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

• Published in: Jornal de pediatria Vol. 81; no. 6; pp. 471 - 477
• Main Authors: Coutinho, Sonia B, Lima, Marília de C, Ashworth, Ann, Lira, Pedro I C
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil 01-11-2005
• Subjects: Adult; Brazil; Breast Feeding - psychology; Breast Feeding - statistics & numerical data; Cohort Studies; Female; Follow-Up Studies; Health Promotion - organization & administration; Hospitals, Maternity; Humans; Infant; Infant, Newborn; Inservice Training; Mothers - psychology; Personnel, Hospital - education; Socioeconomic Factors; Time Factors; Brazil
• ISSN: 0021-7557
• DOI: 10.2223/JPED.1422

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.
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 4 through 10 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.
The performance of maternity B was significantly better than that of maternity A, from steps 4 to 10 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.
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.