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Comment & Response
March 11, 2019

Another Look at the Baby-Friendly Hospital Initiative—Reply

Author Affiliations
  • 1Department of Pediatrics, Newton-Wellesley Hospital, Newton, Massachusetts
JAMA Pediatr. 2019;173(5):496-497. doi:10.1001/jamapediatrics.2019.0118

In Reply I am pleased to respond to Walker’s comments on our Baby-Friendly Hospital Initiative (BFHI) Guideline Synopsis.1 Her statement that the synopsis used the GRADE method is inaccurate because that evidence assessment method was actually used by the World Health Organization (WHO)2 and is widely used and respected because of its rigorous approach to evidence rating. Suggesting that a lower level of evidence was warranted because breastfeeding is not a medical problem reflects confusion concerning the purpose of the BFHI guideline: to analyze the best manner to support breastfeeding, not to judge the value of breastfeeding.

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