Atchan Marjorie, Davis Deborah, Foureur Maralyn
Centre of Midwifery, Child & Family Health, University of Technology, Sydney, NSW.
Breastfeed Rev. 2013 Jul;21(2):15-22.
Studies have identified that the practices of maternity facilities and health professionals are crucial to women's experience of support and breastfeeding 'success'. The Baby Friendly Hospital Initiative (BFHI) was launched globally in 1991 to protect, promote and support breastfeeding. While a direct causal effect has not been established and critics suggest the rhetoric conflicts with women's lived experiences as new mothers, a positive association between the Initiative and breastfeeding prevalence is apparent. Internationally, impact studies have demonstrated that where the Initiative is well integrated, there is an increase in rates of breastfeeding initiation and, to a lesser extent, duration. In consideration of the known health risks associated with the use of artificial baby milks this would suggest that BFHI implementation and accreditation should be a desirable strategy for committed health facilities. However, a variation in both BFHI uptake and breastfeeding prevalence between nations has been reported. This narrative review critically discusses a variety of issues relevant to the uptake and support of breastfeeding and the BFHI, utilising Australia as a case study. Whilst it enjoys 'in principle' policy support, Australia also suffers from a lack of uniformity in uptake and perception of the benefits of BFHI at all levels of the health system. Australian and international studies have identified similar enablers and barriers to implementation.
研究表明，产科机构和医护人员的做法对于女性获得支持的体验以及母乳喂养的“成功”至关重要。1991年，“爱婴医院倡议”（BFHI）在全球范围内发起，旨在保护、促进和支持母乳喂养。虽然尚未确定其直接因果效应，且批评者认为该倡议的言辞与初为人母的女性的生活经历相冲突，但该倡议与母乳喂养普及率之间存在明显的正相关关系。在国际上，影响研究表明，在该倡议得到良好整合的地方，母乳喂养开始率会有所提高，在一定程度上，母乳喂养持续时间也会延长。鉴于使用人工婴儿奶粉存在已知的健康风险，这表明实施和获得“爱婴医院倡议”认证对于有此意愿的医疗机构来说应该是一项理想的策略。然而，据报道，各国在“爱婴医院倡议”的采纳情况和母乳喂养普及率方面存在差异。本叙述性综述以澳大利亚为例，批判性地讨论了与母乳喂养的采纳和支持以及“爱婴医院倡议”相关的各种问题。虽然澳大利亚在“原则上”享有政策支持，但在卫生系统各级对“爱婴医院倡议”的采纳情况和对其益处的认知方面也缺乏一致性。澳大利亚和国际研究已经确定了类似的实施促进因素和障碍。
