Abstract
OBJECTIVE: To asses the performance of the Ten Steps to Successful Breastfeeding in an university hospital. METHODS: Descriptive and quantitative research, in which 103 people were interviewed in the outpatient prenatal clinic, in the maternity-ward and in the Neonatal Intensive Care Unit of a university hospital in Vitória, Southeast Brazil. The "Institutional Self-Evaluation Questionnaire" of the Baby Friendly Hospital Initiative was applied. Using this tool, the outcome was measured by the concordance index (CI) proposed by the World Health Organization and by the United Nations Children's Fund. RESULTS: Although the hospital does not have a policy that addresses promotion, protection and support for breastfeeding, 93.3% of the mothers had contact with their babies immediately after birth (step 4), 83.3% of the professionals guided mothers how to breastfeed (step 5), 86.6% of the neonates did not receive any food or drink other than breast milk (step 6), 100% of babies were housed together with their mothers (step 7), 83.3% of the women were encouraged for breastfeeding on demand (step 8) and 100% of the infants did not use bottles or pacifiers (step 9). CONCLUSIONS: 60% of the steps were completed by the hospital. The greatest difficulty was to inform pregnant women about the importance and the management of breastfeeding (step 3). Therefore, visits to pregnant women are recommended, in order to prepare them for breastfeeding and to explain about the infants' healthy feeding habits.
Highlights
In 1990, in order to promote successful breastfeeding, the World Health Organization and the United Nations Children’s Fund implemented the Baby-Friendly Hospital Initiative (BFHI)(1), a program that mobilizes maternity health care professionals to make changes in routines and conducts based on the completion of the “Ten Steps to Successful Breastfeeding”(2,3) (Chart 1).Introduced by the Brazilian Ministry of Health (BMH) in 1992, with the support of state and municipal departments, the BFHI qualifies professionals by performing evaluations and encourage hospitals to seek accreditation[3,4]
In addition to becoming a referral for other health institutions, accreditation enables the hospital linked to the Brazilian Unified Health System to receive financial incentive for obstetric procedures, paid by the BMH, according to Ordinance GM 1117, of June 07, 2004(5), which is a unique initiative in the world[4]
In view of the foregoing, this study evaluated a university hospital to analyze its maternity policies and practices regarding the “Ten Steps to Successful Breastfeeding.”
Summary
Descriptive and quantitative research, in which 103 people were interviewed in the outpatient prenatal clinic, in the maternity-ward and in the Neonatal Intensive Care Unit of a university hospital in Vitória, Southeast Brazil. The “Institutional Self-Evaluation Questionnaire” of the Baby Friendly Hospital Initiative was applied. Using this tool, the outcome was measured by the concordance index (CI) proposed by the World Health Organization and by the United Nations Children’s Fund
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