Breastfeeding practices in maternity wards in Swaziland

Abstract

The prevalence and duration of breastfeeding have been steadily decreasing in the Third World, despite its known immunolOgical, economic and psycholOgical benefits (1,2). This trend away from breastfeeding may result in major problems through the impact of detrimental infant feeding practices on child health, female fertility and family economics (3). Concern over the decline in breastfeeding has promoted research in many developing and industrialized countries to determine the factors influencing its initiation and duration. Of particular interest has been the role of the healthcare system in breastfeeding trends. Two categories of breastfeeding promotion in a hospital setting exist those that provide information and support, and those that adapt hospital routine to facilitate the establishment and continuation of breastfeeding (4). Research carried out around the world has led to the general conclusion that hospital poliCies, reflected in healthcare worker practices, do influence breastfeeding (2). These policies affect when an infant is first fed, how continuously an infant is with the mother, when subsequent feedings occur, whether supplementary feedings are provided, and what drugs are administered during labor. Taking cognizance of the data collected in international research documenting the influence of the healthcare provider on the decision to breastfeed, the Swaziland Infant Nutrition Action Network (SINAN) conducted a survey of health personnel practices in maternity wards in May 1988. The objective of the survey was to determine whether practices identified in the international literature as being either promotive or detrimental to breastfeeding attempts were, on the basis of self-report, being used by healthcare workers in the country's maternity wards. SINAN planned to use the information gathered to persuade the Swazi government to adopt a nationwide health facility breastfeeding protocol that would standardize maternity