The Baby Friendly Hospital Initiative in Canada: A Narrative Review

Breastfeeding offers substantial benefits to infant health, encompassing physical and neurodevelopmental aspects. National and international guidelines, such as those from the Canadian Paediatric Society (CPS) and World Health Organization (WHO), recommend exclusive breastfeeding for the first six months of life, followed by continued breastfeeding with complementary foods until two years of age or beyond. Despite these recommendations, Canada faces challenges in achieving optimal breastfeeding rates, with only 35% of parents exclusively breastfeeding until the recommended six-month mark. This narrative review aims to assess the implementation rate of the Baby-Friendly Hospital Initiative (BFHI) in Canada, an intervention established by the WHO and the United Nations Children’s Fund (UNICEF) to promote breastfeeding. Comprehensive searches on Google and official websites of relevant associations and organizations were conducted to gather data on the number of designated Baby-Friendly Hospitals using reports from 2016 to 2022. Our findings reveal that only 3% of the 604 total hospitals in Canada available for receiving Baby-Friendly designation have acquired it. Furthermore, the proportion of designated hospitals is less than one-third in each province. There are varying trends in the number of designated Baby-Friendly Hospitals across Canadian provinces and territories. While some have demonstrated a steady increase over the examined period (e.g. Nova Scotia, Alberta), others exhibited a decline or no change (e.g. Ontario, Prince Edward Island). Several factors may have contributed to the low numbers and trends in BFHI designation, including the COVID-19 pandemic, lack of BFHI implementation in hospital accreditation requirements, and the dispersed efforts towards BFHI-related activities. These results underscore the urgent need for enhanced implementation of the BFHI across Canada.