Abstract
International institutions facilitate the contact of health professionals to evidence-based recommendations for promoting exclusive breast feeding (BF). However, the achievement of good rates of exclusive BF is still far from the optimum. The intention of the present work is to determine the barriers identified by managers and health professionals involved in the implementation and sustainability of Clinical Practice Guidelines (CPG) for breastfeeding under the auspices of the Best Practice Spotlight Organization program. A qualitative research study was carried out. The participants were managers, healthcare assistants, nurses, midwives, pediatricians and gynecologists. Semi-structured interviews were conducted which were transcribed and analyzed using the six steps of thematic analysis. Twenty interviews were conducted, which defined four major themes: (1) Lack of resources and their adaptation; (2) Where, Who and How; (3) Dissemination and reach of the project to the professionals; and (4) The mother and her surroundings. This research identifies the barriers perceived by the health professionals involved in the implementation, with the addition of the managers as well. Novel barriers appeared such as the ambivalent role of the midwives and the fact that this CPG is about promoting health. The efforts for promoting the implementation program should be continuous, and the services should be extended to primary care.
Highlights
The interest in the application of recommendations for promoting breastfeeding (BF) in clinical contexts appeared in the 1990s [1]
The results of our study provide updated and novel knowledge of the barriers perceived by all of the professionals involved in the implementation and sustainability of a Clinical Practice Guidelines (CPG) for breast feeding (BF) in a hospital context
New empirical results are provided about a subject that has not been studied from a multidisciplinary perspective, with the inclusion of managers, with a CPG for health promotion, and temporarily framed within the BPSO® program of CPGs implementation
Summary
The interest in the application of recommendations for promoting breastfeeding (BF) in clinical contexts appeared in the 1990s [1]. Since 1991, with the Baby-Friendly Hospital Initiative (BFHI), the WHO and the UNICEF have made contributions to motivate health organizations in the world to support BF through the implementation of 10 steps for successful BF [2]. Public organizations and professional associations have developed clinical practice guidelines (CPGs) for facilitating the contact of healthcare professionals to recommendations based on current scientific knowledge for promoting BF [3,4]. At the worldwide level, the 50% rates of exclusive BF are far from being achieved at 6 months after the birth of the infant, an objective set out by. Res. Public Health 2020, 17, 6248; doi:10.3390/ijerph17176248 www.mdpi.com/journal/ijerph
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