Reassessment of Baby-friendly Hospitals in Brazil.

The purpose of this descriptive, cross-sectional study was to assess adherence to the Baby-friendly Hospital Initiative "Ten Steps to Successful Breastfeeding" in certified hospitals in Brazil in 2002. The Ministry of Health ordered that all 172 hospitals certified from 1992 to 2000 be reassessed. Of the 167 eligible Baby-friendly Hospitals assessed, 137 (82%) met all of the 10 steps. Steps 2 and 3 presented the lowest adherence rates (91% and 92%, respectively), followed by steps 4, 5, and 10, with 95% each. Steps 7 and 9 reflected the highest adherence rate of 99% among all eligible Baby-friendly Hospitals. These findings suggest the need to intensify regular health training programs for professionals working in Baby-friendly Hospitals on managing and promoting breastfeeding and to implement strategies that favor steps 3 and 10, to further promote and support breastfeeding before and after delivery.