• Beatriz Flores-Antón, Maria Carmen Temboury-Molina, Susana Ares-Segura, Celina Arana-Cañedo-Argüelles, Concepción Nicolás-Bueno, Cristina Navarro-Royo, Alberto Pardo-Hernández, and Carmen Rosa Pallás-Alonso.
• Hospital de Fuenlabrada, BFHI Hospital, Madrid, Spain. befloan@gmail.com
• J Hum Lact. 2012 Aug 1; 28 (3): 363-9.

BackgroundPromotion and protection of breastfeeding is a public health objective. In April 2009, health authorities in the Madrid region in central Spain signed a collaboration agreement with The United Nations Children's Fund and created a breastfeeding committee.ObjectiveTo report the creation and implementation of a plan to promote and improve the quality of breastfeeding care in public hospitals in the region of Madrid, according to the Baby-Friendly Hospital Initiative (BFHI) standards.MethodsThe action plan included institutional commitment; creation of a breastfeeding committee in each hospital; outcome analyses, staff training, creation of educational materials; and dissemination of activities. The plan was adopted by the 19 non-BFHI-designated public maternity units in the Madrid region. Each hospital completed a modified version of the World Health Organization self-assessment questionnaire in 2009 (pre-intervention) and again in 2011.ResultsThirteen maternity units (68.4%) established a breastfeeding committee, and 32 months after implementation of the plan, the other 6 hospitals have created one. Nine training courses have been carried out to train professional experts on breastfeeding as trainers. The 271 trainers provided 18-hour breastfeeding courses for 1423 professionals. In 2009, there was only 1 BFHI-accredited hospital. Currently, 52.6% of the other 19 hospitals have some level of accreditation, and 2 are fully accredited.ConclusionsAn intervention to improve the quality of breastfeeding care based on an organized regional approach to the BFHI was useful for BFHI implementation.

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