Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.
Birth. 2011 Sep;38(3):228-37. doi: 10.1111/j.1523-536X.2011.00479.x. Epub 2011 May 20.
The Baby-Friendly Hospital Initiative (BFHI) promotes the World Health Organization International Code of Marketing of Breast-milk Substitutes (WHO Code) and the WHO/UNICEF's Ten Steps to Successful Breastfeeding (Ten Steps). The purpose of this study is to describe and compare maternity hospitals' adherence to the BFHI in 1993 and 2007 for Canada and for each province and territory.
A survey of all Canadian maternity hospitals was conducted in 1993 and 2007 on routine maternity care practices and policies including infant feeding.
The overall response rate was 91 percent (n = 523/572 hospitals) in 1993 and 92 percent (n = 323/353 hospitals) in 2007. Eighty-two percent (415/507) of hospitals in 1993 and 68 percent (198/292) in 2007 had exclusive contracts with formula companies. Fifty-eight percent (302/517) of hospitals in 1993 and 90 percent (289/322) in 2007 never gave breastfeeding mothers sample packs containing formula. Fifty-eight percent (296/507) in 1993 and 85 percent (273/321) in 2007 had written breastfeeding policies (Step 1); 97 percent (503/518) in 1993 and 99 percent (320/322) in 2007 allowed mothers to breastfeed, on cue, whenever the babies indicated an interest 24 hours a day (Step 8); 24 percent (126/519) in 1993 and 64 percent (206/321) in 2007 reported that they did not provide soothers (Step 9); 58 percent (297/513) in 1993 and 68 percent (215/316) in 2007 always offered information on breastfeeding support groups and/or advice at time of discharge (Step 10).
In the 14 years separating the two surveys, Canadian maternity hospitals substantially improved their implementation of the WHO Code and their adherence to the WHO/UNICEF Ten Steps.
婴儿友好医院倡议（BFHI）推广世界卫生组织国际母乳代用品销售守则（世卫组织守则）和世卫组织/儿基会成功母乳喂养的十项措施（十项措施）。本研究的目的是描述和比较加拿大以及每个省和地区的产妇医院在 1993 年和 2007 年对婴儿友好医院倡议的遵守情况。
1993 年和 2007 年对所有加拿大产妇医院进行了常规产妇护理实践和政策调查，包括婴儿喂养。
1993 年的总回复率为 91%（n=523/572 家医院），2007 年为 92%（n=323/353 家医院）。1993 年有 82%（415/507 家）的医院与配方奶粉公司签订独家合同，2007 年有 68%（198/292 家）的医院签订了独家合同。1993 年有 58%（302/517 家）的医院从未向母乳喂养的母亲提供含有配方奶粉的样本包，2007 年有 90%（289/322 家）的医院从未提供过此类样本包。1993 年有 58%（296/507 家）的医院有书面母乳喂养政策（第 1 步），2007 年有 90%（273/321 家）的医院有书面母乳喂养政策；1993 年有 97%（503/518 家）的医院允许母亲在婴儿每天 24 小时表示兴趣时随时进行母乳喂养（第 8 步），2007 年有 99%（320/322 家）的医院允许母亲在婴儿每天 24 小时表示兴趣时随时进行母乳喂养；1993 年有 24%（126/519 家）的医院和 2007 年有 64%（206/321 家）的医院报告称，他们不提供奶嘴（第 9 步）；1993 年有 58%（297/513 家）的医院和 2007 年有 68%（215/316 家）的医院在出院时总是提供有关母乳喂养支持小组和/或建议的信息（第 10 步）。
在两次调查相隔的 14 年中，加拿大产妇医院在实施世卫组织守则和遵守世卫组织/儿基会的十项措施方面取得了重大进展。
