TITLE:
A Maternity Hospital’s Achievement of Baby-Friendly Designation: Exploration of Success Factors
AUTHORS:
Felicitas Ann Diese
KEYWORDS:
Breastfeeding, Maternity Care, Baby-Friendly Hospital, BFH, King’s Theory, Hospital Policy, Infant Outcomes
JOURNAL NAME:
Open Journal of Nursing,
Vol.15 No.11,
November
20,
2025
ABSTRACT: The World Health Organization developed ten steps to successful breastfeeding as a framework for hospitals to gain the Baby-Friendly Hospital (BFH) designation. According to the WHO, this hospital designation promotes positive health outcomes for mothers and infants by encouraging early and exclusive breastfeeding. Many maternity hospitals in the United States have failed to achieve the BFH designation. The purpose of this qualitative study was to identify the processes, resources, and progression of one organization in the eastern United States that gained and maintained the BFH designation. The study identified what care providers at the BFH consider essential to successfully obtaining and maintaining a baby-friendly designation. The study included a 60- to 90-minute interview with nine care providers who worked with maternity patients on the hospital’s maternity unit. The conceptual framework guiding the study was King’s theory of goal attainment, which emphasizes the importance of nurse-patient interactions that promote success in the clinical setting. Thematic Analysis was used to identify the specific findings based on the first-hand accounts of care practitioners. The themes developed from the participant contributions are (a) leadership support, (b) policy and protocols, (c) changing the culture, and (d) enough staff and education. Documenting the success of gaining and maintaining BFH status within the organization provides valuable experiential insights and recommendations for other facilities seeking to implement the World Health Organization and the United Nations International Children’s Emergency Fund’s initiative. The findings regarding the themes may also contribute to enabling maternity hospitals worldwide to achieve BFH designation.