Kang Bee-Ah, Gonzalez-Nahm Sarah, Benjamin-Neelon Sara E
Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD21205, United States.
Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA01003, United States.
Public Health Nutr. 2025 Jan 7;28(1):e34. doi: 10.1017/S1368980024002635.
The Baby-Friendly Hospital Initiative (BFHI) designation is known to increase breast-feeding rates in the USA. However, less is known about barriers and facilitators to breast-feeding support practices in BFHI hospitals and how they differ from non-BFHI hospitals. We examined what barriers and facilitators are perceived to affect breast-feeding practices among BFHI and non-BFHI hospital administrators and further explored factors that presented challenges to the adoption and continuation of breast-feeding support practices.
Cross-sectional study was conducted. We measured whether hospitals were implementing 12 breast-feeding support practices and identified barriers and facilitators to the practices. The survey questionnaire included both structured and open-ended questions.
This study included hospital administrators from both BFHI and non-BFHI hospitals from all regions of the USA to help elucidate potential differences.
A stratified random sample of 50 % of BFHI and 50 % of non-BFHI hospitals was obtained. The final sample size included 113 BFHI and 177 non-BFHI hospital administrators.
Low interest among mothers was reported as the most significant barrier to providing breast-feeding support among all administrators. Non-BFHI hospital administrators were more likely to report cost, nursing staff and physician resistance and hospital infrastructure as barriers to initiating practices. In-person training was cited as the most important facilitator among both groups.
Strengthening prenatal education for mothers and trainings for administrative and nursing staff and physicians is warranted in BFHI and non-BFHI hospitals. Staff management and hospital infrastructure need to be improved particularly in non-BFHI hospitals to provide adequate breast-feeding support for mothers.
众所周知，爱婴医院倡议（BFHI）认证可提高美国的母乳喂养率。然而，对于爱婴医院母乳喂养支持措施的障碍和促进因素，以及它们与非爱婴医院有何不同，我们了解得较少。我们调查了爱婴医院和非爱婴医院的管理人员认为哪些障碍和促进因素会影响母乳喂养措施，并进一步探讨了对采用和持续实施母乳喂养支持措施构成挑战的因素。
开展横断面研究。我们衡量了医院是否实施12项母乳喂养支持措施，并确定了这些措施的障碍和促进因素。调查问卷包括结构化问题和开放式问题。
本研究纳入了来自美国所有地区的爱婴医院和非爱婴医院的管理人员，以帮助阐明潜在差异。
获得了50%的爱婴医院和50%的非爱婴医院的分层随机样本。最终样本量包括113名爱婴医院管理人员和177名非爱婴医院管理人员。
所有管理人员都报告称，母亲兴趣不高是提供母乳喂养支持的最主要障碍。非爱婴医院的管理人员更有可能将成本、护理人员和医生的抵触以及医院基础设施视为开展相关措施的障碍。两组人员都认为面对面培训是最重要的促进因素。
爱婴医院和非爱婴医院都有必要加强对母亲的产前教育以及对行政、护理和医疗人员的培训。尤其在非爱婴医院，需要改善人员管理和医院基础设施，以便为母亲提供充分的母乳喂养支持。
