Hospital Breastfeeding Policies Research Articles

Identifying priorities for practice improvement related to breastfeeding support in a neonatal intensive care unit (NICU) in Medellín, Colombia

PurposeTo identify priority areas and practice improvement strategies related to breastfeeding support, in a neonatal intensive care unit (NICU) in Colombia. MethodsAs part of a quality improvement initiative, this multi-method qualitative descriptive study involved 5 focus group interviews with NICU staff and 6 individual interviews with clinical leaders. Data were complemented by informal conversations with NICU staff and a document review of the hospital's breastfeeding policies and educational materials. Data were analyzed using qualitative content analysis. ResultsPriorities for practice improvement included (1) support for milk expression, (2) support for the transition to direct breastfeeding, and (3) creation of policies and tools related to breastfeeding. Findings highlighted ways in which resource limitations influence priority setting to favour the redistribution of existing assets and mobilization of local facilitators for breastfeeding support. ConclusionFindings will inform the development and implementation of future strategies to enhance breastfeeding support in this unit.

Association between early essential newborn care and breastfeeding outcomes in eight countries in Asia and the Pacific: a cross-sectional observational -study

ObjectiveTo explore the association between early essential newborn care (EENC) policy, practice and environmental interventions and breastfeeding outcomes.DesignCross-sectional observational study.Setting150 national, provincial and district hospitals implementing EENC in eight countries...

Trends in Hospital Breastfeeding Policies in the United States from 2009-2015: Results from the Maternity Practices in Infant Nutrition and Care Survey.

Having a written breastfeeding policy that is routinely communicated to staff is important. Furthermore, hospitals seeking the Baby-Friendly designation are required to purchase infant formula at fair market value. We sought to determine the trends of model policies and receipt of free infant formula among hospitals with maternity care in the United States. The Maternity Practices in Infant Nutrition and Care (mPINC) survey obtained information, every 2 years, on breastfeeding-related practices and policies from hospitals in the United States. We examined the prevalence of hospitals with a model breastfeeding policy, individual policy elements, and how policies were communicated as well as the receipt of free infant formula from 2009 to 2015. Statistical testing is not included because mPINC is a census. The proportion of hospitals with a model breastfeeding policy increased from 14.1% in 2009 to 33.1% in 2015. More hospitals incorporated policy elements on limited use of pacifiers (+21.0% points), early initiation of breastfeeding (+15.5% points), and limiting non-breast milk feeds of breastfed infants (+14.1% points). Fewer hospitals disseminated policies by word of mouth (-2.0% points), whereas, more posted policies (+8.1% points). The percent of hospitals not receiving free infant formula increased from 7.4% in 2009 to 28.7% in 2015. While more hospitals in the United States are implementing model breastfeeding policies and not receiving free infant formula, the majority do not adhere to these practices. Hospitals may consider reviewing their policies around infant feeding to improve care for new mothers.

Impact of State Legislation on Hospital Breastfeeding Support in New York

The purpose of this study was to evaluate whether 2 state mandates, both implemented in 2010, had an impact on NY hospitals providing maternity care. Specifically, we measured changes in hospital staff's awareness, attitudes, and promotion of breastfeeding (BF), maternity care practices, and hospital breastfeeding policies and tested whether they were related to implementation of the Breastfeeding Mothers' Bill of Rights or the mandate for public reporting of hospital-specific BF measures. In 2009 and 2011, written hospital BF policies were collected and evaluated using a 28-item review tool and hospital BF surveys were conducted. The surveys assessed hospital culture and staff attitudes associated with BF promotion and support and recommended maternity care practices. NY hospitals providing maternity care services and hospital staff. Changes over time in hospital BF policies (BF policy score) and implementation of recommended maternity care practices (9 of Ten Steps to Successful BF) were evaluated. The relationships and correlations between these changes in staff awareness, hospital culture, and BF promotion were determined. Between 2009 and 2011, there were increases in BF policy scores, maternity care practices implemented, and lactation staff (P < .001). Greater awareness by hospital administrators of BF measures was associated with more emphasis in promoting BF (P = .02). Hospitals reporting much more emphasis in promoting BF or reporting large changes in organizational culture had greater increases in BF policy scores and the recommended maternity care practices implemented (P < .05). These findings suggest that state mandates requiring key BF policies and support in hospitals and public reporting of BF rates may have led to increased emphasis and promotion of BF, improvement in hospital BF policies, and increased implementation of maternity care practices supporting BF. Implementation of similar policies by other states, combined with rigorous evaluation, is needed to replicate these findings and assess the long-term impact on maternal and infant health outcomes.

Nurse knowledge and attitudes towards breastfeeding in Arizona

Baseline data regarding knowledge and attitudes toward breastfeeding policies and practices were obtained from 169 maternity ward nurses in 4 hospitals (2 urban, 2 rural) in Arizona. Questionnaires were administered at the beginning of a four hour workshop highlighting the benefits of five of the 10 Baby Friendly Hospital initiatives. Participation in the survey was voluntary. The average age of the respondents was 42 ± 11 years. Eighty‐one percent had biological children and 93% of these individuals reported breastfeeding. Analysis of survey data revealed that while 71% knew they had a written breastfeeding policy, only 52% of respondents reported confidence describing their hospital's breastfeeding policies and procedures. While overall attitudes towards breastfeeding were generally positive, these findings suggest that maternity ward nurse knowledge should be assessed to maximize policy implementation related to maternity care practice changes in order to increase lactation success from birth.

Hospital Breastfeeding Policies and Practices in South Korea: A Comparison with the WHO/UNICEF Ten Steps

Hospital Breastfeeding Policies and Practices in South Korea: A Comparison with the WHO/UNICEF Ten Steps

Adherence to the ten steps of the Baby-Friendly Hospital Initiative in Minnesota hospitals.

A worldwide campaign has been initiated to improve the in-hospital care of mothers and babies through increased breastfeeding. The four objectives of the current investigation were to determine the in-hospital breastfeeding rate for Minnesota hospitals, to analyze the relationship between the in-hospital breastfeeding rates and selected hospital demographic characteristics, to determine the rate of adherence to each of the Baby-Friendly Hospital Initiative (BFHI) Ten Steps, and to analyze the relationship between the adherence rates for each of the Ten Steps and selected demographic characteristics. A descriptive survey was conducted and analyzed for the year of 1994 from 79 (83%) Minnesota hospitals. Respondents were directors of nursing, nursing managers, or other staff familiar with their hospital's breastfeeding policies and practices. The average breastfeeding initiation rate was 59 percent. Four of the Ten Steps were implemented with a low adherence rate (0-49%), five were implemented with a moderate rate (50-89%), and none was implemented with a high rate (90-100%). Breastfeeding initiation rates and adherence to the Ten Steps varied with the size of the city and the number of births per year. Improvements in breastfeeding policies, practices, and staff education are needed if Minnesota hospitals are to provide care consistent with the Ten Steps of the BFHI. The results provide baseline information to guide institutional change that could promote successful breastfeeding experiences for postpartum families. This survey instrument could be used easily by researchers in other sites to assess nine of the Ten Steps.

Using the quality improvement process to affect breastfeeding protocols in United States hospitals.

Engaging in the Quality Improvement Process represents an opportunity for lactation consultants and breastfeeding advocates to examine and reevaluate hospital breastfeeding policies and procedures. Cause and effect diagrams that explore the problem of an 8-hour-old baby who has not yet breastfed are presented as examples of a quality tool.

An assessment tool for evaluating hospital breastfeeding policies and practices.

In 1991, UNICEF and WHO launched the Baby Friendly Hospital Initiative, a global initiative promoting breastfeeding within hospitals. This article describes the development and use of a detailed questionnaire to acquire baseline data on hospital breastfeeding policies in the southeastern Pennsylvania Delaware Valley and to classify hospitals by their level of implementation of the Baby Friendly Hospital Initiative. The purpose of the questionnaire is twofold: a) to describe and analyze hospitals' breastfeeding policies and practices, and b) to classify hospitals with respect to their level of implementation of each of the Ten Steps and the implementation of the Ten Steps overall.

Breastfeeding and health care services

Breastfeeding can help prevent the 38,000 daily deaths of infants and young children through its nutritional, immunologic, and sanitary aspects. Nevertheless, it is on the decline in most countries. The World Health Organization (WHO) and United Nations Children's Fund (UNICEF) have combined to issue guidelines on the role of maternity services in promoting breastfeeding, such as, a hospital breastfeeding policy with rooming-in, demand-feeding, and the elimination of bottles and breast milk substitutes. These practices have succeeded in programs around the world and have increased the breastfeeding rate at the same time that infection rates decreased.

Early breastfeeding and discharge home for premature infants in bogota, colombia: Kangaroo method

To identify priority areas and practice improvement strategies related to breastfeeding support, in a neonatal intensive care unit (NICU) in Colombia.As part of a quality improvement initiative, this multi-method qualitative descriptive study involved 5 focus group interviews with NICU staff and 6 individual interviews with clinical leaders. Data were complemented by informal conversations with NICU staff and a document review of the hospital's breastfeeding policies and educational materials. Data were analyzed using qualitative content analysis.Priorities for practice improvement included (1) support for milk expression, (2) support for the transition to direct breastfeeding, and (3) creation of policies and tools related to breastfeeding. Findings highlighted ways in which resource limitations influence priority setting to favour the redistribution of existing assets and mobilization of local facilitators for breastfeeding support.Findings will inform the development and implementation of future strategies to enhance breastfeeding support in this unit.