Campbell H, Gorman D, Wigglesworth A
Fife Joint Breastfeeding Initiative, Fife Health Board, Cupar.
J Public Health Med. 1995 Dec;17(4):450-4.
The objective of this study was to assess the level of support given to breastfeeding mothers during their stay in maternity hospitals. The audit was carried out in maternity hospitals in Fife with the co-ordination of the Fife Joint Breastfeeding initiative.
The subjects consisted of ten maternity hospital staff (medical and midwifery), and 12 antenatal and 21 postnatal women. The design of the study consisted of an audit of hospital policies and practices in comparison with ten internationally recognized standards. This was carried out by adapting the external evaluation instruments from the WHO-UNICEF "Baby Friendly Hospital" materials. Methods relied not only on reported practices but also on direct observation and enquiry.
Action was taken to address areas of practice which fell below the WHO-UNICEF standards: supplementary feeding of breastfed babies, particularly overnight, was reduced; discharge "bounty packs" advertising baby milk manufacturer products were discontinued; a hospital breastfeeding support group was established; the hypoglycaemia policy was revised; and the need for an orientation session on breastfeeding policies for medical staff was recognized.
This audit approach using "Baby Friendly Hospital' materials has helped to define policy, measure performance against recognized standards, identify quality specifications for maternity service agreements and has improved hospital support for breastfeeding mothers. This approach is suitable for maternity hospitals whose breastfeeding rates make them ineligible for "Baby Friendly Hospital" accreditation, and has the potential to be extended to encompass wider "health-promoting hospital" issues such as promotion of infant car seats.
本研究的目的是评估产妇在妇产医院住院期间获得的母乳喂养支持水平。此次审核在法夫郡的妇产医院进行，由法夫郡联合母乳喂养倡议组织协调开展。
研究对象包括十名妇产医院工作人员（医生和助产士）、12名产前女性和21名产后女性。研究设计包括对照十项国际公认标准对医院政策和做法进行审核。这是通过改编世界卫生组织-联合国儿童基金会“爱婴医院”材料中的外部评估工具来进行的。方法不仅依赖于报告的做法，还包括直接观察和询问。
针对不符合世界卫生组织-联合国儿童基金会标准的做法采取了行动：减少了对母乳喂养婴儿的补充喂养，尤其是夜间补充喂养；停止发放宣传婴儿奶粉制造商产品的出院“礼品包”；成立了医院母乳喂养支持小组；修订了低血糖政策；认识到有必要为医务人员举办一次关于母乳喂养政策的培训课程。
这种使用“爱婴医院”材料的审核方法有助于明确政策、对照公认标准衡量绩效、确定产科服务协议的质量规范，并改善了医院对母乳喂养母亲的支持。这种方法适用于母乳喂养率使其不符合“爱婴医院”认证资格的妇产医院，并且有可能扩展到涵盖更广泛的“促进健康医院”问题，如推广婴儿汽车安全座椅。
