Mosher Cynthia, Sarkar Abdullah, Hashem Alaa AbouBakr, Hamadah Reem E, Alhoulan Asma, AlMakadma Yosra A, Khan Tehreem A, Al-Hamdani Abdurahman K, Senok Abiola
College of Medicine Alfaisal University, Riyadh, Saudi Arabia.
Department of Emergency Medicine, King Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
BMJ Open. 2016 Dec 16;6(12):e012890. doi: 10.1136/bmjopen-2016-012890.
The Baby Friendly Hospital Initiative (BFHI) is a practice guideline for healthcare providers to promote breastfeeding and increase breastfeeding rates.
This study aimed to examine reported experiences and views on breastfeeding of women using prenatal and postnatal services, and opinions of staff, in the context of the BFHI programme in Riyadh, Saudi Arabia.
Prospective cohort study.
This prospective, longitudinal study was conducted from December 2013 to September 2015 at two healthcare facilities (BFHI and non-BFHI) in Riyadh Saudi Arabia.
Women 36-40 weeks gestation receiving antenatal care at the hospitals were enrolled. Questionnaires were administered prenatally, at 1, 3 and 6 months postnatal and to the administrator and maternity staff.
We recruited 277 women with an estimated 80% response rate. 156 (BFHI=78/139, non-BFHI=78/138, 56%) participants completed all questionnaires. Most BFHI-hospital participants (77.9%, n=8 for this question) acknowledged seeing the breast feeding policy compared to 23.5% (n=23) at the non-BFHI-hospital (p<0.01). Breast feeding education and encouragement was higher at the BFHI-hospital (93.3%) compared to the non-BFHI-hospital (48.2%; p<0.01). At postpartum discharge, 51% (n=53) of mothers in the BFHI-hospital were breast feeding exclusively versus 29.6% (n=29) at the non-BFHI-hospital. Where formula feed was introduced, women in the BFHI-hospital more often practiced mixed feeding rather than exclusive formula feeding with some switching from mixed feeding to exclusive breast feeding between 3 and 6 months postpartum. Exclusive breast feeding rates declined in both hospitals at 3 and 6 months postpartum with lack of community services for lactation being a major reason. Although BFHI-hospital staff (n=9) were more conversant with BFHI principles, defects in adherence to the BFHI 10 Steps were identified.
This is the first study assessing the effectiveness of BFHI implementation in Saudi Arabia. Although women reported increased breast feeding rates, we identified important weaknesses that could be improved through strict compliance with BFHI practices.
爱婴医院倡议（BFHI）是一项针对医疗服务提供者的实践指南，旨在促进母乳喂养并提高母乳喂养率。
本研究旨在调查在沙特阿拉伯利雅得的爱婴医院倡议项目背景下，使用产前和产后服务的女性对母乳喂养的报告经历和看法，以及工作人员的意见。
前瞻性队列研究。
这项前瞻性纵向研究于2013年12月至2015年9月在沙特阿拉伯利雅得的两家医疗机构（爱婴医院和非爱婴医院）进行。
招募在医院接受产前护理、孕周为36 - 40周的女性。在产前、产后1个月、3个月和6个月对她们进行问卷调查，并对管理人员和产科工作人员进行问卷调查。
我们招募了277名女性，估计应答率为80%。156名（爱婴医院 = 78/139，非爱婴医院 = 78/138，56%）参与者完成了所有问卷。与非爱婴医院的23.5%（n = 23）相比，大多数爱婴医院的参与者（77.9%，该问题n = 8）承认看到了母乳喂养政策（p < 0.01）。爱婴医院的母乳喂养教育和鼓励程度（93.3%）高于非爱婴医院（48.2%；p < 0.01）。产后出院时，爱婴医院51%（n = 53）的母亲进行纯母乳喂养，而非爱婴医院为29.6%（n = 29）。在引入配方奶喂养的情况下，爱婴医院的女性更常采用混合喂养，而不是纯配方奶喂养，并且在产后3至6个月期间，一些女性从混合喂养转为纯母乳喂养。两家医院在产后3个月和6个月时纯母乳喂养率均下降，缺乏社区哺乳服务是主要原因。尽管爱婴医院的工作人员（n = 9）更熟悉爱婴医院倡议的原则，但在遵守爱婴医院倡议的10个步骤方面仍存在缺陷。
这是第一项评估沙特阿拉伯实施爱婴医院倡议有效性的研究。尽管女性报告母乳喂养率有所提高，但我们发现了一些重要的薄弱环节，可通过严格遵守爱婴医院倡议的做法加以改进。
