No medical center in Israel meets the criteria of "baby-friendly" hospitals as defined by the United National Children's Fund (UNICEF) and the World Alliance for Breastfeeding Action (WABA), even though this country is one of dozens of countries that signed an international code setting down criteria for such recognition. Hospitals in more than 60 countries have already officially been approved as "baby-friendly," says Evi Adams, a breastfeeding adviser and a member of the Israel Committee for UNICEF. Recently, more than 40 Israel candidates have applied to take the exam for international authorization as breastfeeding advisers who aim to make local hospitals more "baby-friendly." To qualify for UNICEF and WABA certification as "baby-friendly" institutions, they must all have a written breastfeeding policy that is routinely communicated to all health care staff; train all health care staff in skills necessary to implement this policy; inform all pregnant women of the benefits and management of breastfeeding; help mothers initiate breastfeeding within a half-hour of birth; show mothers how to breastfeed and how to maintain lactation even if separated from their infants; give newborn infants no food or drink other than breast milk, unless medically indicated; establish rooming-in in all maternity wards, where mothers and infants would remain together 24 hours a day; encourage breastfeeding on demand; give no pacifiers to breastfeeding infants; and foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic. Adams says that there are many hospitals in Europe, the US, Asia and Arab countries - including 122 hospitals in Egypt, 376 in Iran, three in Jordan, 21 in Lebanon and two in Algeria - that have been certified, but none in Israel have gone through the approval process, which takes years. Most Israeli hospitals allow representatives of baby milk formulas into maternity wards or allow them to hand out gifts of formulas and toys with advertisements - largely because the companies provide free formula powders to feed all the non-breastfeeding babies there, said Adams. Asked to comment, the Health Ministry's nursing chief, Shoshana Riba, said the encouragement of breastfeeding "is on our priority list, and in recent years, several steps have been taken." Among these is the inclusion of breastfeeding as a subject in all nursing schools; ministry workshops and training courses for the encouragement of breastfeeding, which also are held in tipat halav (family health) centers; the option of rooming-in at most hospitals; and breastfeeding counseling in delivery rooms and on maternity wards before every mother is discharged. Adams said in response that "there has been a change of atmosphere on this matter in the Health Ministry in recent years, and we hope that the promotion of exclusive breastfeeding will continue in a positive direction. For example, we hope that mothers will not need to request rooming-in specifically, but rather that it will be offered to them automatically by the hospitals. However, there is still no official and clear ministry policy aimed at preventing the aggressive marketing of breast milk substitutes by the formula companies."