Effect on rates of breast feeding of training for the Baby FriendlyHospital Initiative
xmlns:v="urn:schemas-microsoft-com:vml"
xmlns:o="urn:schemas-microsoft-com:office:office"
xmlns:w="urn:schemas-microsoft-com:office:word"
xmlns="http://www.w3.org/TR/REC-html40">
Effect on rates of breast feeding of training for the Baby Friendly
Hospital Initiative
Effect on rates of breast feeding of training for the Baby Friendly
Hospital Initiative
Adriano Cattaneo, epidemiologist, aRoberto Buzzetti, medical statistician, b
on behalf of the Breastfeeding Research and Training Working Group.
a Unit for Health Services Research and International Cooperation,
Istituto per l'Infanzia, Via dell'Istria 65/1, 34137 Trieste, Italy, b Centre
for the Evaluation of Effectiveness and Appropriateness of Health Care
(CEVEAS), Modena, Italy
Problem: Breastfeeding rates and related hospital practicesneed
improvement in Italy and elsewhere. Training of staff isnecessary,
but its effectiveness needsassessment. Context: Eight hospitals in different regions ofItaly. Design: Controlled, non-randomised study. Data collectedin
three phases. Training after the first phase in group 1 hospitalsand
after the second phase in group2. Strategies for change: Training of trainers and subsequent trainingof health workers with a slightly adapted version of the 18 hourUnicef course on breastfeeding management andpromotion. Key measures for improvement: Hospital practices, knowledge of
571 healthworkers, and breastfeeding rates at discharge,
three, and sixmonths in 2669 mother and babypairs.
Effects of change: After training hospitals improved their compliancewith the "ten steps to successful breast feeding," from an
averageof 2.4 steps at phase one to 7.7 at phase three.
Knowledge scoresof health professionals increased from 0.41 to
0.72 in group 1(training after phase one) and from
0.53 to 0.75 in group 2 (afterphase two). The rate
of exclusive breast feeding at dischargeincreased significantly
after training: 41% to 77% in group 1and 23% to 73% in group
2, as did the rates of full (exclusiveplus predominant) breast
feeding at three months (37% to 50% ingroup 1 v 40% to
59% in group 2) and any breast feeding at sixmonths (43% to 62% in
group 1 v 41% to 64% in group2). Lessons learnt: Training for at least three days with a courseincluding
practical sessions and counselling skills is effectivein changing
hospital practices, knowledge of health workers, andbreastfeedingrates.
ALL
INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR
GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE
KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED
AS PROVIDING MEDICAL OR LEGAL ADVICE. THE DECISION WHETHER OR NOT TO
VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU
ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.
"A foolish faith in authority is the worst enemy of truth."
-- Albert Einstein, letter to a friend, 1901
"I know of no safe depository of the ultimate powers of the society but the people themselves, and if we think them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education."
-- Thomas Jefferson, letter to William C. Jarvis, September 28, 1820
"What's the point of vaccination if it doesn't protect you from the unvaccinated?"
-- Sandy Gottstein
"Who gets to decide what the greater good is and how many will be sacrificed to it?"