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  1. 1
    357666
    Peer Reviewed

    The Baby-Friendly Hospital Initiative 20 years on: facts, progress, and the way forward.

    Saadeh RJ

    Journal of Human Lactation. 2012 Aug; 28(3):272-5.

    The BFHI provides a framework for addressing the major factors that have contributed to the erosion of breastfeeding, that is, maternity care practices that interfere with breastfeeding. Until practices improve, attempts to promote breastfeeding outside the health service will be impeded. Although inappropriate maternity care cannot be held solely responsible for low exclusive breastfeeding rates and short breastfeeding duration, appropriate care may be a prerequisite for raising them. In many industrialized countries, BFHI activities were slow to start. Over the past 10 years and as the evidence was becoming increasingly solid and the commitment of health workers and decision makers has become stronger, considerable efforts are being made in most industrialized countries to implement the BFHI. However, coordinators of the BFHI in industrialized countries face obstacles to successful implementation that appear unique to these countries. Problems reported include opposition from the health care establishment, lack of support from national authorities, and lack of awareness or acceptance of the need for the initiative among government departments, the health care system, and parents. It is worth highlighting these facts to enable the BFHI coordinators in these countries to make well-designed and targeted plans with achievable objectives. Strengthening and scaling up the BFHI is an undisputed way to reduce infant mortality and improve quality of care for mothers and children. The BFHI has had great impact on breastfeeding practices. Reflecting new infant feeding research findings and recommendations, the tools and courses used to change hospital practices in line with Baby-Friendly criteria are available and ready to be used and implemented. Governments should ensure that all personnel who are involved in health, nutrition, child survival, or maternal health are fully informed and energized to take advantage of an environment that is conducive to revitalizing the BFHI; incorporate the basic competencies for protection, promotion, and support of optimal infant and young child feeding, including the BFHI, into all health-worker curricula, whether facility- or community-based health workers; and recognize that the BFHI has a major role to play in child survival and more so in the context of HIV/AIDS. The World Health Organization and UNICEF strongly recommend using this new set of materials to ensure solid and full implementation of the BFHI global criteria and sustain progress already made. It is one way of improving child health and survival, and it is moving ahead to put the Global Strategy for Infant and Young Child Feeding in place, thus moving steadily to achieving the Millennium Development Goals.
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  2. 2
    353177
    Peer Reviewed

    Impact of baby-friendly hospital practices on breastfeeding in Hong Kong.

    Tarrant M; Wu KM; Fong DY; Lee IL; Wong EM; Sham A; Lam C; Dodgson JE

    Birth. 2011 Sep; 38(3):238-45.

    BACKGROUND: The World Health Organization (WHO) developed the Baby-Friendly Hospital Initiative to improve hospital maternity care practices that support breastfeeding. In Hong Kong, although no hospitals have yet received the Baby-Friendly status, efforts have been made to improve breastfeeding support. The aim of this study was to examine the impact of Baby-Friendly hospital practices on breastfeeding duration. METHODS: A sample of 1,242 breastfeeding mother-infant pairs was recruited from four public hospitals in Hong Kong and followed up prospectively for up to 12 months. The primary outcome variable was defined as breastfeeding for 8 weeks or less. Predictor variables included six Baby-Friendly practices: breastfeeding initiation within 1 hour of birth, exclusive breastfeeding while in hospital, rooming-in, breastfeeding on demand, no pacifiers or artificial nipples, and information on breastfeeding support groups provided on discharge. RESULTS: Only 46.6 percent of women breastfed for more than 8 weeks, and only 4.8 percent of mothers experienced all six Baby-Friendly practices. After controlling for all other Baby-Friendly practices and possible confounding variables, exclusive breastfeeding while in hospital was protective against early breastfeeding cessation (OR: 0.61; 95% CI: 0.42-0.88). Compared with mothers who experienced all six Baby-Friendly practices, those who experienced one or fewer Baby-Friendly practices were almost three times more likely to discontinue breastfeeding (OR: 3.13; 95% CI: 1.41-6.95). CONCLUSIONS: Greater exposure to Baby-Friendly practices would substantially increase new mothers' chances of breastfeeding beyond 8 weeks postpartum. To further improve maternity care practices in hospitals, institutional and administrative support are required to ensure all mothers receive adequate breastfeeding support in accordance with WHO guidelines. (c) 2011, Copyright the Authors. Journal compilation (c) 2011, Wiley Periodicals, Inc.
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  3. 3
    351137
    Peer Reviewed

    The Portuguese version of the Breastfeeding Self-Efficacy Scale-Short Form.

    Zubaran C; Foresti K; Schumacher M; Thorell MR; Amoretti A; Muller L; Dennis CL

    Journal of Human Lactation. 2010 Aug; 26(3):297-303.

    The objective of this study was to translate and psychometrically assess a Portuguese version of the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). The original English version of the BSES-SF was translated to Portuguese and tested among a sample of 89 mothers in southern Brazil from the 2nd to 12th postpartum week followed by face-to-face interviews. The mean total score of the Portuguese version of the BSES-SF was 63.6 +/- 6.22. The reliability analysis of each item in the scale attained significant Cronbach's alphas of 0.63 or superior. The Cronbach's alpha generated by the entire range of 14 questions was 0.71. A factor analysis identified one factor that contributed to 20% of the variance. This study demonstrates that the original English version of the BSES-SF was successfully adapted to Portuguese. The Portuguese version of the BSES-SF constitutes a reliable research instrument for evaluating breastfeeding self-efficacy in Brazil.
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  4. 4
    331138
    Peer Reviewed

    Trends in infant nutrition in Saudi Arabia: compliance with WHO recommendations.

    El Mouzan MI; Al Omar AA; Al Salloum AA; Al Herbish AS; Qurachi MM

    Annals of Saudi Medicine. 2009 Jan-Feb; 29(1):20-3.

    BACKGROUND AND OBJECTIVE: The WHO recommends exclusive breastfeeding in the first 6 months of life. Our objective was to evaluate trends in infant nutrition in Saudi Arabia and the degree of compliance with WHO recommendations. SUBJECTS AND METHODS: A nationwide nutritional survey of a sample of Saudi households was selected by the multistage probability sampling procedure. A validated questionnaire was administered to mothers of children less than 3 years of age. RESULTS: Of 5339 children in the sample, 4889 received breast milk at birth indicating a prevalence of initiation of 91.6%. Initiation of breastfeeding was delayed beyond 6 hours after birth in 28.1% of the infants. Bottle feeding was introduced by 1 month of age to 2174/4260 (51.4%) and to 3831/4260 (90%) by 6 months of age. The majority of infants 3870/4787 (80.8%) were introduced to "solid foods" between 4 to 6 months of age and whole milk feedings were given to 40% of children younger than 12 months of age. CONCLUSIONS: The current practice of feeding of Saudi infants is very far from compliance with even the most conservative WHO recommendations of exclusive breastfeeding for 4 to 6 months. The high prevalence of breastfeeding initiation at birth indicates the willingness of Saudi mothers to breastfeed. However, early introduction of complementary feedings reduced the period of exclusive breastfeeding. Research in infant nutrition should be a public health priority to improve the rate of breastfeeding and to minimize other inappropriate practices.
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  5. 5
    316468

    Focus on ... Breastfeeding decisions for women with HIV. A digest of key resources.

    Setty V

    Baltimore, Maryland, Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Information and Knowledge for Optimal Health [INFO], 2007 Apr. [12] p. (INFO Reports No. 12)

    This issue of Focus On... is intended to help health care practitioners better understand the current state of knowledge on breastfeeding and HIV transmission. It examines the most recent studies and expert guidance on the topic and provides the key points from recent research trials, literature reviews, and program evaluation studies. For women with HIV, infant feeding decisions are shaped by their access to infant feeding counseling and antiretroviral treatment, on the social stigma surrounding people with HIV, exclusive breastfeeding, and exclusive replacement feeding, on access to clean and safe water and food supplements, and on partner and family support. A woman infected with HIV can pass HIV on to her infant during pregnancy, at the time of labor and delivery, and through breastfeeding. Without treatment, between 15% and 30% of infants born to mothers with HIV become infected with HIV during pregnancy, labor, and delivery. An additional 10% to 20% become infected during breastfeeding depending on how long the infant is breastfed. (excerpt)
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  6. 6
    289974
    Peer Reviewed

    The National Breastfeeding Policy in Nigeria: the working mother and the law.

    Worugji IN; Etuk SJ

    Health Care for Women International. 2005 Aug; 26(7):534-554.

    In this article, we examine the National Breastfeeding Policy in Nigeria, the extent to which the law guarantees and protects the maternity rights of the working mother, and the interplay between the law and the National Breastfeeding Policy. Our aim is to make people aware of this interplay to lead to some positive efforts to sanitize the workplace and shield women from some of the practices against them in employment relations in Nigeria as well as encourage exclusive breastfeeding by employed mothers. We conclude that the provisions of the law in this regard are not in accord with the contemporary international standards for the protection of pregnancy and maternity. It does not guarantee and protect the freedom of the nursing mother to exclusively breastfeed the child for at least the 6 months as propagated by Baby Friendly Hospital Initiative (BFHI) and the National Breastfeeding Policy. Moreover, there is no enabling law to back up the National Policy Initiative as it affects employer and employee relations. We, therefore, suggest a legal framework for effective implementation of the National Breastfeeding Policy for women in dependent labour relations. It is hoped that such laws will not only limit some of the practices against women in employment but also will encourage and promote exclusive breastfeeding behaviour by employed mothers. (author's)
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  7. 7
    195128

    Breastfeeding: foundation for a healthy future.

    UNICEF

    New York, New York, UNICEF, 1999 Aug. [15] p.

    If every baby were exclusively breastfed from birth, an estimated 1.5 million lives would be saved each year. And not just saved, but enhanced, because breastmilk is the perfect food for a baby's first six months of life - no manufactured product can equal it. Virtually all children benefit from breastfeeding, regardless of where they live. Breastmilk has all the nutrients babies need to stay healthy and grow. It protects them from diarrhoea and acute respiratory infections - two leading causes of infant death. It stimulates their immune systems and response to vaccinations. It contains hundreds of health-enhancing antibodies and enzymes. It requires no mixing, sterilization or equipment. And it is always the right temperature. Children who are breastfed have lower rates of childhood cancers, including leukaemia and lymphoma. They are less susceptible to pneumonia, asthma, allergies, childhood diabetes, gastrointestinal illnesses and infections that can damage their hearing. Studies suggest that breastfeeding is good for neurological development. And breastfeeding offers a benefit that cannot be measured: a natural opportunity to communicate love at the very beginning of a child's life. Breastfeeding provides hours of closeness and nurturing every day, laying the foundation for a caring and trusting relationship between mother and child. (excerpt)
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  8. 8
    165360

    Early breastfeeding cessation as an option for reducing postnatal transmission of HIV in Africa: issues, risks, and challenges.

    Piwoz EG; Huffman SL; Lusk D; Zehner ER; O'Gara C

    Washington, D.C., Academy for Educational Development [AED], 2001 Aug. 40 p.

    This document examines the recent WHO recommendations for modifying breastfeeding to reduce postnatal transmission of HIV in Africa. Specifically, it reviews the three-stage strategy for "modified breastfeeding" for HIV- positive mothers that involves exclusive breastfeeding followed by an early transition to exclusive replacement feeding. Organized into six chapters, this document also describes a step-by-step process for making the transition from exclusive breastfeeding to exclusive replacement feeding. However, many of the behaviors discussed in this review represent a major change in traditional infant care practices in Africa, and their feasibility and impact on child survival have yet to be determined. It is recommended, therefore, that these guidelines be subjected to additional research and testing before being implemented.
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