Introduction : breastfeeding is a key component of infant health through the reduction of morbidity and mortality. In an effort to protect, promote and support breastfeeding the Baby Friendly Hospital Initiative (BFHI) was introduced in 1991, with the development of indicators for evaluating its implementation. For a facility to be designated as baby friendly, it goes through a process and after successful designation, there is periodic reassessment to evaluate adherence to the indicators. In 2015, we reassessed a metropolitan-level health facility in the Greater Accra region which was designated as baby friendly in 2004 to determine whether the ten steps to successful breastfeeding and the international code of marketing breastmilk substitutes referred to as the Code were adhered to. Methods : a cross sectional observational study with 90 respondents comprising 30 postpartum mothers, 20 pregnant women, 30 clinical staff and 10 mothers with babies in neonatal intensive-care were randomly selected and interviewed by a trained assessor using the WHO/UNICEF BFHI tools for external assessment. The WHO/UNICEF BFHI reassessment statistical tool which was used for data analysis records in percentages. Adherence rates were classified as low (0-49%), moderate (50-89%) or high (90-100). Results : overall, adherence to the BFHI was low (38%). Compliance to the ten steps to successful breastfeeding was low (42%); however, there was a high score (100%) for step 9 (no artificial teats or pacifiers). Moderate scores (60%), (83%) and (75%) were recorded for steps; 3(information on breastfeeding to pregnant women), 7(practice rooming in) and 10 (referral to breastfeeding groups in the communities) respectively. Low scores (0%), (4%), (27%), (32%), (8%) were recorded for the remaining steps; 1 (written policy on breastfeeding), 2(training all staff), 5 (show mothers how to breastfeed), 6(give infant no food or drink), 8(breastfeed on demand) respectively. The Code Recorded a moderate score (54%); though a low score (15%) was recorded for code 4 (importance of not giving samples of infant formula to mothers). Conclusion : the facility adhered poorly to the ten steps to successful breastfeeding and the Code of BFHI. Frequent monitoring and evaluation of the facility and capacity building of staff is recommended.