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The Baby-friendly Hospital Initiative for Neonatal Wards (Neo-BFHI) aims to increase the proportion of breastfed and/or human milk-fed sick, small-for-gestation, and/or preterm newborns. Breastfeeding has many benefits for the child and mother, so increasing the proportion of breastfed premature and sick infants would have a significant impact on their long-term outcome. Successful implementation is critical to the success of the Neo-BFHI initiative. Breastfeeding of sick, small-for-gestation, and/or premature infants presents multiple challenges because of both maternal and infant physiological, psychological, and environmental factors. The paper presents and explains numerous factors that influence the implementation of the Neo-BFHI principles, such as factors related to the hospital environment and healthcare providers, parents and the newborn’s state of health.