Compliance with the Baby-friendly Hospital Initiative for neonatal wards (Neo-BFHI).

An international Self-Assessment survey of policies and practices to protect, promote and support breastfeeding in neonatal wards. Principal investigators: Ragnhild Maastrup, Denmark and Laura N. Haiek, Quebec, Canada.​

The survey is published as an open access article in journal of Maternal and Child Nutrition, and could be found at this link: Compliance with the "Baby-friendly Hospital Initiative for Neonatal wards" in 36 countries.

Article abstract:

In 2012, the Baby-friendly Hospital Initiative for Neonatal Wards (Neo-BFHI) began providing recommendations to improve breastfeeding support for preterm and ill infants. This cross-sectional survey aimed to measure compliance on a global level with the Neo-BFHI's expanded Ten steps to Successful Breastfeeding and three Guiding Principles in neonatal wards. In 2017 the Neo-BFHI Self-Assessment questionnaire was used in 15 languages to collect data from neonatal wards of all levels of care. Answers were summarized into compliance scores ranging from 0 to 100 at the ward, country and international levels. A total of 917 neonatal wards from 36 low, middle and high-income countries from all continents participated. The median international overall score was 77, and median country overall scores ranged from 52 to 91. Guiding Principle 1 (respect for mothers), Step 5 (breastfeeding initiation and support), and Step 6 (human milk use) had the highest scores, 100, 88, and 88, respectively. Steps 3 (antenatal information) and 7 (rooming-in) had the lowest scores, 63 and 67, respectively. High-income countries had significantly higher scores for Guiding principle 2 (family-centered care), Step 4 (skin-to-skin contact) and Step 5. Neonatal wards in hospitals ever-designated Baby-friendly had significantly higher scores than those never designated. Sixty percent of managers stated they would like to obtain Neo-BFHI designation. Currently, Neo-BFHI recommendations are partly implemented in many countries. The high number of participating wards indicates international readiness to expand Baby-friendly standards to neonatal settings. Hospitals and governments should increase their efforts to better support breastfeeding in neonatal wards.

 

A PowerPoint presentation of the results can be found here: Neo-BFHI survey 2018 presentation (PowerPoint).

 

The results have been (or will be) presented at the following conferences:

October 2018, Lecco, Italy. The SCENE symposium by Ragnhild Maastrup.

November 2018, Bogota, Colombia. XII International Conference on Kangaroo Mother Care by Carmen Pallás-Alonso.

April 2019, Santiago de Compostela, Spain. The Spain Breastfeeding Conference by Laura N. Haeik.

October 2019, Copenhagen, Denmark. Nordic Breastfeeding Conference by Ragnhild Maastrup

Contact information for the Neo-BFHI survey:

Ragnhild Maastrup, RN, PhD, IBCLC.
Knowledge Centre for Breastfeeding, Infants with Special Needs, Dept. of Neonatology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
Ragnhild.maastrup@regionh.dk

Laura N. Haiek, MD, MSc,
Medical consultant, Ministère de la Santé et des Services sociaux du Québec;
Assistant professor, Department of Family Medicine, McGill University; Member, St. Mary Hospital Research Center, Quebec, Canada
Laura.haiek@msss.gouv.qc.ca   


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