Abstract
to assess breastfeeding support practices for preterm infants at two Baby-Friendly hospitals in southeastern Brazil, comparing the effect of implementing the guidelines for Baby-Friendly Hospital Initiative for Neonatal wards. a quasi-experimental study, pre- and post-intervention with control. Implementation of this initiative in the intervention hospital using Knowledge Translation. Data collection on compliance with the adapted Ten Steps, Three Guiding Principles and the Code before and after the intervention was carried out via interviews with mothers of preterm babies and professionals, unit observation and documentary analysis in the intervention and control hospitals. Intra-intergroup comparison was performed. increases in global compliance with the Three Principles, Ten Steps, the Code, partial compliance with each Principle and in most Steps was greater in the intervention hospital. Conclusion: this initiative improved practices related to breastfeeding in the intervention hospital, demonstrating the potential to improve care and breastfeeding in neonatal wards.
Highlights
Establishing and maintaining breastfeeding (BF) in preterm infants in neonatal wards (NW) is complex, presenting greater challenges than in full-term and healthy newborns[1,2]
In intervention hospital (IH), there were theoretical-practical training and health education related to BF (Neo-Baby-Friendly Hospital Initiative (BFHI) guidelines, translactation, kangaroo method) as part of the Neo-BFHI implementation process guided by the Knowledge Translation (KT) framework
A protocol was implemented in the IH to control postnatal cytomegalovirus infections, which recommended that raw milk not be given to premature infants born less than 29 weeks for the first eight weeks of life, and premature infants born between 29 and 31 weeks until they complete 35 weeks
Summary
Establishing and maintaining breastfeeding (BF) in preterm infants in neonatal wards (NW) is complex, presenting greater challenges than in full-term and healthy newborns[1,2]. Several factors can make BF difficult in NWs and have been related to the low rates of BF in preterm and risk neonates including: fragility, clinical instability and immaturity of preterm infants; maternal behavior in caring for your child; prolonged hospitalization[2]; separation between mother and infant; maternal illness and stress; delay in enteral and oral feeding; and insufficient skills of health professionals[3]. There is a gap in international and national public policies related to support for BF in preterm and critically ill neonates. The BFHI may not be sufficient to elicit professional attitudes and hospital routines favorable to BF maintenance in this risk group in neonatal units[6]
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