Ingram Jenny, Johnson Debbie, Condon Louise
Centre for Child and Adolescent Health, University of Bristol, UK.
Prim Health Care Res Dev. 2011 Jul;12(3):266-75. doi: 10.1017/S1463423610000423.
To evaluate the effects of Baby Friendly Initiative (BFI) community training on breastfeeding rates, staff and mothers in a large Primary Care Trust (PCT).
UK Government policy promotes the adoption and implementation of the World Health Organization/United Nations Children's Fund BFI as the best evidence to raise breastfeeding initiation and prevalence.
A total of 141 health visitors and nursery nurses were trained on mandatory three-day BFI courses during 2008; 137 staff (100 health visitors, 37 nursery nurses) took part in the evaluation. Breastfeeding attitudes, knowledge and staff confidence in helping mothers to breastfeed were measured using a validated Breastfeeding Questionnaire and a self-efficacy tool at three time points before and after training.
Breastfeeding rates at eight weeks increased significantly, and a baby born in 2009 was 1.57 times more likely to be breastfed than one born in 2006. Statistically significant improvements in staff breastfeeding attitudes, knowledge and self-efficacy were seen after attending the course, in addition to increases in the appropriate management of breastfeeding problems.Process evaluation interviews with 43 health visitors, nursery nurses and managers explored views of the training and changes in practice. The response to the course was overwhelmingly positive and felt to be extremely worthwhile. It has led to renewed enthusiasm, improved the consistency of advice among team members and raised confidence levels of all staff who help mothers with breastfeeding. Health visitors felt confident about enabling nursery nurses to take a greater role in breastfeeding support. A small survey of mothers reported increases in exclusive breastfeeding and signs of increased breastfeeding self-efficacy. Making the training mandatory across the whole PCT has improved the consistency of breastfeeding advice and confidence of all health-care staff who help breastfeeding mothers.
评估爱婴医院倡议（BFI）社区培训对大型初级保健信托基金（PCT）地区母乳喂养率、工作人员及母亲的影响。
英国政府政策推动采用和实施世界卫生组织/联合国儿童基金会的爱婴医院倡议，将其作为提高母乳喂养启动率和普及率的最佳依据。
2008年期间，共有141名健康访视员和托儿所护士参加了为期三天的BFI强制课程培训；137名工作人员（100名健康访视员、37名托儿所护士）参与了评估。在培训前后的三个时间点，使用经过验证的母乳喂养问卷和自我效能工具，对母乳喂养态度、知识以及工作人员帮助母亲进行母乳喂养的信心进行了测量。
八周时的母乳喂养率显著提高，2009年出生的婴儿母乳喂养的可能性是2006年出生婴儿的1.57倍。参加课程后，工作人员在母乳喂养态度、知识和自我效能方面有统计学意义的显著改善，此外，在母乳喂养问题的适当处理方面也有所增加。对43名健康访视员、托儿所护士和管理人员进行的过程评估访谈，探讨了他们对培训的看法以及实践中的变化。对该课程的反应绝大多数是积极的，认为非常值得。它带来了新的热情，提高了团队成员之间建议的一致性，并提高了所有帮助母亲进行母乳喂养的工作人员的信心水平。健康访视员对使托儿所护士在母乳喂养支持中发挥更大作用充满信心。一项对母亲的小型调查显示，纯母乳喂养有所增加，母乳喂养自我效能提高的迹象也有所增加。在整个PCT地区强制进行培训，提高了母乳喂养建议的一致性以及所有帮助母乳喂养母亲的医护人员的信心。
