School of Health Sciences, University of Dundee, Dundee, UK.
Centre for Health Services Studies, University of Kent, Canterbury, Kent, UK.
Matern Child Nutr. 2023 Jan;19 Suppl 1(Suppl 1):e13304. doi: 10.1111/mcn.13304. Epub 2022 Jan 11.
Despite strong policy support in Scotland, United Kingdom, key challenges to scaling up promotion, protection and support for breastfeeding remain. These include low breastfeeding rates and socioeconomic and regional inequalities. The Becoming Breastfeeding-Friendly (BBF) process was implemented to highlight actions that could address these challenges. The Scottish BBF committee employed an iterative process of documentary analysis and evidence reviews supplemented by 18 interviews with key informants. The data were mapped to BBF benchmarks and each gear was scored accordingly. Nineteen draft recommendations addressing policy and practice gaps were prioritised. Ten recommendations were grouped into eight themes, which cross-cut the BBF gears. The process took place from May 2018 to May 2019. The overall BBF Index score for Scotland was 2.4 indicating a strong scaling-up environment for breastfeeding. Five gears were assessed as strong gear strength, and the remaining three were judged as moderate gear strength. Three recommendation themes illuminate strengths and areas for development. The theme 'reinforcing political will' showed effective leadership, strong policies and significant investment in supporting breastfeeding and highlights actions to sustain this. The theme 'strengthening and coordinating breastfeeding messages' revealed a need for coordination between government, health services and the third sector. The theme 'promoting a supportive return to work environment' highlighted that, while employment legislation is not devolved to the Scottish government, action could be taken by employers to optimise an enabling environment for breastfeeding. The BBF process identified strengths and triggered actions to enhance breastfeeding promotion, protection and support in Scotland.
尽管英国苏格兰有强有力的政策支持，但在推广、保护和支持母乳喂养方面仍面临一些关键挑战。这些挑战包括母乳喂养率低、社会经济和地区不平等。为了解决这些挑战，推行了“成为母乳喂养友好型（BBF）”的过程。苏格兰 BBF 委员会采用迭代的文档分析和证据审查过程，并辅以对 18 名主要知情人的访谈。将数据映射到 BBF 基准上，并根据每个齿轮进行相应评分。19 项针对政策和实践差距的建议草案被优先排序。10 项建议分为 8 个主题，涵盖了 BBF 齿轮。该过程于 2018 年 5 月至 2019 年 5 月进行。苏格兰的整体 BBF 指数得分为 2.4，表明母乳喂养的推广环境很强劲。五个齿轮被评估为强齿轮强度，其余三个被评为中齿轮强度。三个建议主题突出了优势和发展领域。“加强政治意愿”主题展示了有效的领导力、强有力的政策和对支持母乳喂养的大量投资，并强调了维持这一工作的行动。“加强和协调母乳喂养信息”主题揭示了政府、卫生服务和第三部门之间需要协调。“促进支持性的重返工作环境”主题强调，虽然就业立法没有下放到苏格兰政府，但雇主可以采取行动，为母乳喂养创造有利环境。BBF 过程确定了优势，并引发了行动，以加强苏格兰的母乳喂养推广、保护和支持。
