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Now Available--The Baby-Friendly Initiative: Evidence-Informed Key Messages and Resources, Best Start Resource Centre and BFI Ontario

After two years of work, The Baby-Friendly Initiative: Evidence-Informed Key Messages and Resources was released on Monday, September 30th, coinciding with the Government of Ontario announcement on increasing breastfeeding support and support for the Baby-Friendly Initiative (BFI).  Both English and French versions are available on the Best Start website and the BFI Ontario website.

This resource includes:

  • Key evidence-based messages for each of the Ten Steps to Successful Breastfeeding (WHO/UNICEF 1989) and the WHO International Code of Marketing of Breastmilk Substitutes (WHO, 1981) and subsequent WHA resolutions.
  • A break-down of each message with supporting rational and evidence.
  • Evidence-informed resources that can be used to support the implementation and maintenance of BFI.
  • References for each step, listed according to type (for example, Randomised Controlled Trial (RTC).

Background and Objectives

BFI Ontario and the Best Start Resource Centre adapted this resource, with permission from the Regional Municipality of Halton.  It provides evidence-informed, consistent messages. The resources mentioned in this new document support BFI implementation and maintenance and will make a user-friendly and practical addition to your BFI tool kit. Specifically, this resource will:

  • Increase health care providers’ confidence as they implement or maintain BFI by providing key messages using evidence-informed language.
  • Assist facilities in using common language and messages regarding BFI that are consistent throughout programming and education within their own organizations.
  • Provide facilities with evidence-informed practical resources to assist with BFI implementation and maintenance.


  • We searched the literature for current evidence supporting the 10 Steps to Successful Breastfeeding and the World Health Organization (WHO) International Code for the Marketing of Breastmilk Substitutes. We listed key studies that supported current best practice. Although we attempted to use current (last 10 years ) literature only, we had to use some older studies. For example, in the area of Rooming-In (Step 7) key studies were mostly from the late 80s and early 90s. Since then, this best practice of rooming-in has become so common that repeat studies are no longer found or even necessary. We also used grey literature, mostly from the WHO database and the Breastfeeding Committee for Canada website.

The literature was used to adapt and develop the Key Messages. We provided further explanations and a brief annotated bibliography for each key message. We included online resources that had been found to be helpful in BFI implementation.

The resource was field tested by front-line service providers in six organizations. There were hospitals and health units from various backgrounds, geographies and at various stages of BFI implementation and maintenance. Their recommendations strengthened the final resource.

Availability and Implementation

The resource is available online only to facilitate linkage to the online resources listed. It will also allow for easier future updating with new evidence and resources. You can find the resource at under resources, then breastfeeding or at under BFI implementation tools.

The Best Start Resource Centre and BFI Ontario will be hosting three webinars to assist service providers in familiarizing themselves with the document, discuss how to use it within their own organization and how to promote it to their community partners. There webinars are planned for January/February. Information will be sent out via the Best Start Resource Centre Networks and the BFI Ontario membership. Please promote the webinars as well as the resource to your contacts and networks, especially any organizations contemplating or pursuing BFI implementation.