Two approaches, one goal: rethinking breastfeeding promotion in maternity hospitals

Abstract We compare the Baby Friendly Hospital Initiative (BFHI), a leader in promoting breastfeeding in maternity hospitals, and the innovative Hospital Policy on Breastfeeding (HPB) Project funded and managed by the Italian Society of Neonatology. The HPB Project’s approach can be described as pragmatic in terms of strategy (free of charge for participating facilities), recruitment process (interprofessional rather than top-down), and management. Furthermore, while the HPB Project complies with EU regulations and restricts the prescription of formula to exclusively breastfed newborns discharged from maternity hospitals, it is not bound by strict adherence to the International Code of Marketing of Breast-milk Substitutes, which, although commendable, has so far prevented a wider adoption of the BFHI initiative. The HPB Project could play a supportive role alongside the BFHI initiative, emphasizing the common goal rather than the differences. Conclusion : The HPB Project might serve as a model to be replicated internationally. What is Known: • The implementation of the Baby Friendly Hospital Initiative (BFHI) has proven to promote breastfeeding in maternity hospitals (MHs). • In Italy, the BFHI has a slow progression with only 36 certified Baby Friendly Hospitals (BFHs). What is New: • The Hospital Policy on Breastfeeding (HPB) Project represents an effective, pragmatic approach to promote the initiation of breastfeeding in Italian MHs. • The HPB Project might serve as a model to be replicated internationally.