All inpatient newborns, except those affected by rare metabolic diseases, will benefit from breastfeeding and human milk. For many, it will mean their survival. This guidance aims to establish a system of care which emphasizes the provision of human milk to small, sick and/or premature infants, especially those who are initially unable to feed directly at breast. Historically, neonatal wards have presented obstacles to successful breastfeeding but a supportive environment can increase access to human milk and exclusive breastfeeding. This document addresses the application of the BFHI principles for small, sick, and premature newborns and their mothers in neonatal wards. It describes the implementation of the Ten Steps for the care of these newborns while giving additional clinical guidance as needed.