All Missouri hospitals that offer maternity services were assessed to measure their compliance with WHO/UNICEF Baby Friendly Hospital Initiative (BFHI). Representatives from seventy six hospitals responded to a telephone survey relating to hospital breastfeeding practices and policies as defined by BFHI's Ten Steps to Successful Breastfeeding. No hospital fully supported the Ten Steps. Compliance with the WHO/UNICEF criteria varied greatly. The least support was for Step I, only 28% of hospitals had a written breastfeeding policy that was communicated to all staff. The greatest support was for Step 3, 93% of hospitals had staff who informed all pregnant women of breastfeeding benefits. In order to increase breastfeeding rates and duration, administrators of hospitals that offer maternity services must increase their efforts to consistently implement the Ten Steps, to become more baby friendly, and to more fully establish a breastfeeding culture within their institutions.