In the United States, roughly one in four births occurs in a certified Baby-Friendly hospital. This paper offers a multidisciplinary perspective on the Baby-Friendly Hospital Initiative (BFHI), including empirical, normative, and historical perspectives. Our analysis is novel in tracing how medical practices of “quality improvement,” which have received little attention in breastfeeding literature, may have shaped the BFHI. Ultimately, we demonstrate that a rich understanding of the BFHI can be obtained by tracing how norms of gender/motherhood interact with, and are supplemented by, other normative, historical, and institutional realities. We conclude with suggestions for practical revisions to the BFHI.