{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:49:40Z","timestamp":1792054180473,"version":"4.4.0"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The Becoming Breastfeeding Friendly (BBF) initiative is an evidence\u2010based decision\u2010making toolbox to support countries in assessing readiness and identifying policies needed to scale up breastfeeding (BF) protection, promotion, and support programs. Mexico has implemented BBF four times, providing an opportunity to examine how adaptations influenced the implementation processes and outcomes. This study aimed to document how BBF implementation evolved across four BBF implementation waves in Mexico (2016\u20132023), identify core functions and key adaptations, and examine perceived outcomes from Committee members' perspectives. A mixed\u2010methods implementation analysis was conducted using BBF process records and qualitative data from interviews and questionnaires with BBF Committee members who had participated since earlier waves as well as those involved more recently. Adaptations were examined using the Model for Adaptation Design and Impact (MADI). Data were analyzed through thematic analysis and integrated using the SWOT framework. Multiple adaptations over time enhanced the operational efficiency of the BBF process without compromising its core functions. Key improvements included strengthened coordination structures, diversified funding, a shift to hybrid and virtual modalities, streamlined subcommittees, and expanded use of digital tools for data collection, coordination, and management. These adaptations improved BBF process coordination and transparency. Committee members reported increased intersectoral collaboration with key policy actors and uptake of BBF recommendations, while political transitions and limited advocacy follow\u2010up were identified as shortcomings of the BBF process. The BBF process was successfully implemented in and adopted by Mexico. Context\u2010sensitive adaptations identified over time strengthened the BBF implementation process while maintaining its core functions, offering lessons for sustaining breastfeeding policy decision\u2010making in Mexico and beyond.<\/jats:p>","DOI":"10.1111\/mcn.70250","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:30:46Z","timestamp":1792053046000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Implementation Analysis of Mexico's Becoming Breastfeeding Friendly Initiative: 2016\u20132023"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2209-0962","authenticated-orcid":false,"given":"Sonia","family":"Hern\u00e1ndez\u2010Cordero","sequence":"first","affiliation":[{"name":"Research Institute for Equitable Development EQUIDE Universidad Iberoamericana Ciudad de M\u00e9xico Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9047-1102","authenticated-orcid":false,"given":"Mireya","family":"Vilar\u2010Compte","sequence":"additional","affiliation":[{"name":"World Bank Washington D.C. USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9919-9731","authenticated-orcid":false,"given":"Vania","family":"Lara\u2010Mej\u00eda","sequence":"additional","affiliation":[{"name":"Research Institute for Equitable Development EQUIDE Universidad Iberoamericana Ciudad de M\u00e9xico Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9848-109X","authenticated-orcid":false,"given":"Bianca","family":"Franco\u2010Lares","sequence":"additional","affiliation":[{"name":"Research Institute for Equitable Development EQUIDE Universidad Iberoamericana Ciudad de M\u00e9xico Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7333-5173","authenticated-orcid":false,"given":"Natalia","family":"Rovelo\u2010Vel\u00e1zquez","sequence":"additional","affiliation":[{"name":"World Bank Washington D.C. USA"},{"name":"Emory University Rollins School of Public Health Atlanta USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2900-4836","authenticated-orcid":false,"given":"Esteves","family":"Georgiana","sequence":"additional","affiliation":[{"name":"Yale School of Public Health New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9416-8039","authenticated-orcid":false,"given":"Rafael","family":"P\u00e9rez\u2010Escamilla","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Sciences Yale School of Public Health New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19116397"},{"issue":"30","key":"e_1_2_10_3_1","first-page":"30","article-title":"& Ghana Becoming Breastfeeding Friendly Committee. (2018). Pilot Testing of the Becoming Breastfeeding Friendly Toolbox in Ghana","volume":"13","author":"Aryeetey R.","journal-title":"International Breastfeeding Journal"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01933-X"},{"issue":"2","key":"e_1_2_10_5_1","first-page":"1472","article-title":"Breastfeeding and Sustainability: Nurturing Health and the Planet","volume":"13","author":"Basrowi R.","year":"2024","journal-title":"Bali Medical Journal"},{"key":"e_1_2_10_6_1","unstructured":"Baumgartner C. H. A.Seeger andS.Grylka.2026. \u201cBecoming Breastfeeding Friendly Schweiz.\u201d Accessed August 27 2026.https:\/\/digitalcollection.zhaw.ch\/server\/api\/core\/bitstreams\/7088a223-ac47-45de-a6f6-94be240e4b04\/content."},{"key":"e_1_2_10_7_1","unstructured":"BBF M\u00e9xico (2023). BBF M\u00e9xico.https:\/\/bbf.ibero.mx\/."},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-014-1591-z"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13355"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.13102"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/cdn\/nzaa161"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00103-018-2784-1"},{"key":"e_1_2_10_13_1","unstructured":"Gobierno de M\u00e9xico. & Secretar\u00eda de las Mujeres. (2025). Secretar\u00eda de las Mujeres.https:\/\/www.gob.mx\/mujeres."},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/cdn\/nzy018"},{"issue":"1","key":"e_1_2_10_15_1","first-page":"51","article-title":"SWOT Analysis: A Theoretical Review","volume":"10","author":"G\u00fcrel E.","year":"2017","journal-title":"Journal of Management Studies"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1108\/17554251011064837"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.13139"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12659"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-020-01021-y"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu17233766"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13304"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13443"},{"issue":"3","key":"e_1_2_10_23_1","first-page":"377","article-title":"Paradoxical Effects of Breastfeeding on Maternal Mood and Stress","volume":"58","author":"Mezzacappa E.","year":"2016","journal-title":"Developmental Psychobiology"},{"issue":"9","key":"e_1_2_10_24_1","article-title":"Breastfeeding and Environmental Consciousness: A Narrative Review of Environmental Implications and Potential Contributions to Reduce Waste and Energy Consumption","volume":"15","author":"Mohapatra I.","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12596"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01932-8"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13339"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.3945\/an.112.002873"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01044-2"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.23.290210"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-019-0245-6"},{"key":"e_1_2_10_32_1","unstructured":"Sturm L. M. S.Hesina M.B\u00fcrger H.Quirgst B.Meidlinger andA.Wolf\u2010Spitzer(2024) Handlungsempfehlungen f\u00fcr ein stillfreundliches \u00d6sterreich. Ergebnisse aus dem \u201cBecoming Breastfeeding Friendly (BBF)\u201d\u2014Prozess in \u00d6sterreich.https:\/\/bbf.ibero.mx\/documents\/bericht_handlungsempfehlungen_furein_stillfreundliches_osterreich.pdf."},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/cdn\/nzz078"},{"key":"e_1_2_10_34_1","unstructured":"United Nations (2015). Transforming Our World: The 2030 Agenda for Sustainable Development.https:\/\/sdgs.un.org\/2030agenda."},{"key":"e_1_2_10_35_1","article-title":"The Lancet Series on Breastfeeding 2023: A Comprehensive Analysis of Determinants, Policies, and Interventions to Protect, Promote and Support Breastfeeding, Highlighting Gaps in Evidence\u2010Based Tools for Prioritization, Scale\u2010Up and Sustainability","author":"Victora C. 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Nurturing the Health and Wealth of Nations: The Investment Case for Breastfeeding.https:\/\/cdn.who.int\/media\/docs\/default-source\/breastfeeding\/global-breastfeeding-collective\/global-bf-collective-investmentcase.pdf?sfvrsn=3545408_5&download=true."},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-019-0898-y"}],"container-title":["Maternal &amp; Child Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.70250","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/mcn.70250","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.70250","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:30:50Z","timestamp":1792053050000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/mcn.70250"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":38,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/mcn.70250"],"URL":"https:\/\/doi.org\/10.1111\/mcn.70250","archive":["Portico"],"relation":{},"ISSN":["1740-8695","1740-8709"],"issn-type":[{"value":"1740-8695","type":"print"},{"value":"1740-8709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-02-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70250"}}