Journal of human lactation : official journal of International Lactation Consultant Association
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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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Despite growing evidence for the positive impact of the Baby-Friendly Initiative (BFI) on breastfeeding outcomes, few studies have investigated the barriers and facilitators to the implementation of Baby-Friendly practices that can be used to improve uptake of the BFI at the local or country levels. This integrative review aimed to identify and synthesize information on the barriers, facilitators, and recommendations related to the BFI from the international, peer-reviewed literature. Thirteen databases were searched using the keywords Baby Friendly, Baby-Friendly Hospital Initiative, BFI, BFHI, Ten Steps, implementation, adoption, barriers, facilitators, and their combinations. ⋯ A wide variety of obstacles and potential solutions to BFI implementation were identified. Findings suggest some priority issues to address when pursuing Baby-Friendly designation, including the endorsements of both local administrators and governmental policy makers, effective leadership of the practice change process, health care worker training, the marketing influence of formula companies, and integrating hospital and community health services. Framing the BFI as a complex, multilevel, evidence-based change process and using context-focused research implementation models to guide BFI implementation efforts may help identify effective strategies for promoting wider adoption of the BFI in health services.
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The journey toward Baby-Friendly status at Jersey Shore University Medical Center in Neptune, NJ began with a desire to improve overall breastfeeding rates at the hospital. Although evidence showed that hospitals that incorporated some or all of the Ten Steps to Successful Breastfeeding had improved breastfeeding rates, it was difficult to overcome barriers that prevented the hospital physicians and nursing staff from seeing the value in adopting this quality initiative. ⋯ This article will discuss the barriers that one hospital encountered and the strategies used to overcome these common barriers to achieving Baby-Friendly status. This hospital is not yet designated as Baby-Friendly but is awaiting the outcome of a site visit in 2012.
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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.