Implementation in Hong Kong
Since 1992, we conduct survey on local hospitals’ practices of the “Ten Steps to Successful Breastfeeding” every year. Below is the result of the latest survey (2025) based on the self-appraisal by 19 local hospitals with maternity units.
(Please click here for the previous reports of the annual survey.)
Ten Steps to Successful Breastfeeding (BF)
(Self-Appraisal by Hospitals)
Remarks:
Public hospitals with maternity unit: 8
Private hospitals with maternity unit: 11 (1 closed down maternity service since April 2024)
All hospitals gave a response unless “H”, no. of hospitals providing information stated
| Hospital % | ||||
| Survey year | 2025 | 2024 | ||
| Public | Private | All | All | |
| 1. Comply with the Code, written infant feeding policy routinely communicated to staff and parents | ||||
| 1.1) With explicit written notice | 100 | 100(H:10) | 100(H:18) | 95 |
| 1.2) Infant feeding policy displayed publicly | 100 | 80(H:10) | 89(H:18) | 84 |
| 1.3) No free or low-cost supplies of breast-milk substitutes accepted | 100 | 100(H:10) | 100(H:18) | 100 |
| 1.4) No promotion of infant foods or drinks other than breast milk | 100 | 100(H:10) | 100(H:18) | 100 |
| 1.5) A system in place to monitor the policy | 100 | 80(H:10) | 89(H:18) | NA |
| 2. Ensure staff have knowledge, competence and skills to support BF | ||||
| 2.1) Acquainted with infant feeding policy | 100 | 100(H:10) | 100(H:18) | 100 |
| 2.2) 20-hr training given to staff within six months of their arrival | ||||
| 2.2a) % of O&G nursing staff | 97 | 83(H:10) | 90(H:18) | 90 |
| 2.2b) % of Paediatric nursing staff | 91 | 66(H:8) | 79(H:16) | 78(H:17) |
| 2.3) 8-hr training given to staff within six months of their arrival | ||||
| 2.3a) % of O&G doctors | 93 | 60(H:5) | 80(H:13) | 77(H:14) |
| 2.3b) % of Paediatric doctors | 95 | 50(H:5) | 77(H:13) | 72(H:14) |
| 2.4) A system in place to assess staff competency | 100 | 80(H:10) | 89(H:18) | NA |
| 3. Discuss the importance and management of BF with pregnant women and their families | ||||
| 3.1) % of pregnant clients taught | 94 | 99(H:10) | 96(H:18) | 97 |
| 3.2) Give group instruction on artificial feeding | 0 | 10(H:10) | 6(H:18) | 5 |
| 4. Facilitate immediate and uninterrupted skin-to-skin contact and support mothers to initiate BF after birth | ||||
| 4.1) Vaginal or Caesarean deliveries without general anaesthesia (skin-to-skin) – % of mothers who had skin-to-skin contact within 5 minutes and >1 hour | 44 | 44(H:10) | 44(H:18) | 49 |
| 4.2) Caesarean deliveries with general anaesthesia (skin to skin when mother responsive) – % of mothers | 36 | 23(H:9) | 29(H:17) | 35(H:18) |
| 5. Support mothers to initiate, maintain breastfeed and manage common difficulties | ||||
| 5.1) Offer breastfeeding assistance within six hours of delivery | 100 | 100(H:10) | 100(H:18) | 100 |
| 5.2) Help mothers of babies in special care maintain lactation | 100 | 90(H:10) | 94(H:18) | 100 |
| 5.3) Teach BF Mothers on hand expression of breast milk | 100 | 100(H:10) | 100(H:18) | NA |
| 6. Give breastfed newborn only breast milk, unless medically indicated | ||||
| 6.1) Give breastfed newborn no food or fluid other than breast milk | 63 | 60(H:10) | 61(H:18) | 68 |
| 6.2) Mothers who decided not to breastfeed were counselled on feeding options and supported in making suitable choices | 100 | 90(H:10) | 94(H:18) | NA |
| 6.3) Mothers who decided not to breastfeed were taught on safe preparation, feeding, and storage of breast-milk substitutes | 100 | 100(H:10) | 100(H:18) | NA |
| 7. Enable mothers and their infants to remain together and to practise rooming-in 24 hours a day | ||||
| 7.1) Mothers and babies with normal vaginal delivery are rooming-in from birth | 100 | 40(H:10) | 67(H:18) | 63 |
| 7.2) All mothers and normal babies stayed in the same room day and night | 100 | 40(H:10) | 67(H:18) | 63 |
| 7.3) % of mothers and babies separated for medical reasons | 40 | 4(H:10) | 20(H:18) | 19 |
| 7.4) There is a nursery for healthy infants | 0 | 100(H:10) | 56(H:18) | 58 |
| 7.5) Encourage mothers of preterm babies to stay close to their babies, day and night | 100 | 90(H:10) | 94(H:18) | NA |
| 8. Support mothers to recognize and respond to their infants’ cues for feeding | 100 | 40(H:10) | 67(H:18) | 63 |
| 9. Counsel mothers on the use and risks of feeding bottles, teats and pacifiers | ||||
| 9.1) Care for BF babies without using feeding bottles, teats or pacifiers | 100 | 90(H:10) | 94(H:18) | 90 |
| 9.2) Teach BF mothers about the risks of using feeding bottles, teats and pacifiers | 100 | 90(H:10) | 94(H:18) | NA |
| 10. Coordinate discharge so that parents and their infants have timely access to ongoing support and care | ||||
| 10.1) Breastfeeding mothers are informed where they can access breastfeeding support in the community | 100 | 100(H:10) | 100(H:18) | 100 |
| 10.2) Facilities coordinate with community services that provide breastfeeding/infant feeding support including: | ||||
| 10.2a) clinical management | 100 | 100(H:10) | 100(H:18) | 100 |
| 10.2b) mother-to-mother support | 63 | 60(H:10) | 61(H:18) | 63 |