Kerala is world's first `baby friendly state'

The Baby Friendly Hospital Initiative of the WHO and UNICEF has certified over 90 per cent of Kerala's maternity hospitals as baby friendly

Kerala's effort to “protect, promote and support exclusive breastfeeding of infants for six months and supplementary breastfeeding beyond” earns the state the accolade of the world's first baby friendly state. The initiative has substantially brought down infant mortality and infant diseases in the state.
The declaration ceremony, jointly organised by the UNICEF, the Kerala Health Department, Indian Academy of Paediatrics and other professional bodies will be held in the state at Kochi.
The honour is constituted under the Baby Friendly Hospital Initiative (BFHI) of the WHO (World Health Organisation) and UNICEF. The BFHI independently assessed 622 maternity hospitals in Kerala and certified these ‘baby-friendly'. The hospitals assessed constitute over 90 per cent of Kerala's maternity hospitals.
Under the BFHI, a state or country can be declared baby-friendly if over 80 per cent of its maternity hospitals are ‘baby-friendly hospitals'.
A hospital is labelled ‘baby-friendly' only when it puts into practice all the ‘Ten Steps to Successful Breastfeeding'. These ten steps include a written breastfeeding policy, staff training and a breastfeeding-friendly attitude in the parents.
The BFHI was launched globally in 1991. A state-level task force was constituted in March 1993 in Kerala and several doctors and trainees were trained. In 12 months, 39 hospitals were transformed into baby-friendly hospitals. In May 1995, all the 43 hospitals with maternity facility in Kochi city had become baby-friendly, paving the way for the city to be declared the first baby-friendly city in India by the then UNICEF representative. Ernakulam became the first district in the country to become baby-friendly in 1996.
Factors that have contributed to this are Kerala's high level of literacy (particularly female literacy), an increased health consciousness, concern for children's rights and gender equality of children. The common practice of active breastfeeding of babies up to age one has also aided the effort.
Kerala has the country's lowest infant mortality rate at 13 per 1000, which is lower than some prosperous western countries.
Also Kerala has the highest rate of institutional delivery in India. Ninety-seven per cent childbirths, according to the Rapid Household Survey taken in 1998-99 for the Reproductive and Child Health Project, take place in a hospital or health facility.
Breastfeeding drastically reduces infant infection, diarrhoea and other diseases. The BFHI initiative, by actively promoting breastfeeding, is claimed to have prevented one million infant deaths worldwide every year.
The BFHI was the direct result of the International Code of Marketing of Breastmilk Substitutes adopted by the World Health Assembly in 1981. The code, drafted by the World Health Organisation, UNICEF, a large number of NGOs and representatives of infant formula manufacturers, set minimum standards to regulate marketing of infant formulas, feeding bottles and teats.
The code stipulates that health facilities should never be involved in the promotion of breastmilk substitutes and that free samples should not be provided to new mothers. However, in developing countries the code has been violated greatly by multinational companies operating here.