Background In 1996 the World Health Organisation (WHO) established a vision regarding breastfeeding in neonatology, based on the evidence that lack of breastfeeding is an important risk factor in infant morbidity and mortality. In 2003 a project was started within our Perinatal Neonatal Centre (PNC) for accreditation of our units (NICU and obstetrics) according to WHO guidelines for breastfeeding in neonatology.

Implications Ten steps are advised by the WHO, but not all were taken into account, because the majority of the infants admitted to the NICU are preterm born, with very low birth weight, are immunocompromised and undergo invasive procedures.

The steps we followed were:

• Have a written breastfeeding policy routinely communicated to health care staff

• Train all health care staff in skills necessary to implement this policy

• Inform all pregnant women of the benefits of breastfeeding and how to breastfeed successfully

• Show mothers how to breastfeed, and how to maintain the flow of breastmilk even if they should be separated from their infants

• Give newborn infants no food and drink other than breastmilk, unless medically indicated

• Allowing mothers and infants to remain together (e.g. Kangaroo Care)

• Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic

Conclusion An external assessment concluded that our PNC met the international criteria for Baby Friendly Hospital Initiative and was certificated in 2007. Our hospital was the first NICU in The Netherlands to be certificated by the WHO.