Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Oct;54(8):102999.
doi: 10.1016/j.jogoh.2025.102999. Epub 2025 Jul 20.

Baby-friendly Hospital Initiative: descriptive analysis of regional implementation, maternity units and women characteristics. The 2021 French National Perinatal Survey

Madeleine Santraine  1 , Anne Alice Chantry  2 , Camille Le Ray  3 , Caroline François  4 , Julie Boudet-Berquier  5 , Véronique Pierrat  6 , Ayoub Mitha  7 ; ENP2021 study group
Collaborators, Affiliations
Free article

Baby-friendly Hospital Initiative: descriptive analysis of regional implementation, maternity units and women characteristics. The 2021 French National Perinatal Survey

Madeleine Santraine et al. J Gynecol Obstet Hum Reprod. 2025 Oct.
Free article

Abstract

Background: Initially created to promote breastfeeding, the Baby-Friendly Hospital Initiative (BFHI) has evolved into a broader quality-of-care approach, centered on the needs of newborns and their families. In France, BFHI adoption increased from 2 % to 17 % of maternity units between 2010 and 2024. However, it remains unclear whether structural or population characteristics influence implementation.

Objective: To describe the characteristics of maternity units, women and newborns in units BFHI-accredited or in-process of accreditation, compared to non-accredited.

Methods: Data were extracted from the 2021 French National Perinatal Survey, including 10,446 women who gave birth to live infants between 36 and 42 weeks of gestation in 453 maternity units. Bivariate analyses compared three groups: BFHI-accredited, in-process, and non-accredited units.

Results: Among maternity units, 12 % were BFHI-accredited and 9 % were in-process. Regional implementation varied widely (0-44 % for accredited and from 0-29 % for in-process). There were no significant differences regarding maternity units' characteristics (size, level of care, administrative status, use of temporary staff). Women's profiles were similar in terms of age, education, employment, and low-risk pregnancy. Women with high social deprivation index were less represented in accredited and in-process units compared to non-accredited (4 % and 3 % vs. 5%), as well as foreign-born women (14 % and 15 % vs. 22%).

Conclusion: In France in 2021, implementation of the BFHI program in France does not appear to be associated with structural, demographic or health characteristics of units and women. Further research should explore the motivations for adopting BFHI and its effects on perinatal care practices.

Keywords: BFHI; Baby-friendly Hospital Initiative; Implementation; Perinatal health; Perinatal policies.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Caroline Francois reports a relationship with IHAB France that includes: employment. Madeleine Santraine reports a relationship with Mustela Foundation that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

MeSH terms