The New Zealand/aotearoa baby-friendly hospital initiative implementation journey: piki ake te tihi--"strive for excellence".

The Baby-Friendly Hospital Initiative (BFHI) was launched by the World Health Organization and United Nations International Children's Emergency Fund in 1991 following the Innocenti Declaration of 1990, of which New Zealand/Aotearoa was a signatory. After a number of unsuccessful attempts to implement BFHI by breastfeeding advocates, the New Zealand Breastfeeding Authority (NZBA) was established in 1999. Successful BFHI implementation was achieved through a number of factors, including the establishment of a national body (NZBA) with oversight of BFHI facility implementation and auditing, Māori and consumer participation at all levels, the recertification requirements for midwives of breastfeeding education by the Midwifery Council, and maternity facilities having paid BFHI coordinators. Once the NZBA was established, BFHI accreditation of maternity facilities had a rapid rise from 0% in 2000 to 96.1% in 2011 (74 of 77 facilities). Data collected over this period shows a 28.8-percentage-point increase of exclusive breastfeeding at discharge from maternity facilitates between 2001 (55.6%) and 2011 (84.4%). Future strategies focus on having all relevant community providers achieve Baby-Friendly Community Initiative accreditation and on the NZBA's lobbying the government for initiatives that support, promote, and protect breastfeeding.