[Creating baby-friendly neonatal intensive care units].

Most expectant parents anticipate giving birth to a healthy newborn. Admission of a neonate to a neonatal intensive care unit (NICU) is thus nearly always a significant and negative shock to parents and family members. We derived core concepts for this article from the World Health Organization/United Nations Children's Fund (WHO/UNICEF)'s Baby Friendly Hospital Initiative: Revised, updated, and expanded for integrated care (2009). This framework document advocates expanding to NICUs guidelines that were originally developed for maternity units. This paper reviews the importance of breastfeeding to the mother-baby dyad and family integration. We suggest how to build a breastfeeding-friendly environment within the NICU using 10 steps that adhere to the NEO-BFHI's three "Guiding Principles". The proposed environment gives special emphasis to providing continued and unlimited kangaroo care, creating a family-centered NICU design, implementing an effective milk expression and monitoring plan, and respecting mothers' individual needs. Suggestions are provided as a reference to government policymakers and medical centers to facilitate the creation of breastfeeding-friendly environments in NICUs.