Scoping Review of Baby-Friendly Hospital Initiative Compliance and Breastfeeding Initiation in Sri Lanka.

OBJECTIVE

To synthesize the evidence for associations between Baby-Friendly Hospital Initiative (BFHI) compliance and breastfeeding initiation in Sri Lanka.

DATA SOURCES

We searched PubMed, ProQuest, Scopus, Embase, MEDLINE, and CINAHL using various Boolean operators for multiple search terms. Studies conducted in Sri Lankan published in English from April 1, 2000, to April 30, 2020 were considered. We also searched Sri Lankan government and international organization websites and hand-searched reference lists of the included documents.

STUDY SELECTION

We screened the titles and abstracts of 99 records and retrieved 31 documents for review and assessment. We selected 24 documents, including the full texts of primary research articles, reviews, discussions, letters to the editor, and government reports if they specifically addressed breastfeeding initiation and BFHI compliance in Sri Lanka.

DATA EXTRACTION

We extracted the data for author(s), year of publication, study setting, study design, aims of the study, population and sample size, inclusion and exclusion criteria, data collection methods, participant response rate, prevalence, associated factors of breastfeeding initiation, and BFHI compliance and its contributing factors if they were available depending on the type of document.

DATA SYNTHESIS

We synthesized the data narratively to address the research questions. We identified contradicting reports of the prevalence of breastfeeding initiation (23.5%-100%) across Sri Lankan hospitals. Breastfeeding initiation was significantly associated with mode of birth. We identified inconsistent compliance with the BFHI, and poor compliance was associated with inadequate staff training and ineffective monitoring systems.

CONCLUSION

We found inadequate evidence to clarify the association between BFHI compliance and breastfeeding initiation in Sri Lanka. It is therefore not possible to conclude whether adherence to Baby-Friendly care is optimizing breastfeeding initiation in Sri Lanka.