Studying the Ten Steps, working to change hospital policies and protocols, educating the hospital staff and healthcare providers on Baby-friendly, hours spent documenting, keeping endless statistics... many facilitators for the Baby-friendly Hospital Initiative (BFHI) often question whether all this work makes a difference for moms and babies. A 2016 study published in Maternal & Child Nutrition should give hope to those worrying about the results of their work.
The systematic review by Perez-Escamilla, Martinez, and Segura-Perez looked at studies from 19 different countries located in South America, North America, Western Europe, Eastern Europe, South Asia, Eurasia, and Sub-Saharan Africa. They found, "Adherence to the BFHI Ten Steps has a positive impact on short-term, medium-term, and long-term breastfeeding (BF) outcomes. There is a dose-response relationship between the number of BFHI steps women are exposed to and the likelihood of improved BF outcomes (early BF initiation, exclusive breastfeeding (EBF) at hospital discharge, and BF, and EBF duration”. Community support (step 10) appears to be essential for sustaining breastfeeding impacts of BFHI in the longer term.” (p. 402).
The authors give five key messages from their review. Here are two important ones to use in staff education and rationale for those questioning the BFHI work you are doing.
·The Ten Steps that form the basis of Baby-friendly Hospital Initiative (BFHI) serve as a quality assurance system based on highly interrelated specific actions at the facility and community level.
·Avoiding in-hospital supplementation appears to be a key step for breastfeeding success, perhaps reflecting adequate implementation of the rest of the Ten Steps.
Although most new couplets are discharged from the hospital within 36-48 hours, the policies, practices, and staff actions DO have long-term consequences. This review brings to light just a few. Keep up the good work - you DO make a difference!
Kathy Parkes, MSN-Ed, RN, IBCLC, FILCA
Professional Development Educator
Perez-Escamilla, R., Martinez, J.L., and Segura-Perez, S. 2016. Impact of the Baby-friendly Hospital Initiative on breastfeeding and child health outcomes: a systematic review. Maternal & Child Nutrition; 12: 402-17. Doi: 10.1111/mcn.12294. https://onlinelibrary.wiley.com/doi/full/10.1111/mcn.12294
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