Baby-friendly maternity wards

Breastfeeding is the key for the growth and development of every child

majka drži svoje nedavno rođeno dijete
UNICEF/Knežević Barišić


UNICEF data show that one in five children in developed countries have never been breastfed. In Croatia, 82.7% of children are breastfed at the time of leaving the maternity hospital. According to the data provided by the Croatian Institute for Public Health for 2017, that number drops to 71.7% from months three to five, and in the case of children from 6 to 11 months of age, only 10.7% are breastfed.

UNICEF’s research “How Parents and Communities Care for the Youngest Children” show that one in three mothers abandon breastfeeding before the child turns two months. After three months, only one-third still breastfeed, while only 19% of mothers breastfeed longer than six months. Most mothers stop breastfeeding when the child is between three and four months old. The research shows that the socio-economic status of the parents is significantly related to the probability that the child will be breastfed and for how long. Mothers with a lower education level and those of a lower socio-economic status, as well as mothers of children with neuroticism and development difficulties, breastfeed less frequently and for a shorter period of time. Mothers with a higher education level, higher socio-economic status, in the age range from 30 and 40 years, and those from urban settlements choose more often to breastfeed exclusively.

The World Health Organisation recommends breastfeeding exclusively during the first six months and after that continued breastfeeding until the child is two years old or older, as long as the child and mother want to do so, with adequate supplemental feeding. The data are clear that along with continued efforts to promote the benefits of breastfeeding during the future-mother’s pregnancy and while staying in the maternity hospital, it is essential to develop programmes for supporting mothers even after that period in order to increase the rate and the length of the period of breastfeeding. This means better support to mothers from paediatricians and neonatal nurses for home visits as well as from the community at large, especially in the period from three to six months of age.

Majka koja doji svoje nedavno rođeno dijete
UNICEF/Knežević Barišić


Through the programme “Baby-Friendly Maternity Hospitals”, UNICEF has been supporting the creation of conditions that support breastfeeding in maternity hospitals. As of 2016, all public maternity hospitals in Croatia bear the title “Baby-Friendly Maternity Hospital”, which means that they implement the “Ten Steps for Successful Breastfeeding”. Maternity hospitals that want to retain the title must request an external re-assessment every three years.

The programme “Baby-Friendly Maternity Hospitals” is an initiative that was co-launched in 1991 by UNICEF and the World Health Organisation with the aim of ensuring support for mothers at the beginning of breastfeeding. Continued investments in equipment and education of the staff have created conditions in all maternity hospitals for the joint stay of mothers and children and higher breastfeeding rates at the time of leaving the maternity hospital.

In order to support mothers to continue to breastfeed successfully, UNICEF supported the creation of a network of breastfeeding support groups through help given to the Croatian Association of Breastfeeding Support Groups. Training for neonatal nurses for home visits was organised to strengthen their skills in providing support to mothers in the period that has proved to be the most challenging one for persisting with breastfeeding, with special emphasis on mothers of children with development difficulties and premature babies. At the moment, there are more than 200 breastfeeding support groups in Croatia.

In the past several years, we have focused in particular on securing conditions that support the breastfeeding of premature babies in neonatal intensive care units and, as of 2017, we also support the pilot programme “Maternity Hospitals – Friends of Mothers”. Ten steps developed at local level were tested in four maternity hospitals in Croatia. We know from experience that it will take time to change practice and attitudes essential for the implementation of standards required in mother-friendly maternity hospitals.