Journal of human lactation : official journal of International Lactation Consultant Association
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In June 2010, the Communities Putting Prevention to Work program (Centers for Disease Control and Prevention) funded a New Jersey (NJ) Office on Nutrition and Fitness, Department of Health and Senior Services project to reduce obesity and increase exclusive breastfeeding by increased implementation of the Baby-Friendly Hospital Initiative in the state of NJ. At baseline, NJ had no Baby-Friendly hospitals and no hospital was using an infant feeding policy that conformed to standards required by Baby-Friendly USA for designation. ⋯ A collaborative initiative can use a single breastfeeding policy template as an aid toward Baby-Friendly designation. Such work streamlines the process and saves time and resources.
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Since 2001, Quebec's ministry of health and social services has prioritized implementation of the Baby-Friendly Initiative (BFI), which includes the original hospital initiative and its expansion to community services. ⋯ Results disseminated to participating organizations allowed comparisons on a regional/provincial perspective and in relation to BFI-designated facilities. Furthermore, this first portrait of BFI compliance in Quebec provided provincial, regional, and local health authorities with valuable information that can be used to bring about policy and organizational changes to achieve the international standards required for Baby-Friendly certification.
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The incidence of breastfeeding of preterm infants is affected by the support provided at the hospital and in the neonatal intensive care unit (NICU). However, policies and guidelines promoting breastfeeding vary both nationally and internationally. ⋯ The Danish NICUs described the support of breastfeeding as a high priority, which was reflected in the recommended policies for breast milk pumping, skin-to-skin contact, and the parents' presence in the NICU, as well as in the restricted use of bottle-feeding. However, support varied between units, and not all units supported optimal breastfeeding.
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Kramer et al's PROBIT (Promotion of Breastfeeding Intervention Trial) research in Belarus studied effects of the Baby-Friendly Hospital Initiative (BFHI) training on breastfeeding duration, exclusivity, and health outcomes. ⋯ PROBIT provides foundational evidence for BFHI policy and follow-up care. Knowing that non-breastfed babies were excluded, caution must be exercised for health comparisons.
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The World Health Organization/United Nations Children's Fund Baby-Friendly Hospital Initiative: Revised, Updated, and Expanded for Integrated Care (2009) identifies the need for expanding the guidelines originally developed for maternity units to include neonatal intensive care. For this purpose, an expert group from the Nordic countries and Quebec, Canada, prepared a draft proposal, which was discussed at an international workshop in Uppsala, Sweden, in September 2011. The expert group suggests the addition of 3 "Guiding Principles" to the Ten Steps to support this vulnerable population of mothers and infants: 1. ⋯ The health care system must ensure continuity of care, that is, continuity of pre-, peri-, and postnatal care and post-discharge care. The goal of the expert group is to create a final document, the Baby Friendly Hospital Initiative for Neonatal Units, including standards and criteria for each of the 3 Guiding Principles, Ten Steps, and the Code; to develop tools for self-appraisal and monitoring compliance with the guidelines; and for external assessment to decide whether neonatal intensive/intermediate care units meet the conditions required to be designated as Baby-Friendly. The documents will be finalized after consultation with the World Health Organization/United Nations Children's Fund, and the goal is to offer these documents to international health care, professional, and other nongovernmental organizations involved in lactation and breastfeeding support for mothers of infants who require special neonatal care.