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Hospital practices and breastfeeding rates before and after the UNICEF/WHO 20-hour course for maternity staff.
J Hum Lact 2012; 28(3):389-99JH

Abstract

BACKGROUND

The Baby-Friendly Hospital Initiative (BFHI) is the most widely promoted program for increasing breastfeeding rates.

OBJECTIVE

To evaluate the impact of BFHI training on hospital practices and breastfeeding rates during the first 12 months of life.

METHODS

Eighty percent of maternity medical and nursing staff at the University Hospital in Split, Croatia, completed the updated and expanded United Nations Children's Fund/World Health Organization 20-hour course. Seven hundred seventy-three mothers (388 in the pre- and 385 in the post-training group) were included in a birth cohort and interviewed at discharge and at 3, 6, and 12 months postpartum to evaluate hospital practices and infant feeding. Six out of 10 Baby-Friendly practices were assessed using standard BFHI forms.

RESULTS

Three months after training was completed, 3 of the Baby-Friendly practices assessed (Step 4, "Initiate breastfeeding within a half-hour of birth"; Step 7, "Rooming-in"; and Step 8, "Feeding on demand") had significantly improved. The proportion of newborns exclusively breastfed during the first 48 hours increased from 6.0% to 11.7% (P < .005). There was no difference in breastfeeding rates at discharge or at 3, 6, or 12 months between the pre- and post-training groups.

CONCLUSION

Training of health professionals, based on the BFHI, was associated with significant improvement in some Baby-Friendly hospital practices and initial exclusive breastfeeding rates. A high rate of in-hospital supplementation may partly explain the lack of improvement in breastfeeding exclusivity and duration after discharge. Strong institutional support and commitment is needed to enable full implementation of recommended Baby-Friendly practices.

Authors+Show Affiliations

University Hospital Split School of Medicine, Split, Croatia. irena.zakarija-grkovic@mefst.hr

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

22674962

Citation

Zakarija-Grkovic, Irena, et al. "Hospital Practices and Breastfeeding Rates Before and After the UNICEF/WHO 20-hour Course for Maternity Staff." Journal of Human Lactation : Official Journal of International Lactation Consultant Association, vol. 28, no. 3, 2012, pp. 389-99.
Zakarija-Grkovic I, Šegvić O, Bozinovic T, et al. Hospital practices and breastfeeding rates before and after the UNICEF/WHO 20-hour course for maternity staff. J Hum Lact. 2012;28(3):389-99.
Zakarija-Grkovic, I., Šegvić, O., Bozinovic, T., Ćuže, A., Lozancic, T., Vuckovic, A., & Burmaz, T. (2012). Hospital practices and breastfeeding rates before and after the UNICEF/WHO 20-hour course for maternity staff. Journal of Human Lactation : Official Journal of International Lactation Consultant Association, 28(3), pp. 389-99. doi:10.1177/0890334412447079.
Zakarija-Grkovic I, et al. Hospital Practices and Breastfeeding Rates Before and After the UNICEF/WHO 20-hour Course for Maternity Staff. J Hum Lact. 2012;28(3):389-99. PubMed PMID: 22674962.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hospital practices and breastfeeding rates before and after the UNICEF/WHO 20-hour course for maternity staff. AU - Zakarija-Grkovic,Irena, AU - Šegvić,Olga, AU - Bozinovic,Toni, AU - Ćuže,Anamarija, AU - Lozancic,Toni, AU - Vuckovic,Ana, AU - Burmaz,Tea, Y1 - 2012/06/06/ PY - 2012/6/8/entrez PY - 2012/6/8/pubmed PY - 2013/1/12/medline SP - 389 EP - 99 JF - Journal of human lactation : official journal of International Lactation Consultant Association JO - J Hum Lact VL - 28 IS - 3 N2 - BACKGROUND: The Baby-Friendly Hospital Initiative (BFHI) is the most widely promoted program for increasing breastfeeding rates. OBJECTIVE: To evaluate the impact of BFHI training on hospital practices and breastfeeding rates during the first 12 months of life. METHODS: Eighty percent of maternity medical and nursing staff at the University Hospital in Split, Croatia, completed the updated and expanded United Nations Children's Fund/World Health Organization 20-hour course. Seven hundred seventy-three mothers (388 in the pre- and 385 in the post-training group) were included in a birth cohort and interviewed at discharge and at 3, 6, and 12 months postpartum to evaluate hospital practices and infant feeding. Six out of 10 Baby-Friendly practices were assessed using standard BFHI forms. RESULTS: Three months after training was completed, 3 of the Baby-Friendly practices assessed (Step 4, "Initiate breastfeeding within a half-hour of birth"; Step 7, "Rooming-in"; and Step 8, "Feeding on demand") had significantly improved. The proportion of newborns exclusively breastfed during the first 48 hours increased from 6.0% to 11.7% (P < .005). There was no difference in breastfeeding rates at discharge or at 3, 6, or 12 months between the pre- and post-training groups. CONCLUSION: Training of health professionals, based on the BFHI, was associated with significant improvement in some Baby-Friendly hospital practices and initial exclusive breastfeeding rates. A high rate of in-hospital supplementation may partly explain the lack of improvement in breastfeeding exclusivity and duration after discharge. Strong institutional support and commitment is needed to enable full implementation of recommended Baby-Friendly practices. SN - 1552-5732 UR - https://www.unboundmedicine.com/medline/citation/22674962/Hospital_practices_and_breastfeeding_rates_before_and_after_the_UNICEF/WHO_20_hour_course_for_maternity_staff_ L2 - http://journals.sagepub.com/doi/full/10.1177/0890334412447079?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -