The impact of training based on the Baby-Friendly Hospital Initiative on breastfeeding practices in the Northeast of Brazil

Abstract

Objective: To evaluate the impact of training based on the Baby Friendly Hospital Initiative on breastfeeding practices in maternity wards and during the first 6 months of life.Methods: Ninety percent of nursing auxiliaries and midwives were trained at two institutions (A and B) in Palmares, Pernambuco state. Three hundred and thirty-four mothers were interviewed within the first 48 hours and 10 days after childbirth to evaluate breastfeeding practices at the maternities and fulfillment of steps four through ten of the Baby Friendly Hospital Initiative. A subset of 166 mothers received seven home visits to evaluate breastfeeding practices throughout the first 6 months of life and to compare results with those of a cohort study conducted in the area in 1998. Results:The performance of maternity B was significantly better than that of maternity A, from steps four to ten and also in terms of exclusive breastfeeding and offering less water or tea to infants (p < 0.001). The comparison with a previous cohort study demonstrated an improvement in breastfeeding practices at the maternity wards and an increase of exclusive breastfeeding prevalence (from 21.2 to 70%), during the first 48 hours after delivery and throughout the first six months. Conclusions:The training promoted partial change to some practices related to breastfeeding, having a positive effect on total and exclusive breastfeeding at the maternity wards. However, there was no significant change to these practices over the first 6 months of life, suggesting the need for effective interventions to support exclusive breastfeeding in the health sector and in the community.J Pediatr (Rio J). 2005;81(6):471-7: Breastfeeding, intervention studies. ResumoObjetivo: Avaliar o impacto de treinamento baseado na Iniciativa Hospital Amigo da Criança sobre práticas relacionadas à amamentação na maternidade e freqüências de aleitamento materno nos primeiros 6 meses de vida.Métodos: Foram treinadas 90% das auxiliares de enfermagem e parteiras de duas maternidades (A e B) de Palmares (PE). Foram entrevistadas 334 mães nas primeiras 48 horas e 10 dias após o parto, para avaliar práticas que estimulam a amamentação nas maternidades e o cumprimento do quarto ao 10 o passo da Iniciativa Hospital Amigo da Criança. Uma subamostra de 166 mães recebeu sete visitas domiciliares, para avaliar as freqüências do aleitamento materno nos 6 primeiros meses de vida. Os resultados foram comparados com os de estudo de coorte realizado na área em 1998.Resultados: O desempenho da maternidade B foi melhor que o da maternidade A quanto às práticas que promovem o aleitamento materno relacionadas aos passos avaliados e quanto às freqüências de amamentação exclusiva. Comparação com coorte histórica evidenciou melhora nas práticas relacionadas à amamentação nas maternidades e aumento nas freqüências do aleitamento materno exclusivo (de 21,2 para 70%), nas primeiras 48 horas após o parto e durante os 6 primeiros meses de vida.Conclusões: O treinamento promoveu mudanças parciais em algumas prá...

Combined pro‐breastfeeding practices are advantageous in facilities providing maternity and newborn services

“…All the practices assessed are, to some extent, included in the BFHI Ten Steps. Thus, this study corroborates previous investigations that have shown a positive impact of the BFHI on breastfeeding indicators (Braun et al, ; Coutinho, Lima Mde, Ashworth, & Lira, ; de Oliveira, Camacho, & Tedstone, ; Lamounier et al, ; Passanha, Benicio, Venancio, & Reis, ; Perez‐Escamilla, Martinez, & Segura‐Perez, ; Venancio, Saldiva, Escuder, & Giugliani, ). This impact has already been demonstrated also in the city where the present study was carried out (Braun et al, ) and in Brazil as a whole (Venancio, Saldiva, Escuder, & Giugliani, ).…”

Impact of the Baby‐friendly Hospital Initiative on breastfeeding and child health outcomes: a systematic review

“…Additional quasi‐experimental and observational studies also provide indirect evidence in support of this finding (i.e. low ABF rates in the short term in the absence of a well‐implemented step 10) (de Oliveira et al, ; Silva et al, ; Coutinho et al, ; Lutter et al, ). The central importance of step 10 calls for increasing investments on structured programmes at the community level such as the Baby Friendly Primary Health Care initiative from Brazil (de Oliveira et al, ) and the Supplemental Nutrition Program for Women, Infants and Children (WIC) breastfeeding peer counselling programme in the United States [National Academies of Sciences, Engineering, and Medicine ()].…”

“…Fourteen pre-post studies without a parallel comparison group were conducted in Brazil, Chile, Croatia, India, Italy, Spain, Turkey, UK and the United States. Five studies were of very low quality (Dasgupta et al, 1997;Bosnjak et al, 2004;Coutinho et al, 2005b;Caldeira & Goncalves, 2007;Duyan Camurdan et al, 2007), eight of low quality (Wright et al, 1996;Cattaneo & Buzzetti, 2001;Philipp et al, 2001;Braun et al, 2003;Philipp et al, 2003;Garcia-de-Leon-Gonzalez et al, 2011;Ingram et al, 2011;Zakarija-Grkovic et al, 2012) and one of moderate quality (Valdes et al, 1993). Studies' description and findings.…”

The influence of low birth weight body proportionality and postnatal weight gain on anthropometric measures of 8-year-old children: a cohort study in Northeast Brazil

“…Breastfeeding categories were analyzed together due to the low frequency of exclusive breastfeeding in the studied region. 37 It is probably for this reason that there was no association between rapid postnatal weight gain and the duration of breastfeeding. However, breastfeeding proved to be a protective factor in relation to the body measurements at 8 years old, as children who were breastfed for longer had lower mean values of BMI and WC.…”