BACKGROUND: The purpose of this study was to describe breastfeeding policies and practices among hospitals in South Korea and the degree to which the hospitals are implementing the WHO/UNICEF Baby Friendly Hospital Initiative. METHODS: A cross-sectional survey of 34 hospitals was used to collect data. Quantitative and qualitative information and insights into current breastfeeding policies and practices were derived from responses of maternal and child health personnel at each hospital. One questionnaire per hospital was completed with personnel from all sections of maternity services, labor and delivery, nursery, and postpartum, contributing information needed to create a composite picture of the hospital's breastfeeding policies and practices. RESULTS: Most hospitals were classified as either high or moderately high implementers on four of the Ten Steps: printed information distributed to breastfeeding mothers, oral breastfeeding instruction given to mothers, infant supplementation, and infant feeding schedules. The remaining steps, including key practices like staff instruction, breastfeeding initiation, rooming-in, and hospital postpartum support are being partially implemented by the majority of hospitals in this study. CONCLUSIONS: Areas identified as needing the greatest attention by hospitals were health care staff training, breastfeeding initiation, supplementation, rooming-in, breastfeeding policy, and postpartum support for the breastfeeding mother.