Meeting the challenge: implementing the Baby Friendly Hospital Initiative in a culturally diverse country.

This paper describes the successful implementation of the WHO/Unicef Baby Friendly Hospital initiative (BFHI) in a large, culturally diverse hospital in the United Arab Emirates (UAE). Breastfeeding rates in the UAE are high (>90 per cent), although mixed feeding is considered the norm. Traditional religious practices for birth are common which may inhibit exclusive breastfeeding. An action research methodology was chosen as the most appropriate method in which to implement BFHI and a five stage cyclic approach was used. Staff knowledge around breastfeeding and BFHI varied enormously because of the diversity of ethnicity amongst staff. It was initially difficult to engage staff, particularly staff in the delivery suite and theatres, as breastfeeding was not seen as a high priority. There was a great resistance to closing the nurseries as both women and staff felt it was a benefit for the women to have some rest away from their babies, and the concepts of bonding and early feeding cues were unknown. By the time of the assessment for BFHI there was a theory-practice transformation. The implementation of BFHI and the successful achievement of the award can be attributed to ownership.