The National Initiative for Children's Healthcare Quality has selected 90 hospitals to participate in Best Fed Beginnings, a national initiative to improve breastfeeding support in hospitals. Participants in the 22-month learning collaborative will work with national breastfeeding and quality improvement experts to implement 10 steps to successful breastfeeding established by the World Health Organization/UNICEF Baby Friendly Hospital Initiative and endorsed by the American Academy of Pediatrics. In addition, senior administrators from the hospitals will participate in a concurrent leadership track highlighting their critical role in supporting system-level changes. The project is funded by the Centers for Disease Control and Prevention.