Abstract
The World Health Organization and United Nations Children's Fund launched the Baby Friendly Hospital Initiative (BFHI) to encourage best infant breastfeeding practices immediately after birth. In Lebanon, few hospitals are currently accredited as Baby Friendly. To assess the knowledge of Lebanese women of BFHI steps, and to explore their attitudes towards Baby Friendly Hospitals, Skin-to-Skin Contact and Kangaroo Care practices. A cross-sectional survey of a random sample of healthy pregnant women from Lebanon's six governorates. The mean (SD) age of the participants (N = 517) was 28.6 (4.7) years. Most participants were unfamiliar with the terms Baby Friendly hospital (93.7%), skin-to-skin contact or kangaroo care (75%), or were inadequately instructed on how to initiate (54.2%) or continue (46.2%) breastfeeding. However, when provided with information about the benefits of BFHI practices, most mothers (> 90%) stated that they would deliver in Baby Friendly hospitals. About 68.4% of mothers refused to give donor human milk to their sick premature infants because of religious beliefs. Knowledge of Baby Friendly hospitals was significantly associated with university education (p = 0.029), higher monthly income (p = 0.042), and previous experiences of skin-to-skin contact (p<0.001), rooming in (p = 0.037), or breastfeeding support (p = 0.036). There is a need for national awareness campaigns that address both the numerous advantages of the BFHI practices and Lebanese women's knowledge gaps about these practices. Such knowledge will help scale up the implementation of BFHI practices in hospitals in Lebanon, thus increasing breastfeeding rates and positively impacting the health of infants and mothers.
Highlights
Breastfeeding provides the newborn with the ideal nutrition that secures optimal growth and development
Most participants were unfamiliar with the terms Baby Friendly hospital (93.7%), skin-to-skin contact or kangaroo care (75%), or were inadequately instructed on how to initiate (54.2%) or continue (46.2%) breastfeeding
When provided with information about the benefits of Baby Friendly Hospital Initiative (BFHI) practices, most mothers (> 90%) stated that they would deliver in Baby Friendly hospitals
Summary
Breastfeeding provides the newborn with the ideal nutrition that secures optimal growth and development. To be accredited as ‘Baby Friendly’ by WHO/UNICEF, a maternity facility has to report at least 75% exclusive breastfeeding rate among mothers at discharge, to adhere to the International Code of Marketing Breast-milk Substitutes, and to successfully implement the “Ten Steps to Successful Breastfeeding” These steps are: “1) Have a written breastfeeding policy that is routinely communicated to all health care staff, 2) Train all health care staff in skills necessary to implement this policy, 3) Inform all pregnant women about the benefits and management of breastfeeding, 4) Help mothers initiate breastfeeding within a half-hour of birth, 5) Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants, 6) Give newborn infants no food or drink other than breast milk unless medically indicated, 7) Practice rooming in—allow mothers and infants to remain together—24 hours a day, 8) Encourage breastfeeding on demand, 9) Give no artificial teats or pacifiers ( called dummies or soothers) to breastfeeding infants, 10) Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic” [3, 4]. In Lebanon, few hospitals are currently accredited as Baby Friendly
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