Breastfeeding: The Ten Steps

Ten Steps to Successful Breastfeeding:

A guideline meant to facilitate implementation of the Baby-Friendly Hospital Initiative.

Health care facilities play a vital role in the establishment of breastfeeding. The Ten Steps to Successful Breastfeeding provide a supportive pathway enabling women to achieve their breastfeeding intentions and guiding the training of healthcare workers in breastfeeding support.

The Ten Steps were presented to the world in the 1989 as the WHO/UNICEF Joint Statement on the Protection, Promotion and Support of Breastfeeding: The special role of the Maternity Services. The Innocenti Declaration in 1990 called upon the world to fully implement the Ten Steps in all maternities by 1995.

In Australia, the BFHI is implemented by the Australian College of Midwives. The accreditation programme is based on the Ten Steps to Successful Breastfeeding and demonstrates a facilities or health services commitment in offering the highest standard of maternity care to mothers, babies and their families. 

In Australia in 2006, the Baby Friendly Hospital Initiative became the Baby Friendly Health Initiative

in order to more accurately reflect the expansion of the initiative into community health settings.

At the time of writing, Australia has 276 maternity facilities, with 59 Accredited under the BFHI assessment process.

That’s just 21.4%

October 2023

What are the Ten Steps?

• Step 1: Have a written breastfeeding policy that is routinely communicated to all health care staff.

  • Why hospitals should have a clear breastfeeding policy

  • The WHO Code and Why we need it? The Documentaries

  • How the Formula Industry Fooled the World

• Step 2: Train all health care staff in skills necessary to implement this policy.

  • Why Your Doctor or Nurse Might Not Be An Expert in Breastfeeding.

• Step 3: Inform all pregnant women about the benefits and management of breastfeeding.

  • Breastfeeding is a Women's Health Issue

  • How Breastmilk is Made

  • Making a Plan for The 4th Trimester

  • Formula is not the same as breastmilk: the first year

  • Sore nipples: separating fact from fiction

  • Setting your breastfeeding goals: what, why and how

  • What does exclusive breastfeeding mean?

• Step 4: Help mothers initiate breastfeeding within a half-hour of birth.

  • Helping Your Baby to Attach

  • Skin to Skin Contact

  • The Magical Hour

• Step 5: Show mothers how to breastfeed and how to maintain lactation, even if they should be separated from their infants.

  • Feed frequently to make milk

  • Baby-led attachment

  • Breastfeeding in the first 14 days

  • Double Pumping

  • Breast compression: what is it, when to use it and why.

  • Helping Your Baby to Attach

  • The Piggy Bank Method of Expressing

  • Power Pumping

  • Learning to breastfeed

  • Breastmilk and Your Newborn baby

  • Choosing a breast pump: what do you need to know?

  • Breastfeeding Positions

  • Getting Attached

  • Babies hands and breastfeeding

  • Don't put up with pain

  • Laid-back breastfeeding

  • Expressing & Pumping Breastmilk

  • The gentle art of hand expressing

• Step 6: Give newborn infants no food or drink other than breast milk unless medically indicated.

  • Why babies are so unsettled around Day 3 (or 2 or 4…)

  • Why your milk might be delayed.

  • Milk Supply Regulation: what is happening around 6-12 weeks?

  • Triple Feeding: what you need to know

  • What does a “Fussy Baby” look like anyway?

  • Do you have a low milk supply?

  • Fact check: how your breastmilk changes in appearance … and what it means

  • Breastfeeding, Drugs & Medications

  • Another Mother’s Breastmilk

  • Breastfeeding in Public

• Step 7: Practice rooming-in - allow mothers and infants to remain together - 24 hours a day.

  • Rooming-in: Keeping newborns and mothers together

  • Setting up your Bedside Nursery

  • Setting up your daytime nursery

• Step 8: Encourage breastfeeding on demand.

  • Breastfeeding, Routines and Schedules

  • One breast or two? How many sides is a feed?

  • Newborn Sleep Cycles: what to expect.

  • Cluster Feeding

• Step 9: Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.

  • Breastfeeding and Dummies: what you need to know

  • What is a Supplemental Nursing System (SNS) and why are they used?

• Step 10: Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

  • Breastfeeding Support Organisations

  • What is breastfeeding support anyway?

  • Outsourcing support: doulas

  • Why you need a Village and where to find them.