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Compliance with the Baby-friendly Hospital Initiative for Neonatal Wards (Neo-BFHI): A cross-sectional study in 36 countries
Copenhagen University Hospital, Copenhagen, Denmark.
Ministère de la Santé et des Services sociaux, Québec, Québec; McGill University, Montreal, Québec, Canada; St. Mary's Research Centre, Montréal, Québec.
North-West University, Potchefstroom, South Africa.
Shaarei Zedek Medical Center, Jerusalem, Israel.
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2019 (English)In: Maternal and Child Nutrition, ISSN 1740-8695, E-ISSN 1740-8709, Vol. 15, no 2, article id e12690Article in journal (Refereed) Published
Abstract [en]

In 2012, the Baby-friendly Hospital Initiative for Neonatal Wards (Neo-BFHI) began providing recommendations to improve breastfeeding support for preterm and ill infants. This cross-sectional survey aimed to measure compliance on a global level with the Neo-BFHI’s expanded Ten steps to Successful Breastfeeding and three Guiding Principles in neonatal wards. In 2017 the Neo-BFHI Self-Assessment questionnaire was used in 15 languages to collect data from neonatal wards of all levels of care. Answers were summarized into compliance scores ranging from 0 to 100 at the ward, country and international levels. A total of 917 neonatal wards from 36 low, middle and high-income countries from all continents participated. The median international overall score was 77, and median country overall scores ranged from 52 to 91. Guiding Principle 1 (respect for mothers), Step 5 (breastfeeding initiation and support), and Step 6 (human milk use) had the highest scores, 100, 88, and 88, respectively. Steps 3 (antenatal information) and 7 (rooming-in) had the lowest scores, 63 and 67, respectively. High-income countries had significantly higher scores for Guiding principle 2 (family-centered care), Step 4 (skin-to-skin contact) and Step 5. Neonatal wards in hospitals ever-designated Baby-friendly had significantly higher scores than those never designated. Sixty percent of managers stated they would like to obtain Neo-BFHI designation. Currently, Neo-BFHI recommendations are partly implemented in many countries. The high number of participating wards indicates international readiness to expand Baby-friendly standards to neonatal settings. Hospitals and governments should increase their efforts to better support breastfeeding in neonatal wards.

Place, publisher, year, edition, pages
Blackwell Science Ltd. , 2019. Vol. 15, no 2, article id e12690
Keywords [en]
Baby-friendly Hospital Initiative, breastfeeding, preterm, compliance, lactation, monitoring
National Category
Nursing Nutrition and Dietetics Pediatrics
Identifiers
URN: urn:nbn:se:oru:diva-68837DOI: 10.1111/mcn.12690ISI: 000461886000007PubMedID: 30198645Scopus ID: 2-s2.0-85054869079OAI: oai:DiVA.org:oru-68837DiVA, id: diva2:1247265
Note

Funding Agency:

Ministere de la Sante et des Services sociaux du Quebec

Available from: 2018-09-11 Created: 2018-09-11 Last updated: 2019-06-19Bibliographically approved

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