“Baby-Friendly Hospital Initiative” encourages breastfeeding 

Background

The World Health Organization (WHO) and the American Academy of Pediatrics (AAP) recommend that mothers breastfeed their children exclusively for six months. In the United States 75% of all babies born in 2008 were breastfed, but only 35% for a full three months. Only 15% were exclusively breastfed for the recommended six months. In 1991

the WHO and the United Nations Children‘s Fund developed the “Baby-Friendly Hospital Initiative“. It provides for ten practices that promote breastfeeding. These include breastfeeding the baby within the first hour after birth, no feeding with other foods such as baby formula and no use of pacifiers.

The study by Perrine et al. considered the intention of mothers to breastfeed and to investigate whether the practices of the “Baby-Friendly Hospital Initiative“ support women in breastfeeding.

Methodology

Perrine et al. used data from the long-term study “Infant Feeding Practices Study II (IFPS II)” which was conducted

between 2005 and 2007. The mothers were surveyed through eleven questionnaires regarding infant feeding and care. One questionnaire was answered prior to giving birth and the others were sent at regular intervals in the first 12 months after the birth.

59.6% (1,792 women) of the participants stated that they intended to breastfeed their baby exclusively. 1,457 of these mothers filled out their questionnaires completely and regularly. Perrine et al. used them for their study. 85% indicated during pregnancy that they intended to breastfeed exclusively for at least three months, 57.8% were planning to breastfeed at least five months.

Results

• 41.6% of the participants breastfed their baby for less than one month (feed exclusively with breast milk), 45.3% for at least three months and 24.9% breastfed for five months or longer.
• “... there was a substantial gap between exclusive breastfeeding intention and exclusive breastfeeding duration, with only 32.4% of women surveyed achieving their exclusive breastfeeding intention.”
• The percentage of women who met their own exclusive breastfeeding intention increased significantly with the number of “Baby-Friendly Hospital Initiative” practices to promote breastfeeding used by the hospital.
• “Those who experienced 5 practices had twice the odds of achieving their exclusive breastfeeding intentions compared with those who experienced 0 to 1 practice.”
• From the practices studied to promote breastfeeding, “breastfeeding within 1 hour of birth”, “giving only breast milk“, “no pacifiers” and “rooming in” had only one significant impact on long-term breastfeeding, namely the exclusive feeding with breast milk.
• 15% of the participants had already stopped breastfeeding by the time they left the hospital. This shows how important the first few days after birth and the length of hospital stay are for breastfeeding.
• “Increased Baby-Friendly hospital practices, particularly giving only breast milk in the hospital, may help more mothers achieve their exclusive breastfeeding intentions.”
• Baby-Friendly practices in hospitals alone are not sufficient to assure the achievement of breastfeeding intentions. Mothers also need support from health professionals, family, society and employers.

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