As a global effort to implement practices that protect, promote and support breastfeeding, the World Health Organisation (WHO) and United Nations International Children’s Emergency Fund (UNICEF) following the Innocenti Declaration of 1990, launched the BFHI in 1991. To assist a successful implementation of the initiative, tools and materials such as a course for maternity staff, a self-appraisal tool and an external assessment tool were developed, field-tested and provided. A guiding principle referred to as the 10 steps to successful breastfeeding for the implementation of the BFHI was also developed as a global criterion. The 10 steps are to be fully implemented by health facilities in order to be designated as baby friendly. Since its launching, the BFHI is now implemented in more than one hundred and fifty-two (152) countries with measurable and proven impact including the likelihood of babies being breastfed exclusively for six months.
The Gambia adopted and piloted the BFHI as an operational target for Infant and Young Child Feeding (IYCF) in 1993 in four health facilities namely Basse, Bansang, Edward Francis Small Teaching Hospital, and Essau. In 1998-2000, it was expanded to 16 other facilities bringing the total number of health facilities implementing the initiative to 20. Since then, series of activities have been taking place, chief amongst them are training of health workers and the development of health facility breastfeeding policies.