New national guidelines on implementing the baby-friendly initiative in Nigeria are close to final after a two-year effort led by the Federal Ministry of Health with support from Alive & Thrive and UNICEF.

"The current exclusive breastfeeding rate in Nigeria falls short of the national and global targets at 29%,'' said Dr. Binyerem C. Ukaire, director and head of the Nutrition Division at the Federal Ministry of Health. The low rate led the Nutrition Division to initiate the development of Nigeria’s version of Baby-Friendly Initiative Guidelines, aimed at increasing promotion and support for breastfeeding as well as creating the enabling environment for exclusive breastfeeding at facilities, communities and workplaces.

Development of the guidelines was preceded by implementation of the WHO Baby-Friendly Hospital Initiative (BFHI). Almost all countries in the world have implemented the BFHI at some point in time. BFHI global guidance is encapsulated in a set of 10 steps to protect, promote and support breastfeeding in health facilities. The steps cover critical management procedures and key clinical practices.

In 1991, Nigeria launched its BFHI in response to the 1990 Innocenti declaration for the protection, promotion and support of breastfeeding to combat malnutrition and other related childhood illnesses.

More than 1,000 hospitals out of the then 25,000 hospitals were designated Baby-Friendly Hospitals between 1991 and 2006. But the adoption of the policy initiatives of the Global Strategy for Infant and Young Child Feeding and International Code on marketing of Breast-milk Substitutes reinforced the necessity for the review of a broader Baby-Friendly Initiative (BFI) in Nigeria – one that looked beyond care delivered in facilities to the provision of services and setting of standards relevant to infant care in communities, including workplaces.

In 2009, the National Council on Health (NCH) held in Kano in 2009, made a resolution that the BFI should be scaled-up to the Baby Friendly Community Initiative in Nigeria. For example, the Community BFI reinforced the establishment of Breastfeeding Support groups, which is presently tagged Community-Infant and Young Child Feeding (C-IYCF) Support groups to link to PHC facilities across the Federation.

In 2019, the Federal Ministry of Health’s Nutrition Division, in collaboration with Alive & Thrive, UNICEF, Action Against Hunger and other stakeholders, initiated a review of the national BFI guidelines. A series of workshops brought stakeholders together to discuss the various guidelines and how to overcome various challenges in scaling up implementation.

At the most recent workshop, held over the course of three days in April in Lagos, stakeholders finalized the draft of the national guidance. The guidelines will now be prepared for printing and then disseminated to health officials and leadership across the country’s 36 states and the Federal Capital Territory.

“Alive & Thrive has been a valued partner in the BFI process since 2019, as well as in other IYCF initiatives in the country,” Dr. Ukaire said. “The Nutrition Division will continue to count on Alive & Thrive's continued partnership as the country moves to implement the BFI Guidelines and other MIYCN policies.”