The Baby Friendly Hospital Initiative (BFHI) is a worldwide programme well known to midwives globally for supporting the initiation of successful breastfeeding. In low resource countries, initiation of breastfeeding immediately after birth would help to reduce neonatal complications such as infection. Knowledge of the 10 steps is critical for midwives in developing countries, yet our research in Uganda suggested that midwives’ knowledge is poor, despite a commitment at government level. There is a disconnect between policy and practice which must be addressed to ensure that midwives give standardised advice to new mothers to ensure successful and exclusive breastfeeding. This is especially important in Uganda, as there is no postnatal community care, so women receive no support once they leave hospital.