Baby-Friendly Hospital Initiative Is Associated with Lower Rates of Neonatal Hyperbilirubinemia

Abstract

Background: The Baby-Friendly Hospital Initiative (BFHI) advances practices that support exclusive breastfeeding. BFHI practices are associated with increased breastfeeding rates, however, other patient outcomes are not well described. This study examined the association of BFHI practices with hyperbilirubinemia and phototherapy between groups of newborns born before and after BFHI implementation at an urban, tertiary academic medical center in South Carolina. Materials and Methods: We conducted a retrospective study of healthy, term newborns born between July and September 2011 (n = 956), before BFHI implementation, and newborns born during the same period in 2013 (n = 1,131) after BFHI implementation. Primary outcomes were neonatal hyperbilirubinemia, phototherapy treatment, and hospital readmissions for hyperbilirubinemia within 30 days of discharge. We compared rates of outcomes between the study groups using unadjusted and adjusted odds ratios (OR). Results: Among newborns born before versus after BFHI implementation, 20.3% versus 6.98% were diagnosed with hyperbilirubinemia ( p < 0.001), 5.75% versus 1.95% received phototherapy ( p < 0.001), and 0.31% versus 0.35% were readmitted to the hospital for hyperbilirubinemia within 30 days ( p = 0.88). In adjusted analyses, newborns born after BFHI implementation were significantly less likely to develop neonatal hyperbilirubinemia (OR 0.28 [95% confidence intervals; CI 0.20-0.37]) and receive phototherapy treatment (OR 0.27 [95% CI 0.15-0.49]) than newborns born before BFHI implementation. Conclusions: Implementation of BFHI practices is associated with significant decreases in neonatal hyperbilirubinemia and phototherapy without affecting readmission rates. Exclusive breastfeeding has traditionally been considered a risk factor for the development of neonatal jaundice. This study demonstrates that BFHI practices may mitigate that risk.

Türkiye, Konya'da bebek dostu bir hastanede indirekt neonatal hiperbilirubinemi ve uzun fototerapi süresi ile ilişkili risk faktörleri

“…[4][5][6] Also, in a study of Hudson et al they found that implementation of baby-friendly hospital initiative for breastfeeding in a single hospital center was significantly associated with reduced rates of neonatal hyperbilirubinemia and phototherapy treatment among newborns, without increased rates of 30-day hospital readmissions for the treatment of hyperbilirubinemia. [24] In our study, we found that the formula was the first prelacteal feed in babies who received phototheraphy treatment >24 hours period. Also, statistical significance was achived between the two groups for first prelacteal feed.…”

The impact of the baby friendly hospital initiative on healthcare utilization among newborns insured by Medicaid in Delaware

“…Our analysis showed a modest increase in all-cause 30-day readmissions following BFHI. Hudson and colleagues have previously shown a reduction in hyperbilirubinemia without any change in readmission for hyperbilirubinemia following BFHI in a single center [ 17 ]. A study from a single center in the West Indies showed an increase in admission for hypernatremic dehydration following BFHI [ 18 ].…”

Reducing admissions for neonatal jaundice are needed to maximise benefits of breastfeeding promotion

“…This is particularly true in South-East Asian communities with higher rates due to a genetic predisposition to glucose-6-phosphate dehydrogenase deficiency. Strengthening breastfeeding support to prevent breastfeeding jaundice, 5 and optimising NNJ management, will maximise the benefits of breastfeeding promotion. Lai Ling Hui…”