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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Baby-Friendly Hospital Accreditation, In-Hospital Care Practices, and Breastfeeding

Wendy Brodribb, Sue Kruske and Yvette D. Miller
Pediatrics April 2013, 131 (4) 685-692; DOI: https://doi.org/10.1542/peds.2012-2556
Wendy Brodribb
aSchool of Medicine, Discipline of General Practice, and
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Sue Kruske
bQueensland Centre for Mothers and Babies, School of Psychology, The University of Queensland, Queensland, Australia; and
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Yvette D. Miller
bQueensland Centre for Mothers and Babies, School of Psychology, The University of Queensland, Queensland, Australia; and
cSchool of Public Health and Social Work, Queensland University of Technology, Queensland, Australia
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Abstract

OBJECTIVES: To investigate the effect of Baby-Friendly Hospital Initiative (BFHI) accreditation and hospital care practices on breastfeeding rates at 1 and 4 months.

METHODS: All women who birthed in Queensland, Australia, from February 1 to May 31, 2010, received a survey 4 months postpartum. Maternal, infant, and hospital characteristics; pregnancy and birth complications; and infant feeding outcomes were measured.

RESULTS: Sample size was 6752 women. Breastfeeding initiation rates were high (96%) and similar in BFHI-accredited and nonaccredited hospitals. After adjustment for significant maternal, infant, clinical, and hospital variables, women who birthed in BFHI-accredited hospitals had significantly lower odds of breastfeeding at 1 month (adjusted odds ratio 0.72, 95% confidence interval 0.58–0.90) than those who birthed in non–BFHI-accredited hospitals. BFHI accreditation did not affect the odds of breastfeeding at 4 months or exclusive breastfeeding at 1 or 4 months. Four in-hospital practices (early skin-to-skin contact, attempted breastfeeding within the first hour, rooming-in, and no in-hospital supplementation) were experienced by 70% to 80% of mothers, with 50.3% experiencing all 4. Women who experienced all 4 hospital practices had higher odds of breastfeeding at 1 month (adjusted odds ratio 2.20, 95% confidence interval 1.78–2.71) and 4 months (adjusted odds ratio 2.93, 95% confidence interval 2.40–3.60) than women who experienced fewer than 4.

CONCLUSIONS: When breastfeeding-initiation rates are high and evidence-based practices that support breastfeeding are common within the hospital environment, BFHI accreditation per se has little effect on both exclusive or any breastfeeding rates.

  • BFHI
  • baby-friendly
  • breastfeeding
  • Australia
  • hospital practices
  • Abbreviations:
    BFHI —
    Baby-Friendly Hospital Initiative
    BFHI hospital —
    BFHI-accredited hospital
    non-BFHI hospital —
    non–BFHI-accredited hospital
    • Accepted December 6, 2012.
    • Copyright © 2013 by the American Academy of Pediatrics

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    Pediatrics
    Vol. 131, Issue 4
    1 Apr 2013
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    Baby-Friendly Hospital Accreditation, In-Hospital Care Practices, and Breastfeeding
    Wendy Brodribb, Sue Kruske, Yvette D. Miller
    Pediatrics Apr 2013, 131 (4) 685-692; DOI: 10.1542/peds.2012-2556

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    Baby-Friendly Hospital Accreditation, In-Hospital Care Practices, and Breastfeeding
    Wendy Brodribb, Sue Kruske, Yvette D. Miller
    Pediatrics Apr 2013, 131 (4) 685-692; DOI: 10.1542/peds.2012-2556
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