluye la certificación IHAN de las instituciones como una estrategia clave en la mejora de las prácticas de cuidado en las maternidades, pero continua considerándola como opcional. Creemos que la consideración de opcional debilitaría una de las estrategias más efectivas para la obtención de mejoras sostenibles en la calidad de los cuidados en las Maternidades y en las Tasas de Lactancia, avalada por la evidencia científica y la experiencia de muchos países.
  3. Comunicaciones recientes desde OMS y UNICEF indican un acuerdo sobre el mantenimiento del orden, el número y el contenido esencial de cada uno de los 10 Pasos hacia una lactancia natural, originales. Habrá algunas modificaciones de definición y de interpretación de los Pasos. La mayoría de estos cambios son mejoras y reflejan la evidencia científica actual. Sin embargo seguimos considerando preocupante la nueva definición del Paso 9.
  4. La base para los cambios propuestos para los 10 Pasos, es una revisión de 136 páginas sobre la evidencia, publicada por la OMS el 3 de noviembre del año pasado- después del periodo abierto a comentario público para la guía operativa- en un documento denominado de forma muy similar: “Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services.” A pesar de que cada uno de los Pasos fue revisado individualmente, la revisión no abordó la eficacia del programa IHAN como un todo, lo que es un componente habitualmente clave en la evaluación de programas. Dado que en el protocolo GRADE, utilizado para la elaboración de este documento, la única evidencia considerada apropiada fue la derivada de ensayos clínicos, un conjunto significativo de evidencia quedó por examinar. Pero ello no significa que no haya evidencia o que la evidencia existente sea negativa. Los resultados de este análisis llevaron a la propuesta inicial de eliminación del Paso 9 que ha sido ahora reinstaurado, aunque sin que avise contra los riesgos de utilizar biberones y chupetes. A pesar de que el proceso aplicado por la OMS puede haber sido riguroso y apropiado para abordar la calidad de la evidencia sobre otros temas concretos, medibles cuantitativamente con preguntas de definición precisa, como ocurre especialmente en determinadas cuestiones del ámbito médico, este proceso no es el método más adecuado para examinar la evidencia relacionada con las complejidades socio-culturales y éticas que rodean a la IHAN. Este método ha fracasado en el retrato de la realidad que aquellos que llevan trabajando e investigando en este campo han experimentado en los 30 años. Al parecer en casos similares, otro tipo de protocolos son utilizados por la OMS, como el usado en el documento publicado recientemente: Intrapartum Care for Positive Childbirth Experience que incluye cualquier tipo de diseño de investigación cuantitativa incluyendo estudios observacionales, y no se limita al ámbito de los ensayos clínicos.
  5. Es muy probable que los cambios propuestos debiliten y perturben el trabajo productivo y beneficios de la IHAN que en la actualidad tiene lugar en todos los rincones del mundo.

Lo que hemos hecho

Nuestra alianza ha enviado numerosas cartas y documentos a la OMS y a UNICEF y hemos mantenido múltiples debates con representantes de estas organizaciones. También enviamos un detallado memorando a los Representantes de los Estados Miembros en el Comité Ejecutivo de la Asociación Mundial de la Salud (AMS) antes de su reunión de enero en Ginebra. Durante su asistencia a la reunión, varios de nuestros miembros mantuvieron encuentros vis-a-vis con representantes de la AMS y con los líderes de OMS y UNICEF y les comunicaron nuestras preocupaciones.

Basados en la evaluación de la evidencia y en la información remitida por nuestra alianza, OMS y UNICEF parecen haber realizado cambios sustanciales en el borrador-propuesta inicial, incluyendo el mantenimiento del orden, el número y el contenido de cada uno de los 10 Pasos originales. Sin embargo aún persisten numerosas brechas en el alineamiento de nuestros planteamientos con los de OMS y UNICEF.

Urgimos a mantener el retraso de la publicación de la propuesta de Guía Operacional que conceda tiempo para conversaciones y mejoras adicionales. El plan original de OMS y UNICEF era la publicación de la Nueva Guía en noviembre de 2017. Según una comunicación reciente, hay una nueva fecha probable de publicación: finales de marzo 2018.

Qué podéis hacer

Si apoyáis continuar con una revisión exhaustiva y global de este tema, dirigida a la búsqueda de lo mejor para madres y bebés, es crítico que OMS, UNICEF y vuestros representantes en la Asamblea Mundial de la Salud oigan vuestras preocupaciones de forma inmediata. La Guía Operacional podría ser incluida en una resolución de la Asamblea Mundial de la Salud que será presentada para su aprobación por los estados miembros en la reunión de mayo de 2018. La lista de delegados de 2017 puede verse aquí y podría ser útil para identificar y localizar a vuestros propios delegados.

Podríais desear enfatizar algunos o todos de los siguientes puntos y recomendaciones que continuamos promoviendo en nuestras negociaciones con OMS y UNICEF:

  1. Conservar globales las guías, los criterios, las herramientas simplificadas de monitorización y evaluación y los sistemas de puntuación.
  2. Mantener el modelo de curso de formación estandarizado que puede ser usado o adaptado a nivel mundial.
  3. Continuar con las acreditaciones, como parte del proceso, basadas en evaluaciones externas que incluyan entrevistas con madres y sean realizadas por expertos.
  4. Dar la bienvenida a la indicación de OMS y UNICEF de que mantendrán los niveles de cumplimiento para los hospitales en un 80% del estándar.
  5. Agradecer la indicación de OMS y UNICEF de mantener el orden, el número y el sentido original de los 10 Pasos.
  6. Celebrar el hecho de que el Código y el sistema de monitorización interna sean incorporados en el Paso 1 sobre políticas de alimentación infantil.
  7. Recomendar la revisión del texto utilizado en el recuperado Paso 9, para clarificar la responsabilidad de la institución de minimizar el uso de biberones, tetinas y chupetes. Incluir texto sobre riesgos, y la necesidad de que los padres reciban información sobre las implicaciones que conlleva el uso de biberones, tetinas y chupetes.
  8. Continuar manteniendo las prácticas de seguridad y respeto en el parto como un componente de la IHAN.
  9. Incorporar lenguaje motivador a lo largo del documento de la Guía Operacional.
  10. Mantener como sujetos objeto de la IHAN a los recién nacidos sanos. Adoptar un conjunto diferente de estándares en relación al apoyo de la lactancia en los recién nacidos enfermos o prematuros, como la NEO-IHAN desarrollada por la alianza de países nórdicos y Canadá.
  11. Incluir un apartado que trate de los aspectos éticos relacionados con la realización de ensayos clínicos aleatorios en la investigación en lactancia materna.
  12. Incorporar una discusión sólida sobre cómo Los 10 Pasos se interrelacionan en un todo global y constituyen un programa integral de apoyo a la lactancia materna.

Apreciamos sinceramente la oportunidad de comunicación con la OMS y UNICEF en este tema importante y esperamos continuar haciéndolo de manera fluida. Juntos, podemos fortalecer los cimientos que apoyan la lactancia en todo el mundo.

Muchas gracias por vuestro apoyo.



Trish MacEnroe, coordinadora, Red Global Iniciativa Baby-Friendly para los países industrializados y CEEIS (BFHI Network)

Elizabeth Sterken, vicepresidenta, International Baby Food Action Network (IBFAN)

Michele Griswold, presidenta, Asociación Internacional de consultoras de lactancia (ILCA)

Ann Calandro, presidenta, La Liga de La Leche Internacional (LLLI)

Felicity Savage, presidenta, World Alliance for Breastfeeding Action (WABA)


Traducción autorizada del texto original en inglés : “Discussions with the WHO and UNICEF Regarding the Future of the Global Baby-Friendly Hospital Initiative”. Traducción realizada por Mª Teresa Hernández Aguilar, Coordinadora Nacional IHAN- España (Iniciativa para la Humanización de la Asistencia al Nacimiento y la Lactancia).

Las traducciones adicionales de esta comunicación están disponibles en inglés, italianofrancés.

Nota del editor: La Asociación Internacional de Consultores de Lactancia quisiera aplaudir los importantes esfuerzos de defensa y promoción de nuestros representantes, Kathleen Marinelli, Joan Dodgson y Linda Smith, quienes han trabajado en esta colaboración.


Discussioni con l’OMS e l’UNICEF riguardo al futuro dell’Iniziativa mondiale Ospedale Amico dei Bambini

Cari Colleghi,

vi scriviamo a nome di cinque Organizzazioni (BFHI Network, IBFAN, ILCA, LLLI, WABA), che si sono riunite per fornire un feedback all’Organizzazione Mondiale della Sanità (OMS) e al Fondo delle Nazioni Unite per l’Infanzia (UNICEF) in seguito alle modifiche da loro proposte all’Iniziativa mondiale Ospedale Amico dei Bambini (Baby-Friendly Hospital Initiative – BFHI).

Vogliamo assicurarci che tutte le parti interessate delle nostre reti siano informate sui cambiamenti che OMS e UNICEF hanno proposto, sulle preoccupazioni che abbiamo espresso e sulle modifiche che abbiamo formulato alle loro proposte. Siamo contente di riferirvi che OMS e UNICEF hanno già accolto alcune delle nostre proposte di modifica.


L’11 ottobre scorso OMS e UNICEF hanno pubblicato la bozza della Guida operativa BFHI riveduta dal titolo “Protection, promotion, and support of breastfeeding in facilities providing maternity and newborn services: The revised Baby-friendly Hospital Initiative 2017.” (“Protezione, promozione e sostegno dell’allattamento in strutture che offrono servizi di maternità e per neonati: l’Iniziativa Ospedale Amico dei Bambini rivista nel 2017”).

Questo documento è stato messo a disposizione dei commenti del pubblico per due settimane e più di 300 persone e organizzazioni hanno fornito un feedback durante questo breve periodo. In base alle preoccupazioni generali espresse da più parti sull’entità delle modifiche proposte e sui tempi estremamente brevi concessi per leggere la bozza e fornire un feedback, OMS e UNICEF hanno deciso di rinviare la pubblicazione della bozza della Guida operativa BFHI per permettere ulteriori consultazioni con le nostre cinque organizzazioni che si occupano di allattamento. Da allora, le nostre organizzazioni hanno formato un gruppo di lavoro, sviluppato un elenco di 10 aree di criticità, e lavorato a stretto contatto per fornire un feedback consolidato e costruttivo a OMS e UNICEF sulle modifiche proposte. Siamo felici di comunicarvi che sono stati fatti dei progressi nell’accogliere le nostre preoccupazioni.

Aree di criticità che persistono

Il nostro gruppo di lavoro è d’accordo con OMS e UNICEF sul fatto che la BFHI andrebbe aggiornata e rivitalizzata e che dovrebbe includere elementi ad ampio raggio e di comprovata evidenza scientifica per guidare in modo più efficace l’applicazione sicura delle pratiche. Anche se il nostro gruppo non è stato incluso in tutte le discussioni in corso, le ultime informazioni suggeriscono che alcune questioni preoccupanti perdurano:


  1. La bozza della Guida operativa del 2017 parla ancora dello sviluppo di criteri nazionali. Include ancora gli standard globali, ma solo come base per gli standard nazionali. Anche se una parte della nostra raccomandazione (mantenere standard globali forti) è stata accolta, continuiamo a ritenere che questo approccio porti ad una variabilità troppo ampia di pratiche e a standard non coerenti a livello mondiale, minando di fatto il senso degli indicatori globali. Gli standard globali sono alla base della BFHI e sono essenziali per monitorare lo sforzo mondiale per migliorare i tassi di allattamento. Per raggiungere gli standard internazionali di buone pratiche, è essenziale avere dei modelli di corsi di formazione standardizzati, che già esistono in gran parte, e che potrebbero richiedere soltanto piccoli adattamenti per questa revisione della BFHI.
  2. La bozza sostiene il riconoscimento di “Ospedale Amico” come strategia-chiave per migliorare l’assistenza materno-infantile, ma il riconoscimento continua ad essere una componente facoltativa. Riteniamo che un riconoscimento “optional” indebolisca una delle strategie più efficaci utilizzate per ottenere miglioramenti sostenibili nella qualità dell’assistenza materno-infantile e nei tassi di allattamento, come evidenziato dalla ricerca e dalla buona riuscita dell’iniziativa in molti paesi.
  3. Una comunicazione recente di OMS e UNICEF indica un accordo sul fatto che la struttura, la numerazione e i temi di ognuno dei Dieci Passi originali verranno mantenuti. Verranno apportate modifiche alla descrizione e all’interpretazione di diversi Passi. La maggior parte delle modifiche rappresenta un miglioramento e riflette le prove di efficacia attuali. Noi sosteniamo questa azione che permette ai Dieci Passi di evolvere con la ricerca. Tuttavia, la definizione proposta per il Passo 9 rimane una criticità.
  4. Le modifiche proposte ai Dieci Passi si basano su una revisione della letteratura di 136 pagine pubblicata dall’OMS il 3 novembre u.s. – dopo il periodo per commenti pubblici – dal titolo molto simile: “Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services.” (“Proteggere, promuovere e sostenere l’allattamento in strutture che offrono servizi di maternità e per neonati.”). Mentre sono stati presi in considerazione ognuno dei Passi in maniera singola, la revisione non ha affrontato l’efficacia del programma BFHI nel suo complesso, che solitamente rappresenta una componente chiave della valutazione complessiva di un programma. Il protocollo GRADE utilizzato per creare questo documento, ha preso in considerazione i trials randomizzati controllati (Randomized Controlled Trials – RCTs) come prova utile. Un corpus significativo di ricerche non è stato esaminato, il che non significa una mancanza di prove oppure prove negative. Questo approccio ha portato alla proposta iniziale di eliminare il Passo 9, che attualmente risulta re-inserito, sebbene non metta ancora in guardia sui rischi associati all’uso di biberon e tettarelle. Mentre il processo dell’OMS per la valutazione delle prove di efficacia per argomenti specifici può essere rigoroso ed appropriato per indagare su questioni ben definite e quantificabili come quelle che si incontrano tipicamente in ambiti medici, non è il metodo più adatto per esaminare le prove di efficacia che riguardano le complessità socio-culturali ed etiche della BFHI. Questo metodo non è riuscito a rappresentare la realtà delle persone che lavorano nell’ambito della BFHI e che in questo ambito hanno fatto ricerca negli ultimi 30 anni. Sembra che ci siano altri tipi di protocolli utilizzati dall’OMS, come quello per il documento di recente pubblicazione “Intrapartum Care for Positive Childbirth Experience” (“Assistenza al travaglio/parto per un’esperienza positiva della nascita”), che esamina tutti i tipi di ricerca quantitativa, come per esempio gli studi osservazionali, e non si limita agli RCTs.
  5. Le modifiche proposte rischiano di attenuare e interrompere gli sforzi efficaci e produttivi portati avanti per la BFHI in tutti gli angoli del mondo.

Cosa abbiamo fatto

Il nostro gruppo ha inviato numerose lettere e documenti a OMS e UNICEF e ha avuto molte discussioni con i rappresentanti di queste Organizzazioni. Abbiamo anche inviato un dettagliato memorandum ai rappresentanti degli Stati Membri del Comitato Esecutivo dell’Assemblea Mondiale della Sanità (World Health Assembly – WHA) prima della loro riunione di gennaio a Ginevra. Alcuni nostri rappresentanti presenti all’incontro si sono incontrati faccia a faccia con i rappresentanti della WHA, i leader dell’OMS e dell’UNICEF per esprimere le nostre preoccupazioni.

Sembra che OMS e UNICEF, basandosi su una valutazione delle prove e delle informazioni fornite dal gruppo, abbiano apportato modifiche sostanziali alla bozza iniziale proposta, compreso l’aver mantenuto la struttura, la numerazione e i temi di ognuno dei Dieci Passi originali. Tuttavia, permangono notevoli distanze fra il nostro pensiero e quello di OMS e UNICEF.

Continuiamo a premere per posticipare la pubblicazione della Guida operativa proposta, al fine di concedere ulteriore tempo, scambi di idee e miglioramenti. Il piano originale di OMS e UNICEF prevedeva di lanciare le nuove linee guida a novembre 2017. Secondo una comunicazione recente, una nuova data di pubblicazione potrebbe essere a fine marzo 2018.

Cosa potete fare

Se sostenete una continua e comprensiva revisione globale di questi temi incentrata su ciò che è meglio per madri e bambini, è fondamentale far sentire le vostre preoccupazioni in tempi brevi all’OMS (nutrition@who.int), all’UNICEF (nutrition@unicef.org) ed ai vostri rappresentanti WHA. A maggio prossimo, alla riunione della WHA, la bozza della Guida Operativa potrebbe essere messa in agenda come uno degli argomenti di discussione degli Stati Membri. L’elenco dei delegati WHA del 2017 si trova qui e può essere utile per identificare e ritrovare i propri delegati.

Potreste voler sottolineare alcuni o tutti i seguenti punti e raccomandazioni che continuiamo a promuovere nelle nostre discussioni:

  1. Mantenere i materiali globali: le linee guida, i criteri globali, strumenti snelli di monitoraggio, di valutazione e di assegnazione di punteggio.
  2. Mantenere modelli di corsi di formazione standardizzati, che si possono utilizzare o adattare a livello globale.
  3. Mantenere il riconoscimento basato su valutazioni esterne, comprensive di interviste alle madri, condotte da persone appositamente formate, come parte del processo.
  4. Accogliere l’indicazione espressa da parte di OMS e di UNICEF che verranno mantenuti i livelli minimi che gli ospedali devono raggiungere all’attuale standard dell’80%.
  5. Accogliere l’indicazione espressa da parte di OMS e UNICEF che verranno mantenuti la struttura, la numerazione e i temi di ognuno dei Dieci Passi originali.
  6. Accogliere l’indicazione espressa che il Codice Internazionale ed il monitoraggio facciano parte integrante del Passo 1 sulle politiche dell’alimentazione dei neonati e dei bambini.
  7. Spingere affinché il Passo 9, re-introdotto, chiarisca la responsabilità della struttura nell’assicurare un utilizzo minimo di biberon, tettarelle e ciucci. Inserire indicazioni sui rischi e sull’opportunità di utilizzarli solo su indicazione medica oppure dopo un consenso informato dei genitori.
  8. Mantenere le pratiche di travaglio/parto sicure e rispettose come componente della BFHI.
  9. Privilegiare un linguaggio di empowerment, che rende le donne e le famiglie protagoniste, in tutta la Guida Operativa.
  10. Mantenere il focus della BFHI sui neonati sani. Adottare una serie distinta di standard relativi al supporto dell’allattamento per neonati pretermine e malati, come nella Néo BFHI, l’iniziativa per i reparti di patologia neonatale e terapia intensiva sviluppata inizialmente dal Gruppo di Lavoro Nordico e del Québec.
  11. Includere una discussione sulle questioni etiche relative alla svolgimento di studi randomizzati su temi che riguardano l’alimentazione dei neonati e dei bambini, compresi quelli specifici sull’allattamento.
  12. Includere una discussione approfondita sull’interrelazione tra ciascuno dei 10 Passi e su come essi agiscono in sinergia per formare un intervento completo di sostegno all’allattamento.

Apprezziamo l’opportunità dello scambio di idee con OMS e con UNICEF in questo passaggio importante e ci auguriamo di proseguire questo lavoro in modo aperto e trasparente. Insieme, possiamo rafforzare le fondamenta che supportano l’allattamento in tutto il mondo.


Grazie del vostro sostegno,

Trish MacEnroe
Baby-Friendly Hospital Initiative Network of Industrialized Nations, Central and Eastern European Nations and Independent States (BFHI Network)

Elisabeth Sterken
Co-chair IBFAN Global Council
International Baby Food Action Network (IBFAN)

Michele Griswold
International Lactation Consultant Association (ILCA)

Ann Calandro
La Leche League International (LLLI)

Felicity Savage
World Alliance for Breastfeeding Action (WABA)

Traduzione autorizzata del testo originale in inglese: “Discussions with the WHO and UNICEF Regarding the Future of the Global Baby-Friendly Hospital Initiative”. Traduzione a cura di Elise Chapin.

Ulteriori traduzioni di questa comunicazione sono disponibili in inglese, francese e spagnolo.


ILCA, ABM, and WABA Joint Statement for the Commission on the Status of Women (CSW62)

ILCA participates with the Commission on the Status of Women (CSW), a functional commission of the United Nations Economic and Social Council (ECOSOC). It is a global policy-making body dedicated exclusively to promoting gender equality and the empowerment of women.

Every year, representatives of Member States, United Nations entities and non-governmental organizations in consultative status with ECOSOC gather at United Nations Headquarters in New York for the Commission’s annual session. This year, CSW62 takes place from 12-23 March. The theme for this year’s session is “Challenges and opportunities in achieving gender equality and the empowerment of rural women and girls.”

Attending CSW is an opportunity for ILCA to influence policy makers and governments, and to network with other organizations working toward similar goals. ILCA’s UN Liaisons, Geri Fitzgerald and Lisa Mandell, in collaboration with the Academy of Breastfeeding Medicine (ABM) and World Alliance for Breastfeeding Action (WABA), developed the following statement to distribute at CSW. This statement was further ratified by 1000 Days, Helen Keller International, International Baby Food Action Network (IBFAN), and Training and Assistance for Health and Nutrition Foundation (TAHN). Lisa Mandell attended CSW62 on 12-13 March and distributed the statement to many people; she was also able to bring breastfeeding and the need for skilled lactation support to the attention of speakers in several sessions, and she attended a Town Hall meeting with the UN Secretary-General, António Guterres. Geri Fitzgerald will attend CSW62 on 19 March to further ILCA’s networking by attending sessions sponsored by the WHO, UNAIDS, UN Women, Zambia, Denmark and PAHO.

The statement is below:

Empowerment of rural women and girls: How breastfeeding and skilled lactation support can empower rural women and improve health outcomes

Breastfeeding empowers women, including rural women and girls, to provide their children with optimal nutrition, improve child survival, and promote long-term health for both mother and child. Breastfeeding is the foundation of life.

There are two important and relevant documents which address the means to empower women and girls in this context:

  1. The Draft Agreed Conclusions prepared by the CSW62 Bureau highlights importance of implementing economic and social policies for the empowerment of rural women and girls. This document identifies the critical need to increase access to quality care before, during, and after childbirth.
  2. The Sustainable Development Goals include ensuring access by infants to safe, nutritious, and sufficient food (2.1); ending all forms of malnutrition and achieving targets on stunting and wasting in children under 5 years of age (2.2); addressing the nutritional needs of lactating women (2.2); reducing neonatal mortality (3.2); ensuring access to reproductive health-care services (3.7); and recognizing and valuing unpaid care provided by women and girls (5.4).

It is critical that breastfeeding and skilled lactation support are included in policies designed to achieve the above goals.  As the cornerstone of any comprehensive policy designed to improve the health and well-being of childbearing women and their children, breastfeeding can save lives and improve long-term health of the entire community.

Breastfeeding according to World Health Organization (WHO) recommendations has the capacity to save over 800,000 infant lives per year. Human milk is always clean, readily available, requires no access to fuel, clean water, or electricity, and is environmentally sustainable. Human milk provides reliable and sustainable nutrition for optimal growth of infants, while protecting the infant from infection and food insecurity in risky environments. An infant who is not breastfed for the first 6 months of life is 14 times more likely to die compared with an infant who receives human milk only. Infants not breastfed have a higher risk of many diseases. Infants whose mothers lack adequate breastfeeding support are at risk for premature weaning. Women who breastfeed for a shorter duration or not at all are at higher risk of many diseases, and they experience shorter birth intervals with resulting negative health outcomes.

These negative consequences of not breastfeeding have a higher impact among rural women and their children.

  • Rural women have poor access to health care. When health care providers offer skilled support for breastfeeding, initiation and duration rates increase.
  • Rural women and their infants are at increased risk of disease, and have less access to fuel, clean water, and electricity needed to prepare alternatives to human milk.

By improving health outcomes from day 1, the goal of empowering women and girls is attainable.  Lactation support to improve breastfeeding initiation and duration is a critical step toward reaching this goal.  Actions to advance breastfeeding as part of nutrition, food security and poverty reduction strategies galvanize efforts to achieve sustainable development goals.

Therefore, we recommend and urge governments, health ministers and political leaders to invest in the future of rural women and girls by developing policies for sustainable practices that increase access to quality care, including skilled breastfeeding support, before, during, and after childbirth.


Introducing ILCA’s New Executive Director: Jessica Lytle

The Board of Directors of the International Lactation Consultants Association is pleased to announce the hiring of a new Executive Director, Jessica Lytle.

Some of you may have had the opportunity to meet Jessica at a conference or work with her on a committee as she has been on staff with ILCA for the last five years in a number of capacities.

She was chosen based on her strategic organizational skills, her knowledge of the organization, and her deep commitment to the mission and vision of ILCA, including the advancement of the IBCLC profession worldwide.

Jessica brings nearly 20 years in non-profit management experience, including serving as ILCA’s membership manager and assistant executive director. She is particularly committed to ensuring ILCA’s global impact and to working towards the organizational mission.

In her past roles at ILCA, she was instrumental in the shift to equity pricing for membership, which has increased ILCA’s accessibility to lactation supporters in lower-resource countries around the globe. She also played a key role in the initial development of the Global Partners Program.

Jessica has recently served as ILCA’s interim executive director. During this time, she has already begun the process of streamlining both staff and volunteer operations, ensuring that time and talent are spent as efficiently and effectively as possible.

Jessica lives in North Carolina. When she is not supporting ILCA, she spends her time with her husband and two boys on the baseball field.

We hope you will join us at the upcoming ILCA conference in Portland, Oregon, United States where you will have the opportunity to meet Jessica face-to-face.


Submissions OPEN for 2018 Journal of Human Lactation Photo Contest


Every year, the Journal of Human Lactation (JHL) hosts a photo contest for the coveted cover spot on each edition. The JHL is a quarterly, peer-reviewed journal publishing original research, insights in practice and policy, commentaries, and case reports relating to research and practice in human lactation and breastfeeding. The annual photo contest is your opportunity to contribute to the journal and highlight your community.

The photo(s) on JHL’s cover are changed annually. JHL is your journal, and we want to feature your photos!

The photo(s) portray the broad field of human lactation, including the IBCLC helping new families (in a wide variety of scenarios), breastfeeding in various cultural contexts around the globe, and the science of lactation.


  • Keep the photo simple: Focus on the subject while limiting background items and distractions. Frame your photo carefully for full effect.
  • High Resolution and Size: Photos must meet the MINIMUM specifications:
    • A jpeg file
    • At least 300DPI
    • At least 4″ tall and wide.
  • If selected, photo consent is required for all persons in photo: If a recognizable person is in the photo and your image is selected, (e.g., the face of a parent/baby/clinician etc.) you will be asked to submit a signed photo consent form. If you do not have a standard photo consent form, we can provide one to you if your photo is chosen.

Please do not send photos of lesser size and resolution. Photos that do not meet these specifications cannot be considered.


  • Deadline is 1 September 2018: NO EXCEPTIONS
  • Include your name, the photo consent, and if you are not the photographer, the name of the photographer, and full contact information, preferably with a second email address.
  • The photographer will need to sign non-exclusive copyright – in other words, allowing JHL to use the photo, but the photographer is free to use it elsewhere as one chooses.
  • You will receive an auto response email to confirm your submission.


IBCLC Day: Celebrating YOUR Contribution to World Health through Lactation


Breastfeeding education. Home lactation support. Helping breastfeeding and chestfeeding families in clinics and hospitals. Human milk research. Emergency and disaster support for displaced families with infants. These are just a few of the ways that you as International Board Certified Lactation Consultants® (IBCLCs®) are contributing to world health outcomes by sharing your expertise.

On 7 March, we welcome your community to celebrate YOU by thanking IBCLCs.

We hope you will also take this opportunity to celebrate the IBCLCs that have made a difference in your life, through mentorship, community, or support.

Show your IBCLC pride! Starting now, use our IBCLC Day frame on your Facebook image to help build recognition for your profession.


Find the IBCLC Day frame here.

Find IBCLC Day images for you and your community to share here.


We have also welcomed code-compliant organizations that would like to provide special offers to IBCLCs for #happyIBCLCday to do so on our event page. Feel free to check out what they have shared with you here. We also hope that you will share with us what you are doing in your local community to celebrate!



Honor IBCLCs Locally and Globally with the IBCLC Care Award


As the international professional organization for the International Board Certified Lactation Consultant® (IBCLC®), we know that those who have achieved this credential provide valuable expertise in the field of lactation care.

IBCLCs globally provide skilled support to individual caregivers in their efforts to breast/chestfeed. Because of the nature of this work, it is most effectively conducted on a local or regional level. We believe that IBCLCs deserve international acclaim for the differences that they are making in the lives of caregivers and their children, which is one of the reasons we host the IBCLC Care Award in conjunction with the International Board of Lactation Consultant Examiners® (IBLCE®).

This award honors Hospital-Based Facilities and Community-Based Agencies around the world that hire IBCLCs, have dedicated lactation programs and show evidence of lactation projects that promote, protect and support breastfeeding.

In order to be awarded the IBCLC Care Award, Hospital-Based Facilities and Community-Based Agencies must provide the name of the IBCLC(s) on staff and a detailed program description, including goals, outcomes, and evidence. Hospital and Community Agency awardees are provided with a press release describing the IBCLC Care Award for distribution to their local media outlets. In addition, they are listed for two years in the IBCLC Care Directory, which is accessed by parents looking for quality lactation support services. When two years have passed, these groups are encouraged to re-apply with a new lactation project to continue being listed in the directory. Because the directory lists programs supporting IBCLCs from all over the world, it gives local programs credibility in their communities and internationally.

IBCLCs work in their communities to encourage the fundamental, incredible connection between a parent and his/her child. The IBCLC Care Award is one way to honor the work of IBCLCs, recognize the facilities and agencies that hire them, encourage others to benefit from their services and inspire a new generation of lactation professionals.

If you are interested in recognizing the work of IBCLCs on your staff in your hospital or community on a global scale, you can click here to learn more about the qualifications and complete the online application

Apply now! Applications will be accepted online from 15 January 2018 through 16 February 2018.

The award was created by International Board of Lactation Consultant Examiners® (IBLCE®) and International Lactation Consultant Association® (ILCA®). Learn more and apply here.


2018 IBCLC Care Awards Now Open

Lactation Matters Post Titles

Let potential clients know that your Hospital-Based Facility or Community-Based Agency recognizes the role of the International Board Certified Lactation Consultant® (IBCLC®) in protecting, promoting and supporting breastfeeding by applying for the IBCLC Care Award.

The IBCLC Care Awards are promoted to new families and the general public which means your facility can enjoy the benefits of positive public relations in your community, including:

  • Enhanced attractiveness to potential patients
  • Competitive edge in recruiting lactation consultants, nurses, midwives, mother support counselors and other medical staff
  • General good will in the community by providing excellent care in helping new families reach their breastfeeding goals

Visit the IBCLC Care Directory to see which Hospital-Based Facilities are already benefiting from the IBCLC Care Award program!

Hospital-Based Facilities and Community-Based Health Agencies that staff currently certified IBCLCs can apply online to become a recognized IBCLC Care Award facility. Learn more about the qualifications and complete the online application here.

Apply now! Applications will be accepted online starting 15 January 2018 through 16 February 2018.

The award was created by International Board of Lactation Consultant Examiners® (IBLCE®) and International Lactation Consultant Association® (ILCA®). Learn more and apply here.


Powered by WordPress. Designed by WooThemes

Translate »