>Is there any follow up to ensure that once a facility gets the Baby
Friendly
designation, it continues to adhere to the practices. I have some concerns
about facilities making a big show to get the designation, and then falling
back into its old ways.<

Yes, there is.  They have to be re-inspected -- the certification is only
for a certain period.  Here in the UK there have been examples of a hospital
losing its BFI status.  I don't know where the info for north american BFI
is -- I am sure others on Lactnet know -- but if you have these concerns, I
would urge you to get all the info on BFHI you can and read it through.
[And, of course BFHI is an international initiative, just that it is more
helpful to read about it in one's own idiom, so UK info may not be so
useful].

Since 1993 when BFI appeared in the UK I have had many criticisms of it,
some of them to do with philosophy and some with implementation.  I still
think it is an imperfect tool, and I have concerns that it may not make
things *much* better for women, however, I think it is the tool to hand and
that it will do more good than harm on balance [at least, I hope so] and
that, as a stage on the road to really doing something about breastfeeding,
it is what we have got and we should use it.  I am quite puzzled by how
fringe BFI seems to be in the USA -- judging from the discussion on Lactnet.
Here in the UK it has become quite a big force in hospitals, and with the
new accreditation in the community may do something to raise awareness among
community workers of how *their* practice systematically and consistently
undermines breastfeeding.

Magda Sachs
Breastfeeding Supporter, BfN, UK

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