Poster Topical Area: Global Nutrition

Location: Hall D

Poster Board Number: 544

E11-03 - Becoming Breastfeeding Friendly Toolbox: A global evidence-based country guide for scaling up breastfeeding programs

Sunday, Jun 10
8:00 AM – 6:00 PM

Objectives: Becoming Breastfeeding Friendly(BBF) is a quality control policy toolbox designed to enable countries to assess their readiness and track progress with effective scaling up of breastfeeding protection, promotion and support programs.

The BBF toolbox is grounded in the evidence-based Breastfeeding Gear Model, which posits that eight gears (advocacy; political will; legislation & policies; funding & resources; training & program delivery; promotion; research & evaluation; and coordination, goals & monitoring) are required to work harmoniously to successfully scale up national breastfeeding programs. The BBF toolbox consists of: a) an index (the BBFI) containing 54 benchmarks measuring the eight gears; b) real-world case studies which guide a country on how to score the benchmarks as well as how to develop effective scaling up plans; and c) a 5-meeting process to apply the index and utilize the case studies to make policy recommendations. The toolbox components were developed with assistance from a global Technical Advisory Group of breastfeeding and metric experts. The BBF toolbox underwent rigorous pretesting in Mexico and Ghana to evaluate its feasibility in national assessments of breastfeeding scaling up readiness.

Implementing the toolbox in Mexico and Ghana yielded key policy recommendations for workforce development, maternity leave extension and BFHI improvements. Process feedback resulted in improvements to the BBF toolbox: a) modifications to BBFI including benchmark and scoring descriptions/definitions, data source clarifications, scoring changes; b) revision of case studies into three classifications of smaller examples, evidence-based briefs, and broader case studies; c) ongoing material development to support countries with strengthening the 5-meeting process (e.g., stakeholder engagement guidance; prioritization of recommendations; online trainings). The BBF toolbox application has now been expanded to Great Britain, Myanmar, and Samoa.

The BBF toolbox serves as a dynamic evidence-based guide that countries can use to assess their readiness to and progress with scaling up breastfeeding protection, promotion, and support.


Funding Source: Family Larsson-Rosenquist Foundation

CoAuthors: Gabriela Buccini – Yale University; Katherine Doucet – Yale University; Muriel Gubert – University of Brasilia; Amber Hromi-Fiedler – Yale University

Rafael Pérez-Escamilla

Yale University
New Haven, Connecticut