Could baby-friendly hospitals change breastfeeding in Lebanon?

In Lebanon, only about one in four infants under six months old is exclusively breastfed. For many mothers, the hospital’s practices in the first hours after delivery, from immediate skin-to-skin contact and early breastfeeding support, can shape what happens long after they leave. Yet in Lebanon, one recommendation remains largely absent from the conversation, choosing a Baby-Friendly hospital. Despite evidence-based guidance from the World Health Organization and UNICEF, and a strong willingness among Lebanese mothers to seek this kind of care once they know about it, awareness remains low and only three hospitals in the country hold full Baby-Friendly accreditation.

A recommendation most mothers never hear about

The World Health Organization and UNICEF recommend that breastfeeding begin within the first hour of life, continue exclusively for six months, and carry on alongside solid foods until age two or beyond. Exclusive breastfeeding means breast milk only, no water, formula, or other liquids, aside from medically prescribed supplements.

The reasoning behind the recommendation is well established. Breast milk changes composition to match an infant's needs and carries antibodies and other protective compounds. Early initiation is linked to lower rates of newborn infection and mortality, and exclusive breastfeeding reduces gastrointestinal illness in infancy. Mothers benefit as well, including a reduced long-term risk of breast and ovarian cancer.

None of this is meant to cast judgment on mothers who cannot or choose not to breastfeed. Some infants and mothers need alternatives for medical or personal reasons, and the responsibility of the health system in those cases is the same.

Lebanon's national rate of 22.7 percent for infants under six months sits well below the global average of roughly 48 percent.

What "baby-friendly" means

WHO and UNICEF launched the Baby-Friendly Hospital Initiative worldwide to replace hospital routines that worked against breastfeeding, newborns whisked away from mothers, formula given as a default rather than an exception, inconsistent advice from different staff, with a single, evidence-based standard of care.

To be accredited, a hospital must pass an external assessment demonstrating compliance with the "Ten Steps to Successful Breastfeeding," which include training staff on a written infant-feeding policy, supporting immediate skin-to-skin contact after birth, rooming mothers and babies together, helping with common breastfeeding difficulties, avoiding unnecessary formula or supplemental fluids, and connecting families to follow-up support after discharge. Research cited by BFHI advocates has found that early skin-to-skin contact alone is associated with a meaningful increase in breastfeeding rates in the following months.

A gap between interest and awareness

Lebanese mothers appear receptive to the idea, even if most have never heard of it. A study by Oueidat et al. for pregnant women across Lebanon's six governorates found that the vast majority had not previously heard of the Baby Friendly Hospital Initiative, and roughly half said they had not received adequate guidance on starting or continuing breastfeeding.Yet more than 90 percent said they would consider giving birth at a baby-friendly hospital once they understood what the designation meant.

That gap, high potential interest, low awareness, points to an opportunity as much as a shortfall.

Where Lebanon stands now

As of February 2026, only three hospitals in the country carry full Baby-Friendly accreditation: Marjaayoun Governmental Hospital, Ain Wazein Medical Hospital, and Rasoul Aazam Hospital. The Ministry of Public Health, in partnership with UNICEF, formally recognized the three facilities after they completed all ten steps to successful breastfeeding. Earlier government figures had referenced 16 hospitals as "implementing" the initiative, but implementation and full accreditation are not the same thing, and most of that broader group has not completed the process.

Three accredited facilities are a small footprint for a country's entire maternity system, particularly given the added strain on Lebanon's health infrastructure and the rising share of costs mothers now pay out of pocket.

What the initiative can and cannot fix

A hospital program cannot address every obstacle to breastfeeding. Maternity leave policy, workplace conditions, family expectations, and access to community support after discharge all shape whether a mother who starts breastfeeding is able to continue it for months. The Baby-Friendly Hospital Initiative addresses only the earliest chapter of that story, but it happens to be the chapter where the most fragile habits are formed.

Given the apparent willingness of mothers to seek out this kind of care once they know it exists, expanding accreditation beyond three hospitals would allow more families to start on stronger footing from the very first hour, without taking away anyone's right to choose otherwise.