Feldman-Winter Lori, Ustianov Jennifer, Anastasio Julius, Butts-Dion Sue, Heinrich Patricia, Merewood Anne, Bugg Kimarie, Donohue-Rolfe Sarah, Homer Charles J
Department of Pediatrics, Children's Regional Hospital at Cooper-Cooper Medical School of Rowan University, Camden, New Jersey;
National Institute for Children's Health Quality, Boston, Massachusetts.
Pediatrics. 2017 Jul;140(1). doi: 10.1542/peds.2016-3121. Epub 2017 Jun 7.
In response to a low number of Baby-Friendly-designated hospitals in the United States, the Centers for Disease Control and Prevention funded the National Institute for Children's Health Quality to conduct a national quality improvement initiative between 2011 and 2015. The initiative was entitled Best Fed Beginnings and enrolled 90 hospitals in a nationwide initiative to increase breastfeeding and achieve Baby-Friendly designation.
The intervention period lasted from July 2012 to August 2014. During that period, data on process indicators aligned with the Ten Steps to Successful Breastfeeding and outcome measures (overall and exclusively related to breastfeeding) were collected. In addition, data on the Baby-Friendly designation were collected after the end of the intervention through April 2016. Hospitals assembled multidisciplinary teams that included parent partners and community representatives. Three in-person learning sessions were interspersed with remote learning and tests of change, and a Web-based platform housed resources and data for widespread sharing.
By April 2016, a total of 72 (80%) of the 90 hospitals received the Baby-Friendly designation, nearly doubling the number of designated hospitals in the United States. Participation in the Best Fed Beginnings initiative had significantly high correlation with designation compared with hospital applicants not in the program (Pearson's [235]: 0.80; < .01). Overall breastfeeding increased from 79% to 83% ( = 1.93; = .057), and exclusive breastfeeding increased from 39% to 61% ( = 9.72; < .001).
A nationwide initiative of maternity care hospitals accomplished rapid transformative changes to achieve Baby-Friendly designation. These changes were accompanied by a significant increase in exclusive breastfeeding.
鉴于美国爱婴医院数量较少，疾病控制与预防中心资助美国国家儿童健康质量研究所于2011年至2015年开展了一项全国性质量改进倡议。该倡议名为“最佳喂养开端”，在全国范围内招募了90家医院，以增加母乳喂养并获得爱婴医院称号。
干预期从2012年7月持续至2014年8月。在此期间，收集了与成功母乳喂养十步骤相一致的过程指标数据以及结局指标（总体和仅与母乳喂养相关的）。此外，在干预结束后至2016年4月期间收集了爱婴医院称号的数据。医院组建了包括家长合作伙伴和社区代表在内的多学科团队。三次面对面学习课程穿插着远程学习和变革测试，一个基于网络的平台存储了资源和数据以供广泛共享。
到2016年4月，90家医院中有72家（80%）获得了爱婴医院称号，使美国指定医院的数量几乎翻了一番。与未参与该项目的医院申请者相比，参与“最佳喂养开端”倡议与获得称号的相关性显著更高（Pearson's [235]：0.80；<0.01）。总体母乳喂养率从79%提高到83%（=1.93；=0.057），纯母乳喂养率从39%提高到61%（=9.72；<0.001）。
一项针对产科医院的全国性倡议实现了快速变革，以获得爱婴医院称号。这些变革伴随着纯母乳喂养率的显著提高。
