The Baby-Friendly Community and Health Services Initiative Within the Joint Action PreventNCD: Rationale, Structure and Methodology.

The first 1000 days of life are a critical period for establishing lifelong health and development. Breastfeeding, as part of the Nurturing Care Framework, provides unique immunological, nutritional, and psychosocial benefits, while also contributing to the prevention of obesity, diabetes, and other non-communicable diseases (NCDs). Despite its well-documented advantages, breastfeeding rates remain suboptimal across Europe due to systemic barriers such as insufficient parental leave, aggressive marketing of breastmilk substitutes, limited specialised training in breastfeeding support within health services and inadequate community support. Within the European Joint Action Prevent NCD (GA No. 101128023), Task 6.5 'Baby-Friendly Community and Health Services (BFC&HS)' addresses this gap by implementing and scaling up the Norwegian best practice 'Baby-Friendly Community Health Services' (BFCHS) in seven countries (Italy, Norway, Slovenia, Spain, Greece, Ukraine and Lithuania). The initiative applies to community and primary care settings, workplaces, educational institutions, and emergency response systems, with a focus on equity and vulnerable populations, through proactive outreach to underserved families, adaptation of services to local social and cultural contexts, coordinated care pathways between maternity and community services, and systematic monitoring of access and breastfeeding outcomes across key social determinants. The Task BFC&HS is structured into five subtasks: preparatory context analysis and stakeholder engagement; implementation of the BFCHS guidance through a staged Baby-Friendly designation process; capacity building via training and e-learning; creation of breastfeeding-friendly environments; and promotion of the Nurturing Care Framework. Methodology emphasises a settings-based, multisectoral approach rooted in the Ottawa Charter, combining evidence-based standards, monitoring with WHO/UNICEF indicators, and transnational knowledge exchange. By integrating breastfeeding promotion within broader health strategies, the Task aims to embed supportive environments, strengthen local health systems, and reduce inequities and to contribute to the development and testing of a potentially scalable model for addressing NCD prevention and health equity through breastfeeding promotion across several European contexts.