Baby-Friendly Hospital Initiative and exclusive breastfeeding during hospital stay

Authors

  • Mariana Pujól Von Seehausen Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Programa de Pós-Graduação em Epidemiologia em Saúde Pública. Rio de Janeiro, RJ, Brasil https://orcid.org/0000-0001-8926-1677
  • Maria Inês Couto de Oliveira Universidade Federal Fluminense. Instituto de Saúde Coletiva. Departamento de Epidemiologia e Bioestatística. Niterói, RJ, Brasil https://orcid.org/0000-0003-0439-6295
  • Maria do Carmo Leal Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil https://orcid.org/0000-0002-3047-515X
  • Rosa Maria Soares Madeira Domingues Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil https://orcid.org/0000-0001-5722-8127
  • Cristiano Siqueira Boccolini Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Laboratório de Informação em Saúde. Rio de Janeiro, RJ, Brasil https://orcid.org/0000-0002-4804-5641

DOI:

https://doi.org/10.11606/s1518-8787.2023057004283

Keywords:

Breast Feeding, Hospitals, Maternity, Postpartum Period, Cross-Sectional Studies

Abstract

OBJECTIVE: To estimate the prevalence of exclusive breastfeeding during maternity hospital stay (outcome) and to analyze the association between delivery in a Baby-Friendly Hospital (BFH) and the outcome. The hypothesis is that accreditation to this program improves exclusive breastfeeding during maternity hospital stay. Exclusive breastfeeding is essential in reducing neonatal morbidity and mortality. METHODS: This study is based on secondary data collected by the “Birth in Brazil: National Survey into Labour and Birth”, a population-based study, conducted with 21,086 postpartum women, from February 1, 2011, to October 31, 2012, in 266 hospitals from all five Brazilian regions. Face-to-face interviews were conducted mostly within the first 24 hours after birth, regarding individual and gestational characteristics, prenatal care, delivery, newborn’s characteristics, and breastfeeding at birth. A theoretical model was created, allocating the exposure variables in three levels based on their proximity to the outcome. This hierarchical conceptual model was applied to perform a multiple logistic regression (with 95%CI and p < 0.05). RESULTS: In this study, 76.0% of the babies were exclusively breastfed from birth until the interview. Babies born in public (AOR = 1.73; 95%CI: 1.10–2.87), mixed (AOR = 2.48; 95%CI: 1.35–4.53) and private (AOR = 5.54; 95%CI: 2.38–12.45) BFHs were more likely to be exclusively breastfed during maternity hospital stay than those born in non–BFHs, as well as those born by vaginal birth (AOR = 2.16; 95%CI: 1.79–2.61), with adolescent mothers (AOR = 1.83; 95%CI: 1.47–2.26) or adults up to 34 years old (AOR =1 .31; 95%CI: 1.13–1.52), primiparous women (AOR = 1.51; 95%CI: 1.34–1.70), and mothers living in the Northern region of Brazil (AOR = 1.99; 95%CI: 1.14–3.49). CONCLUSIONS: The Baby-Friendly Hospital Initiative promotes exclusive breastfeeding during hospital stay regarding individual and hospital differences.

References

Khan J, Vesel L, Bahl R, Martines JC. Timing of breastfeeding initiation and exclusivity of breastfeeding during the first month of life: effects on neonatal mortality and morbidity - a systematic review and meta-analysis. Matern Child Health J. 2015;19(3):468-79. https://doi.org/10.1007/s10995-014-1526-8

Boccolini CS, Carvalho ML, Oliveira MI, Pérez-Escamilla R. Breastfeeding during the first hour of life and neonatal mortality. J Pediatr (Rio J). 2013;89(2):131-6. https://doi.org/10.1016/j.jped.2013.03.005

Nolan LS, Parks OB, Good M. A review of the immunomodulating components of maternal breast milk and protection against necrotizing enterocolitis. Nutrients. 2019;12(1):14. https://doi.org/10.3390/nu12010014

World Health Organization; UNICEF. Ten steps to successful breastfeeding. Geneva (CH):WHO; 2020 [cited 2020 Mar 30]. Available from: https://www.who.int/activities/promoting-baby-friendly-hospitals/ten-steps-to-successful-breastfeeding

Leal MC, Silva AAM, Dias MAB, Gama SGN, Rattner D, Moreira ME, et al. Birth in Brazil: national survey into labour and birth. Reprod Health. 2012;9:15. https://doi.org/10.1186/1742-4755-9-15

Vasconcellos MTL, Silva PL, Pereira AP, Schilithz AO, Souza Junior PR, Szwarcwald CL. Sampling design for the Birth in Brazil: National Survey into Labor and Birth. Cad Saude Publica. 2014;30 Suppl 1:S1-10. https://doi.org/10.1590/0102-311x00176013

Domingues RM, Szwarcwald CL, Souza PR Jr, Leal MC. Prenatal testing and prevalence of HIV infection during pregnancy: data from the "Birth in Brazil" study, a national hospital-based study. BMC Infect Dis. 2015;15:100. https://doi.org/10.1186/s12879-015-0837-8

Dias MAB, Domingues RMSM, Schilithz AOC, Nakamura-Pereira M, Diniz CSG, Brum IR, et al. Incidence of maternal near miss in hospital child birth and postpartum: data from the Birth in Brazil study. Cad Saude Publica. 2014;30 Supl:S169-81. https://doi.org/10.1590/0102-311x00154213

Silva AAM, Leite AJM, Lamy ZC, Moreira MEL, Gurgel RQ, Cunha AJLA, Leal MC. Neonatal near miss in the Birth in Brazil survey. Cad Saude Publica. 2014;30 Suppl 1:S1-10. https://doi.org/10.1590/0102-311x00129613

Bramson L, Lee JW, Moore E, Montgomery S, Neish C, Bahjri K, Melcher CL. Effect of early skin-to-skin mother-infant contact during the first 3 hours following birth on exclusive breastfeeding during the maternity hospital stay. J Hum Lact. 2010;26(2):130-7. https://doi.org/10.1177/0890334409355779

Pierro J, Abulaimoun B, Roth P, Blau J. Factors associated with supplemental formula feeding of breastfeeding infants during postpartum hospital stay. Breastfeed Med. 2016;11(4):196-202. https://doi.org/10.1089/bfm.2015.0091

Pechlivani F, Vassilakou T, Sarafidou J, Zachou T, Anastasiou CA, Sidossis LS. Prevalence and determinants of exclusive breastfeeding during hospital stay in the area of Athens, Greece. Acta Paediatr. 2005;94(7):928-34. https://doi.org/10.1111/j.1651-2227.2005.tb02013.x

Victora CG, Huttly SR, Fuchs SC, Olinto MT. The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. Int J Epidemiol. 1997;26(1):224-7. https://doi.org/10.1093/ije/26.1.224

Leal MC, Esteves-Pereira AP, Nakamura-Pereira M, Torres JA, Theme-Filha M, Domingues RMSM, et al. Prevalence and risk factors related to preterm birth in Brazil. Reprod Health. 2016;13 Suppl 3:127. https://doi.org/10.1186/s12978-016-0230-0

Lopes FO, Oliveira MIC, Brito AS, Fonseca VM. [Factors associated with the use of supplements among newborns in communal wards in Rio de Janeiro, 2009]. Cienc Saude Colet. 2013;18(2):431-9. Portuguese. https://doi.org/10.1590/s1413-81232013000200014

Asole S, Spinelli A, Antinucci LE, Di Lallo D. Effect of hospital practices on breastfeeding: a survey in the Italian Region of Lazio. J Hum Lact. 2009;25(3):333-40. https://doi.org/10.1177/0890334409333849

Araújo RG, Fonseca VM, Oliveira MIC, Ramos EG. External evaluation and self-monitoring of the Baby-friendly Hospital Initiative’s maternity hospitals in Brazil. Int Breastfeed J. 2019;14:1. https://doi.org/10.1186/s13006-018-0195-4

La Forgia GM, Couttolenc BF. Desempenho hospitalar brasileiro: em busca da excelência. São Paulo: Singular, 2009.

Ministério da Saúde (BR). Portaria Nº 1.153 de 22 de maio de 2014. Redefine os critérios de habilitação da Iniciativa Hospital Amigo da Criança (BFHI), como estratégia de promoção, proteção e apoio ao aleitamento materno e à saúde integral da criança e da mulher, no âmbito do Sistema Único de Saúde (SUS). Brasília, DF; 2014.

Domingues RMSM, Dias MAB, Nakamura-Pereira M, Torres JA, d'Orsi E, Pereira APE, et al. Process of decision-making regarding the mode of birth in Brazil: from the initial preference of women to the final mode of birth. Cad Saude Publica. 2014;30 Suppl 1:S1-16. https://doi.org/10.1590/0102-311x00105113

Esteves TMB, Daumas RP, Oliveira MIC, Andrade CAF, Leite IC. Factors associated to breastfeeding in the first hour of life: systematic review. Rev Saude Publica 2014;48(4):697-708. https://doi.org/10.1590/S0034-8910.2014048005278

Carvalho ML, Boccolini CS, Oliveira MIC, Leal MC. The baby-friendly hospital initiative and breastfeeding at birth in Brazil: a cross sectional study. Reprod Health. 2016;13 Suppl 3:119. https://doi.org/10.1186/s12978-016-0234-9

Boccolini CS, Carvalho ML, Oliveira MIC, Vasconcellos AGG. Factors associated with breastfeeding in the first hour of life. Rev Saude Publica. 2011;45(1):69-78. https://doi.org/10.1590/s0034-89102010005000051

Qiu L, Zhao Y, Binns CW, Lee AH, Xie X. Initiation of breastfeeding and prevalence of exclusive breastfeeding at hospital discharge in urban, suburban and rural areas of Zhejiang China. Int Breastfeed J. 2009;4:1. https://doi.org/10.1186/1746-4358-4-1

Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, et al. Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016;387(10017):491-504. https://doi.org/10.1016/S0140-6736(15)01044-2

Cartwright J, Atz T, Newman S, Mueller M, Demirci JR. Integrative review of interventions to promote breastfeeding in the late preterm infant. J Obstet Gynecol Neonatal Nurs. 2017;46(3):347-56. https://doi.org/10.1016/j.jogn.2017.01.006

Alonso-Díaz C, Utrera-Torres I, Alba-Romero C, Flores-Antón B, Lora-Pablos D, Pallás-Alonso CR. Breastfeeding support in Spanish neonatal intensive care units and the Baby-Friendly Hospital Initiative: a national survey. J Hum Lact. 2016;32(4):613-26. https://doi.org/10.1177/0890334416658246

Vannuchi MTO, Monteiro CA, Rea MF, Andrade SM, Matsuo T. The Baby-Friendly Hospital Initiative and breastfeeding in a neonatal unit. Rev Saude Publica. 2004;38(3):422-8. https://doi.org/10.1590/S0034-89102004000300013

Finkelstein SA, Keely E, Feig DS, Tu X, Yasseen AS 3rd, Walker M. Breastfeeding in women with diabetes: lower rates despite greater rewards. A population-based study. Diabet Med. 2013;30(9):1094-10. https://doi.org/10.1111/dme.12238

Meirelles CAB, Oliveira MIC, Mello RR, Varela MAB, Fonseca VM. Justifications for formula supplementation in low-risk newborns at a Baby-Friendly Hospital. Cad Saude Publica. 2008;24(9):2001-12. [Portuguese] https://doi.org/10.1590/S0102-311X2008000900006

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Published

2023-04-12

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Original Articles

How to Cite

Baby-Friendly Hospital Initiative and exclusive breastfeeding during hospital stay. (2023). Revista De Saúde Pública, 57(1), 28. https://doi.org/10.11606/s1518-8787.2023057004283