The Guidelines and Evaluation Criteria

BFUSA’s Guidelines and Evaluation Criteria give meaning and specific definition to each of the Ten Steps. It is the most important tool hospitals will use to guide their work through the Baby-Friendly designation process. As indicated by its title, this document includes both the Guidelines facilities would need to follow to achieve full Baby-Friendly status and Evaluation Criteria that clearly spell out the minimum standards that a facility must achieve in order to become Baby-Friendly designated.

  • GUIDELINES (Implementation Guidance): These are the standards of care that facilities should strive to achieve for all patients.
  • EVALUATION CRITERIA:  These are the minimum standards that a facility must achieve to become Baby-Friendly designated.

In July, 2021, BFUSA released the updated Guidelines and Evaluation Criteria (GEC), 6th edition, for the United States. This version of the GEC will apply to all Baby-Friendly designation assessment request letters received on or after June 1, 2023. The Interim GEC, which has been the basis for assessments since February 1, 2020, will remain in effect until that time. Each of these documents is available for download in the box to the right.

BFUSA Guidelines & Evaluation Criteria, 6th Edition

The release of the updated document represents the culmination of three years of work by BFUSA to bring the GEC for the US fully into alignment with the Implementation Guidance released by WHO and UNICEF in 2018, as well as their Competency Verification Toolkit released in 2020. BFUSA also took this opportunity to address some important issues that have been brought to our attention over the past few years.

Learn about the 6th Edition of the GEC

Many aspects of the 6th Edition GEC are new, while many things are similar to previous editions. This video features BFUSA’s former and current CEOs, Trish MacEnroe and Eileen Fitzpatrick, discussing the important changes made in the 6th Edition of the GEC and what it means for facilities seeking to pursue Baby-Friendly designation in the United States.

(9 minutes, 50 seconds)

Implementation Dates

The following are Baby-Friendly USA’s published dates for implementing the updated Guidelines and Criteria, allowing ample time for facilities to prepare:

  • All facilities with on-site assessments taking place before June 1, 2023, will be assessed using the Interim GEC.
  • Facilities whose assessment request letters are either post marked or emailed on or after June 1, 2023, will be assessed using the 6th Edition GEC.

Supporting Materials

Here are some additional materials to help implement the Guidelines:

Check-Off Tool for Selecting and Analyzing Images/Content/Context for BFHI Compliant Education Materials — provides guidance for the use of imagery and content in educational materials.

Training Program Performance Indicator Checklist — a step-by-step tool to help you verify the current knowledge and skills of staff/providers and offer training to fill in identified gaps.