Breastfeeding Knowledge Assessment & Training

Assessing Breastfeeding & BFHI knowledge

In 2018, WHO (World Health Organization) and UNICEF (United Nations Children’s Fund) released new Implementation guidance for the revised Baby-friendly Hospital Initiative (BFHI) Guidance in which revisions to the Ten Steps to Successful Breastfeeding (Ten Steps) are described. One of the most significant revisions to the Ten Steps was made to Step 2, which now says, “Ensure that staff have sufficient knowledge, competence and skills to support breastfeeding”. This reformulation of Step 2 introduced a transition in BFHI from a focus on training to a focus on competency verification. 


The new BFHI Step 2 focuses on verification to ensure that direct care providers have the knowledge, competence and skills to support breastfeeding, especially during the first few days in maternity facilities. The organizations released a Competency Verification Toolkit is designed to assist countries and health care systems to feasibly link competencies to clinical practice. Competency verification is essentially “the test” of whether a provider can do the job accurately, sensitively and correctly. If a direct care provider cannot clearly demonstrate competence in a task, then primary or remedial education or training is required.


The Competency Verification Toolkit included a list of multiple choice questions and case studies created by WHO & UNICEF. We at the Oklahoma Breastfeeding Resource Center (OBRC) utilized the provided toolkit to build an online assessment tool to assist our Oklahoma Birthing Hospitals in their BFHI journeys. The link to the OBRC Assessment Tool is below.  This 45-question tool is free for anyone to use and takes approximately 30 minutes to complete. Scores per domain as well as a list of all questions and the selected answers are automatically emailed to the address that you provide. Emailed results will show one's scores for each domain. Next to each domain score is a link to OBRC's online course for that domain in case a team member needs further education for a particular domain.


Our assessment tool is in the BETA phase!

*Please note that the assessment tool is currently in the Beta phase. This tool was created using materials provided by BFUSA, WHO & UNICEF to help Baby-Friendly hospitals comply with the newest Step 2 guidelines on Competency Assessment of direct care providers. 

Coming Soon!

Our 7 domain course are in the BETA phase and almost ready for launch. The information about these courses is below.

7 Domain Breastfeeding Education - Description

These online courses were created in response to the 2018 BFHI Guidance advocates for national education systems to ensure that direct care providers are trained in breastfeeding during pre-service education. Facilities that provide maternity and newborn services need to ensure that the competencies of all their direct care providers are up to date. Competency assessment can identify gaps in skills or knowledge (in pre-service education settings) that require or would benefit from further training. These domains describe the minimally-required competencies for all types of direct care providers (midwives, nurses, family physicians, obstetricians, pediatricians, etc.) within a perinatal team, it is designed to be flexible and guide the needed enhancement of an individual’s knowledge, skills and/or attitudes.


  • $15 per person (2.75 credit card charge when paying via our learning management system, Digital Chalk)
  • $7 per person with BBFOK discount. 
  • These courses are self-paced.
  • This course works best in a Chrome, Firefox or Safari browser.
  • This course has a 30-day time limit from the day you start the course.  
  • Receive a Certificate of Completion for each Domain course completed. (Great for BFHI assessments!)
  • Learning objectives coming soon.

Price & Discounts

Price per enrollment into each course is: $7.00

  • $2.75 credit card charge is added to each online purchase via the Digital Chalk site.


  • Bulk Order Discounts: 
    • $2 off per course for order of all 7 domain courses.
    • $5 off per person for orders of 25-39 enrollments.
    • $10 off per person for orders of 40 or more enrollments. 
  • Enrollments do not expire. However, once an enrollee creates and account and begins a class, they must finish the course within the advertised timeframe.
  • Request a Bulk Order Invoice email us:

Payment Options

1) Pay online for an individual orders in our learning management system, Digital Chalk


2) Request an invoice and pay by check or online (for any number of enrollments)