Baby Friendly Hospital Initiative: 25 Years of Experience in Brazil

Abstract

Objective: To describe the experience of the 25-year-old trajectory of the Baby Friendly Hospital Initiative (BFHI) in Brazil. The first unit was implemented in 1992.Methods: Information and data were collected from publications on the World Health Organization (WHO), the United Nations International Children’s Emergency Fund (UNICEF) and the Ministry of Health websites and in national and international journals, about the period 1990-2017. The descriptors used were: “iniciativa hospital amigo da criança”, “hospital amigo da criança”, “baby friendly initiative hospital”, “aleitamento materno” and “breastfeeding”. The number of hospitals in the 25 years, the course of the BFHI and its repercussions on breastfeeding in Brazil were evaluated.Results: The BFHI is an intervention strategy in hospital care at birth focused on the implementation of practices that promote exclusive breastfeeding from the first hours of life and with the support, among other measures of positive impact on breastfeeding, of the International Code of Marketing of Breastmilk Substitutes. Currently, the initiative has been revised, updated and expanded to integrate care for newborns in neonatal units and care for women since prenatal care. It can be concluded that, during these 25 years, the quantity of hospitals varied greatly, with numbers still below the capacity of hospital beds. BFHI shows higher rates of breastfeeding than non-accredited hospitals. However, the number of hospitals are still few when compared to other countries.Conclusions: The BFHI has contributed to breastfeeding in Brazil in recent decades. Greater support for public policies is needed to expand the number of accredited institutions in the country.

Fatores associados ao uso de complemento lácteo entre recém-nascidos no ambiente hospitalar

“…A oferta a recém-nascidos de bebidas ou alimentos que não seja o leite materno deve ser restrita aos casos em que há indicação clínica 10,11 . A OMS indica que taxas de aleitamento materno exclusivo para bebês e crianças pequenas entre 50% a 89% são consideradas como boas.…”

“…Nessa diretiva, urge a necessidade dos bebês serem colocados em contato pele a pele com suas mães, imediatamente após o parto, por pelo menos uma hora e orientar a mãe a identificar se o bebê mostra sinais de que está querendo ser amamentado, oferecendo auxílio se necessário 11 , na medida em que essa prática protege os bebês quanto ao uso de complemento lácteo, sem indicação clínica, na maternidade.…”

Gestão de risco e as estratégias do plano de contingência para COVID-19

“…As políticas públicas devem ser entendidas como um conjunto de medidas, representadas através de programas, planos e metas, criadas pelos governos, voltadas à garantia de acesso pela população aos direitos estabelecidos por Lei, tais como a assistência ou prestação de serviços. Essas medidas integram parte importante da administração pública, já que representam as ações dos governos criadas para melhor atender as necessidades dos cidadãos [11][12][13] . O risco é um fenômeno coletivo, que atinge uma população.…”

Cesarean section prevalence at a baby-friendly hospital in southern Brazil: current context in the face of COVID-19

“…The Baby-Friendly Hospital Initiative (BFHI) is a global initiative to promote, protect and support breastfeeding. The implementation of the "Ten Steps to Successful Breastfeeding" requires cesarean surgery rates less than or equal to 30% or development of a plan to reduce cesarean rates to 10% per year [4][5][6] . Thus, in a baby-friendly hospital, cesarean section must be indicated in specific situations when there is an obstetric risk associated to chilbirth 7,8 .…”