By Venkitesh Ramakrishnan BBC reporter in Kochi

The southern Indian state of Kerala has won international praise for its efforts to persuade women to return to breastfeeding.

The United Nations Children's Fund (Unicef) and the World Health Organisation (WHO) have given Kerala the title of "the world's first baby-friendly state".

The award refers to Kerala's success in reducing infant death and disease by encouraging natural methods and by regulating baby foods, feeding bottles and plastic teats.

Nine out of 10 of the state's maternity hospitals are described as "baby-friendly", in accordance with a UN initiative promoting breastfeeding.

The initiative is said to have prevented a million infant deaths a year throughout the world.

Global initiative

The announcement was formally made by State Governor Sikander Bakht at a ceremony in the city of Kochi on Thursday.

(Award recognises efforts to) protect, promote and support exclusive breastfeeding of infants

Citation

Also present were senior Unicef and WHO representatives.

The commendation praised Kerala for its efforts to "protect, promote and support exclusive breastfeeding of infants for six months and supplementary breastfeeding beyond".

The WHO and Unicef assess the performance of maternity units under the "baby-friendly hospital initiative" launched globally in 1991.

It lays down 10 specific steps for successful breastfeeding, including

• a written breastfeeding policy

• relevant staff training

• persuading mothers to breastfeed their babies.

Infant mortality

Kerala was quick off the mark, setting up a state-level task force in March 1993, and training doctors and health-workers to promote breastfeeding among new mothers.

The billionth baby's birth raised baby care's profile

Unicef and WHO assessors found 622 hospitals in Kerala, more than 90% of the state's maternity facilities, to be "baby-friendly", far above the 80% requirement for the award.

Kerala's excellent social indicators - almost 100% literacy, high life expectancy and a high level of health awareness - helped its implementation of the "baby-friendly" scheme.

The state has the lowest infant mortality rate in India.

Its 13 deaths for every 1,000 live births sharply contrasts with India's average infant mortality rate of 63.

Baby care has drawn national attention in India since the birth of the country's billionth child in 2000.