PubMed Baby Friendly

Assessment of the Baby Friendly Hospital Initiative Implementation in the Eastern Mediterranean Region.

Assessment of the Baby Friendly Hospital Initiative Implementation in the Eastern Mediterranean Region.

Children (Basel). 2018 Mar 11;5(3):

Authors: Al-Jawaldeh A, Abul-Fadl A

Abstract
The Baby-Friendly Hospital Initiative (BFHI) is a global program for promoting support and protection for breastfeeding. However, its impact on malnutrition, especially in countries of the Eastern Mediterranean region (EMR) that are facing the turmoil of conflict and emergencies, deserves further investigation. Having said that, this paper aims to discuss the status and challenges to BFHI implementation in the EMR countries. Data on BFHI implementation, breastfeeding practices, and nutritional status were collected from countries through structured questionnaires, personal interviews, and databases. The 22 countries of the EMR were categorized as follows: 8 countries in advanced nutrition transition stage (group I), 5 countries in early nutrition transition stage (group II), 4 countries with significant undernutrition (group III), and 5 countries in complex emergency (group IV). The challenges to BFHI implementation were discussed in relation to malnutrition. BFHI was not implemented in 22.7% of EMR countries. Designated Baby-Friendly hospitals totaled 829 (group I: 78.4%, group II: 9.05%; group III: 7.36%; group: IV5.19%). Countries with advanced nutrition transition had the highest implementation of BFHI but the lowest breastfeeding continuity rates. On the other hand, poor nutritional status and emergency states were linked with low BFHI implementation and low exclusive breastfeeding rates but high continuity rates. Early initiation and longer duration of breastfeeding correlated negatively with overweight and obesity (p < 0.001). In countries with emergency states, breastfeeding continues to be the main source of nourishment. However, suboptimal breastfeeding practices prevail because of poor BFHI implementation which consequently leads to malnutrition. Political willpower and community-based initiatives are needed to promote breastfeeding and strengthen BFHI in the region.

PMID: 29534482 [PubMed]

Baby-Friendly Practices Minimize Newborn Infants Weight Loss.

Baby-Friendly Practices Minimize Newborn Infants Weight Loss.

Breastfeed Med. 2018 Feb 28;:

Authors: Procaccini D, Curley ALC, Goldman M

Abstract
INTRODUCTION: It is accepted that newborns lose weight in the first few days of life. Baby-Friendly practices that support breastfeeding may affect newborn weight loss. The objective of this study were: 1) To determine whether Baby-Friendly practices are associated with term newborn weight loss day 0-2 in three feeding categories (exclusively breastfed, mixed formula fed and breastfed, and formula fed). 2) To determine whether Baby-Friendly practices increase exclusive breast feeding rates in different ethnic populations.
MATERIALS AND METHODS: This was a retrospective case-control study. Term newborn birth weight, neonatal weights days 0-2, feeding type, type of birth, and demographic information were collected for 1,000 births for the year before Baby-Friendly designation (2010) and 1,000 in 2013 (after designation). Ultimately 683 in the first group and 518 in the second met the inclusion criteria.
RESULTS: Mean weight loss decreased day 0-2 for infants in all feeding types after the initiation of Baby-Friendly practices. There was a statistically significant effect of Baby-Friendly designation on weight loss for day 0-2 in exclusively breastfed infants (p < 0.01) after controlling for birth weight. Exclusive breast feeding increased in all ethnic groups after Baby-Friendly practices were put in place.
CONCLUSION: There was a decrease in mean weight loss day 0-2 regardless of feeding type after Baby-Friendly designation. Exclusive breast feeding increased in the presence of Baby-Friendly practices.

PMID: 29489390 [PubMed - as supplied by publisher]

Facilitate Treatment Adjustment After Overdosing: Another Step Toward 21st-Century Medicine.

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Facilitate Treatment Adjustment After Overdosing: Another Step Toward 21st-Century Medicine.

J Clin Pharmacol. 2017 Jun;57(6):704-711

Authors: Koch G, Schropp J, Pfister M

Abstract
Overdosing occurs frequently because of prescription errors in neonates, infants, children, adolescents, and adults. Currently there is no quantitative approach that can be used by clinicians to adjust dosing so that toxic drug concentrations can be brought back to levels observed with safe and efficacious therapeutic doses. We present a mathematical solution that offers the time between last overdosing and next therapeutic dose to achieve therapeutic drug concentrations as soon as possible. To facilitate applications of this solution in clinical practice, a minimal amount of information has to be provided, and no simulations are necessary to compute the optimal waiting time. For educational purposes, we provide access to an online decision support tool for overdosing situations (Time to next Dose Calculator) that (1) computes the waiting time after accidental overdosing in patients with normal elimination and (2) computes the waiting time and adjusted reference dosing for patients with abnormal elimination. This user-friendly online tool will help clinicians to quickly adjust a dosing schedule in overdosing situations to mitigate risk for negative clinical consequences.

PMID: 28150316 [PubMed - indexed for MEDLINE]

A Call to Action to Address Barriers to Breastfeeding and Lactation Faced by Student-Mothers.

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A Call to Action to Address Barriers to Breastfeeding and Lactation Faced by Student-Mothers.

Nurs Womens Health. 2017 Dec;21(6):431-437

Authors: Albrecht SA, Wang J, Spatz D

Abstract
Many new mothers returning to school after childbirth face barriers within their academic settings to meeting their goals for exclusive breastfeeding. Potential barriers to breastfeeding faced by student-mothers include lack of legal protection, lack of breastfeeding-friendly university policies, inadequate availability of breastfeeding facilities, and insufficient awareness of the importance of breastfeeding among mothers, health care providers, and university administrators and faculty. Here we advocate for six action steps to help remove barriers to breastfeeding faced by student-mothers.

PMID: 29223206 [PubMed - indexed for MEDLINE]

Evaluation of factors contributing to the decline in exclusive breastfeeding at 6 months postpartum: The 2011-2016 National Surveys in Taiwan.

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Evaluation of factors contributing to the decline in exclusive breastfeeding at 6 months postpartum: The 2011-2016 National Surveys in Taiwan.

Birth. 2018 Feb 16;:

Authors: Waits A, Guo CY, Chien LY

Abstract
BACKGROUND: Since 1992, breastfeeding promotion in Taiwan considerably raised the breastfeeding rates; however, more recent surveillance showed that breastfeeding indicators stagnated or even decreased.
METHODS: We analyzed 6 cross-sectional national surveys of 69 159 postpartum women to examine the breastfeeding trends at 6 months postpartum during 2011-2016 in Taiwan and the contributing role of maternal and environmental factors. Data were collected through telephone interviews, using structured questionnaires with randomly selected mothers, who gave birth in those years. A multinomial logistic regression was used to analyze the data.
RESULTS: Partial breastfeeding rates at 6 months postpartum increased from 2011 to 2016 (25.4%-45.1%, crude odds ratio [OR] = 1.14 per year of study); however, the rates of exclusive breastfeeding at 6 months postpartum declined (24.5%-14.8%, crude OR = 0.91 per year of study). During this period, increases in maternal age and educational level, employment outside the house, and prepregnancy obesity were observed. Despite a growing number of births at certified baby-friendly hospitals, fewer mothers experienced early skin-to-skin contact and rooming-in in 2016 than in 2011. Adjustment for breastfeeding-related factors did not appreciably change the odds ratio for year of birth. Prenatal intention to breastfeed was most strongly associated with breastfeeding at 6 months postpartum (OR > 5).
CONCLUSIONS: Maternal and environmental factors in the study could not explain the decline in exclusive breastfeeding. The decline in exclusive breastfeeding, accompanying the increase in partial breastfeeding, suggests that more support is needed for mothers who intend to breastfeed exclusively.

PMID: 29451326 [PubMed - as supplied by publisher]

'That's when I struggle' … Exploring challenges faced by care givers of children with tuberculosis in Botswana.

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'That's when I struggle' … Exploring challenges faced by care givers of children with tuberculosis in Botswana.

Int J Tuberc Lung Dis. 2016 Oct;20(10):1314-1319

Authors: Stillson CH, Okatch H, Frasso R, Mazhani L, David T, Arscott-Mills T, Matlhare M, Steenhoff AP

Abstract
SETTING: Government-funded public health clinics in and around Gaborone, Botswana.
OBJECTIVE: To explore the challenges faced by care givers of children on treatment for tuberculosis (TB) to inform a more child-friendly approach to Botswana's National TB Programme (NTP) strategy.
DESIGN: Qualitative study using 28 in-depth interviews with care givers of children receiving anti-tuberculosis treatment.
RESULTS: Care givers identified five main challenges: long delays in their child's diagnosis, difficulty attending clinic for daily treatment, difficulty administering TB medications, stock-outs of TB medications leading to treatment interruptions, and inadequate TB education. Care givers prioritized these same five areas to improve the overall management of their child's TB.
CONCLUSION: Our findings suggest that despite accessing care through an NTP that adheres to World Health Organization guidelines, care givers for children on treatment in Botswana continue to encounter significant challenges. While each of these represents a potential threat to successful treatment, they can be addressed with relatively small systematic and programmatic adjustments. These results will inform the next version of the Botswana NTP guidelines towards a more child- and care giver-centered approach.

PMID: 27725041 [PubMed - indexed for MEDLINE]

Intention and Initiation of Breastfeeding Among Women Who Are Incarcerated.

Intention and Initiation of Breastfeeding Among Women Who Are Incarcerated.

Nurs Womens Health. 2018 Feb;22(1):64-78

Authors: Shlafer RJ, Davis L, Hindt LA, Goshin LS, Gerrity E

Abstract
The Baby-Friendly Hospital Initiative recommends that all mothers be shown how to breastfeed, even when mothers and newborns are separated. Most incarcerated women are separated from their infants after the postpartum hospital stay, creating barriers to breastfeeding. We examined breastfeeding among a sample of women participating in a prison-based pregnancy program. Quantitative data indicated that women who discussed breastfeeding with their doulas were more likely to initiate breastfeeding. Three qualitative themes were identified: Benefits of Breastfeeding, Barriers to Breastfeeding, and Role of the Doula. We identified incongruence between the expected standard of breastfeeding support and the care incarcerated women received. Findings suggest that prison-based doula care might be an effective intervention for supporting breastfeeding among incarcerated women and highlight the importance of education for perinatal nurses about breastfeeding support of incarcerated women.

PMID: 29433701 [PubMed - in process]

Factors Influencing Southeastern U.S. Mothers' Participation in Baby-Friendly Practices: A Mixed-Methods Study.

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Factors Influencing Southeastern U.S. Mothers' Participation in Baby-Friendly Practices: A Mixed-Methods Study.

J Hum Lact. 2018 Jan 01;:890334417750143

Authors: Munn AC, Newman SD, Phillips SM, Mueller M, Taylor SN

Abstract
BACKGROUND: Mothers in the southeastern United States, including rural-dwelling and African American mothers, have historically had low rates of breastfeeding; however, no studies have investigated these mothers' experiences of breastfeeding support processes associated with the Baby-Friendly Hospital Initiative. Research aim: This study aimed to determine factors influencing southeastern U.S. mothers' participation in Baby-Friendly practices and breastfeeding decisions.
METHODS: Using a convergent parallel mixed-methods design, medical record review of mother-infant dyads ( n = 234) provided data to determine if those who participated in more than half of the Ten Steps to Successful Breastfeeding had improved breastfeeding outcomes. Logistic regression was conducted to determine whether maternal demographic/clinical characteristics were predictive of Baby-Friendly practice participation. Qualitative methods included in-depth interviews ( n = 16). Directed content analysis was conducted to identify themes. Results of the analysis of the two data sets were triangulated to enhance understanding of mothers' barriers to and facilitators of participation in Baby-Friendly practices.
RESULTS: Rural-dwelling and African American mothers had greater odds of nonparticipation in Baby-Friendly practices relative to other groups (odds ratios = 5 and 10, respectively; p ≤ .01). Mothers who received lactation consultation and had moderate (15-44 min) or completed (≥ 45 min) skin-to-skin contact had greater odds of participation in Baby-Friendly practices (both odds ratios ≥ 17.5; p < .05). Directed content analysis revealed six themes: maternal desire to breastfeed, infant state, maternal state, milk supply concerns, provider support, and access to breastfeeding equipment and support services.
CONCLUSION: Rural-dwelling African American mothers had limited knowledge of Baby-Friendly practices; however, culturally tailored services could improve Baby-Friendly practice participation and breastfeeding success.

PMID: 29432703 [PubMed - as supplied by publisher]

Longitudinal assessment of anti-PGL-I serology in contacts of leprosy patients in Bangladesh.

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Longitudinal assessment of anti-PGL-I serology in contacts of leprosy patients in Bangladesh.

PLoS Negl Trop Dis. 2017 12;11(12):e0006083

Authors: Richardus RA, van der Zwet K, van Hooij A, Wilson L, Oskam L, Faber R, van den Eeden SJF, Pahan D, Alam K, Richardus JH, Geluk A

Abstract
BACKGROUND: Despite elimination efforts, the number of Mycobacterium leprae (M. leprae) infected individuals who develop leprosy, is still substantial. Solid evidence exists that individuals living in close proximity to patients are at increased risk to develop leprosy. Early diagnosis of leprosy in endemic areas requires field-friendly tests that identify individuals at risk of developing the disease before clinical manifestation. Such assays will simultaneously contribute to reduction of current diagnostic delay as well as transmission. Antibody (Ab) levels directed against the M.leprae-specific phenolic glycolipid I (PGL-I) represents a surrogate marker for bacterial load. However, it is insufficiently defined whether anti-PGL-I antibodies can be utilized as prognostic biomarkers for disease in contacts. Particularly, in Bangladesh, where paucibacillary (PB) patients form the majority of leprosy cases, anti-PGL-I serology is an inadequate method for leprosy screening in contacts as a directive for prophylactic treatment.
METHODS: Between 2002 and 2009, fingerstick blood from leprosy patients' contacts without clinical signs of disease from a field-trial in Bangladesh was collected on filter paper at three time points covering six years of follow-up per person. Analysis of anti-PGL-I Ab levels for 25 contacts who developed leprosy during follow-up and 199 contacts who were not diagnosed with leprosy, was performed by ELISA after elution of bloodspots from filter paper.
RESULTS: Anti-PGL-I Ab levels at intake did not significantly differ between contacts who developed leprosy during the study and those who remained free of disease. Moreover, anti-PGL-I serology was not prognostic in this population as no significant correlation was identified between anti-PGL-I Ab levels at intake and the onset of leprosy.
CONCLUSION: In this highly endemic population in Bangladesh, no association was observed between anti-PGL-I Ab levels and onset of disease, urging the need for an extended, more specific biomarker signature for early detection of leprosy in this area.
TRIAL REGISTRATION: ClinicalTrials.gov ISRCTN61223447.

PMID: 29228004 [PubMed - indexed for MEDLINE]

Implementation of Steps 1-9 to Successful Breastfeeding Reduces the Frequency of Mild and Severe Episodes of Diarrhea and Respiratory Tract Infection Among 0-6 Month Infants in Democratic Republic of Congo.

Implementation of Steps 1-9 to Successful Breastfeeding Reduces the Frequency of Mild and Severe Episodes of Diarrhea and Respiratory Tract Infection Among 0-6 Month Infants in Democratic Republic of Congo.

Matern Child Health J. 2018 Feb 07;:

Authors: Zivich P, Lapika B, Behets F, Yotebieng M

Abstract
INTRODUCTION: Global initiatives to improve breastfeeding practices have focused on the Ten Steps to Successful Breastfeeding. The aim of this study was to assess the effect of implementing Baby-Friendly Hospital Initiative (BFHI) steps 1-9 and BFHI steps 1-10 on incidence of diarrhea and respiratory illnesses in the first 6 months of life.
METHODS: We reanalyzed a cluster randomized trial in which health-care clinics in Kinshasa, Democratic Republic of Congo, were randomly assigned to standard care (control group), BFHI steps 1-9, or BFHI steps 1-10. Outcomes included episodes of diarrhea and respiratory illness. Piecewise Poisson regression with generalized estimation equations to account for clustering by clinic was used to estimate incidence rate ratios (IRR) and 95% confidence intervals (CI).
RESULTS: Steps 1-9 was associated with a decreased incidence of reported diarrhea (IRR 0.72, 95% CI 0.53, 0.99) and respiratory illness (IRR 0.48, 95% CI 0.37, 0.63), health facility visits due to diarrhea (IRR 0.60, 95% CI 0.42, 0.85) and respiratory illness (IRR 0.47, 95% CI 0.36, 0.63), and hospitalizations due to diarrhea (IRR 0.42, 95% CI 0.17, 1.06) and respiratory illness (IRR 0.33, 95% CI 0.11, 0.98). Addition of Step 10 attenuated this effect: episodes of reported diarrhea (IRR 1.24, 95% CI 0.93, 1.68) and respiratory illness (IRR 0.77, 95% CI 0.60, 0.99), health facility visits due to diarrhea (IRR 0.76, 95% CI 0.54, 1.08) and respiratory illness (IRR 0.75 95% CI 0.57, 0.97), and hospitalizations due to respiratory illness (IRR 0.48 95% CI 0.16, 1.40); but strengthened the effect against hospitalizations due to diarrhea (IRR 0.14, 95% CI 0.03, 0.60).
CONCLUSIONS: Implementation of steps 1-9 significantly reduced incidence of mild and severe episodes of diarrhea and respiratory infection in the first 6 months of life, addition of step 10 appeared to lessen this effect.
TRIAL REGISTRATION: NCT01428232.

PMID: 29417366 [PubMed - as supplied by publisher]

The Baby Friendly Hospital Initiative and the ten steps for successful breastfeeding. a critical review of the literature.

The Baby Friendly Hospital Initiative and the ten steps for successful breastfeeding. a critical review of the literature.

J Perinatol. 2018 Feb 07;:

Authors: Gomez-Pomar E, Blubaugh R

Abstract
There is no doubt regarding the multiple benefits of breastfeeding for infants and society in general. Therefore, the World Health Organization (WHO) in a conjoint effort with United Nations International Children's Emergency Fund (UNICEF) developed the "Ten Steps to Successful Breastfeeding" in 1992, which became the backbone of the Baby Friendly Hospital Initiative (BFHI). Following this development, many hospitals and countries intensified their position towards creating a "breastfeeding oriented" practice. Over the past two decades, the interest increased in the BFHI and the Ten Steps. However, alongside the implementation of the initiative, extensive research continues to evaluate the benefits and dangers of the suggested practices. Hence, it is our intention to make a critical evaluation of the current BFHI and the Ten Steps recommendations in consideration of the importance of providing an evidence-based breastfeeding supported environment for our mothers and infants.

PMID: 29416115 [PubMed - as supplied by publisher]

Factors associated with submission to HIV rapid test in childbirth care.

Factors associated with submission to HIV rapid test in childbirth care.

Cien Saude Colet. 2018 Feb;23(2):575-584

Authors: Oliveira MIC, Silva KSD, Gomes DM

Abstract
Rapid HIV tests are used in maternity hospitals to prevent mother-to-child transmission. This study aimed to analyze factors associated with submission to the rapid HIV test (outcome). This is a cross-sectional study conducted in 2009 in 15 hospitals from the Rio de Janeiro's Unified Health System (SUS) by interviewing a representative sample of 835 pregnant women hospitalized for birth and by verifying medical records. Adjusted prevalence ratios were obtained by Poisson regression according to a hierarchical model, and variables associated with the outcome (p ≤ 0.05) remained in the final model. According to medical records (MR), 79.6% of mothers were submitted to rapid HIV test and, according to interviews (INT), 55.7%. At the distal level, the lack of a partner (MR), having ≥ 6 residents at home (MR) and non-white skin color (INT) were associated with a higher prevalence of the outcome. At the intermediate level, not having a negative HIV serology from prenatal care (MR and INT) was associated with a higher prevalence of the outcome, as well as PHC prenatal care (MR) and lack of prenatal care (INT). At the proximal level, delivery in a hospital not certified as Baby-Friendly was associated with a higher prevalence of outcome (MR and INT).

PMID: 29412415 [PubMed - in process]

The effect of Baby-friendly status on exclusive breastfeeding in U.S. hospitals.

The effect of Baby-friendly status on exclusive breastfeeding in U.S. hospitals.

Matern Child Nutr. 2018 Feb 07;:

Authors: Patterson JA, Keuler NS, Olson BH

Abstract
In 2014, a leading hospital accreditation agency, mandated hospitals publicly report their exclusive breastfeeding (EBF) rates. This new regulation provided an opportunity to explore differences in EBF outcomes using a standardized definition across a large hospital sample in the United States. The purpose of this study was to examine the relationships between population demographics and the Baby-friendly (BF) hospital designation on EBF rates in hospitals throughout the United States. We obtained EBF rates from 121 BF hospitals and 1,608 hospitals without the BF designation. Demographic variables were computed using census tract data for the population surrounding each hospital. Relationships were explored using linear regression. We found that EBF rates were positively correlated with a bachelor's degree, log income, and those who identified as White or Asian and negatively correlated with those without college attendance, individuals living below the poverty line, and those who identified as African American or Hispanic. For all models, the BF designation of a hospital was associated with higher EBF rates (p < 0.01; effect sizes, 0.11-0.49) with the exception of the model containing log income. Using a multiple linear regression model that was allowed to contain more than one independent variable, we were able to explain 22% of the variability in EBF rates. The BF hospital designation was associated with significantly higher EBF rates independent of demographic variables. Support for hospitals to attain the BF hospital designation is a meaningful public health goal.

PMID: 29411938 [PubMed - as supplied by publisher]

Breastfeeding and the substance-exposed mother and baby.

Breastfeeding and the substance-exposed mother and baby.

Birth. 2018 Feb 07;:

Authors: MacVicar S, Humphrey T, Forbes-McKay KE

Abstract
BACKGROUND: Breastfeeding rates are typically low for women with a substance-use disorder. This is despite the specific benefits of breastfeeding to alleviate the severity of neonatal abstinence syndrome and the well-documented generic advantages. This study explored the feasibility of in-hospital, tailored breastfeeding support for the substance-exposed mother and baby.
METHODS: This was a mixed-methods feasibility study undertaken in Scotland from April 2014 to May 2015. Women with a substance-use disorder either received standard Baby-Friendly Initiative care only or were given additional support which included a dedicated breastfeeding support worker, personalized capacity-building approach, and a low-stimuli environment for 5 days. Feasibility outcome measures were maternal recruitment, satisfaction and acceptability of support, breastfeeding on fifth postnatal day, and severity of neonatal abstinence syndrome.
RESULTS: Fourteen mother-infant dyads participated. Intervention participants demonstrated higher rates of continued breastfeeding and reported a greater degree of satisfaction with support and confidence in their breastfeeding ability. Maternal experience of health care practices, attitudes, and postnatal environment influenced their perceptions of breastfeeding support. Breastfed infants were less likely to require pharmacotherapy for neonatal withdrawal and had a shorter hospital stay.
CONCLUSIONS: The findings highlight the feasibility of tailored breastfeeding support for the substance-exposed mother and baby and endorse the promotion and support of breastfeeding for this group. Future research should include a statistically powered randomized controlled trial to evaluate clinical efficacy.

PMID: 29411890 [PubMed - as supplied by publisher]

Interventions promoting exclusive breastfeeding up to six months after birth: A systematic review and meta-analysis of randomized controlled trials.

Interventions promoting exclusive breastfeeding up to six months after birth: A systematic review and meta-analysis of randomized controlled trials.

Int J Nurs Stud. 2018 Jan 12;80:94-105

Authors: Kim SK, Park S, Oh J, Kim J, Ahn S

Abstract
BACKGROUND: The World Health Organization (WHO) recommends that mothers practice exclusive breastfeeding (EBF) of their infants for 6 months. Various breastfeeding support interventions have been developed to encourage mothers to maintain breastfeeding practices. Research aim: This study aims to review how effectively breastfeeding support interventions enable mothers to practice EBF for 6 months and to suggest the best intervention strategies.
METHODS: Six databases were searched, including MEDLINE, EMBASE, Cochrane, CINAHL, PsycINFO, and KoreaMed. The authors independently extracted data from journals written in English or Korean and published between January 2000 and August 2017. Randomized controlled trials (RCTs) reporting EBF until 6 months were screened.
RESULTS: A total of 27 RCTs were reviewed, and 36,051 mothers were included. The effectiveness of breastfeeding support interventions to promote EBF for 6 months was significant (odds ratio [OR] = 2.77; 95% confidence interval [CI]: 1.81-3.76). A further subgroup analysis of intervention effects shows that a baby friendly hospital initiative (BFHI) intervention (OR = 5.21; 95% CI: 2.15-12.61), a combined intervention (OR = 3.56; 95% CI: 1.74-7.26), a professional provider led intervention (OR = 2.76; 95% CI: 1.76-4.33), having a protocol available for the provider training program (OR = 2.87; 95% CI: 1.89-4.37) and implementation during both the prenatal and postnatal periods (OR = 3.32; 95% CI: 1.83-6.03) increased the rate of EBF for 6 months.
CONCLUSION: We suggest considering a multicomponent intervention as the primary strategy and implementing BFHI interventions within hospitals. Evidence indicates that intervention effectiveness increases when a protocol is available for provider training, when interventions are conducted from the pre- to postnatal period, when the hospital and community are connected, and when healthcare professionals are involved.

PMID: 29407349 [PubMed - as supplied by publisher]

Newborn follow-up after discharge from the maternity unit: Compliance with national guidelines.

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Newborn follow-up after discharge from the maternity unit: Compliance with national guidelines.

Arch Pediatr. 2018 Jan 29;:

Authors: Roisné J, Delattre M, Rousseau S, Bourlet A, Charkaluk ML

Abstract
BACKGROUND: In the context of shorter hospital stays in maternity units, in 2014 the French health authorities issued guidelines for newborn follow-up after discharge from maternity units. A medical visit is recommended between the 6th and 10th day of life, as are home visits from midwives. This study was designed to evaluate compliance with these guidelines.
METHODS: The study was observational, prospective, multicenter, and was conducted in March and April 2015 in three maternity units in northern France that participate in the Baby Friendly Hospital Initiative (BFHI). Follow-up practices (medical visit between the 6th and 10th day, home visits from a midwife) and demographic, social, and medical data were recorded during the stay in the maternity unit, and through a phone interview 1 month later, in singleton term-born infants.
RESULTS: The study population included 108 mother-infant pairs. The recommended medical visit was effectively performed by a physician between the 6th and 10th day of life for 20 newborns (19%) (95% CI: [11; 26]). During the 1st month, at least one home visit from a midwife was recorded for 96 mother-infant pairs (89%). The only factor positively correlated with a medical visit between the 6th and 10th day was the mother's choice, made early during the hospital stay and independently of the real length of stay, for early discharge from the maternity unit.
CONCLUSION: Compliance with national guidelines was poor for the recommended medical visit between the 6th and 10th day of life. Information needs to be improved.

PMID: 29395890 [PubMed - as supplied by publisher]

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