BFHI News Brief: News From the Baby-Friendly Hospital Initiative Network

Abstract

The last meeting of The Network took place June 2018 in Steenwijk, Netherlands. It was the tenth face-to-face meeting of national coordinators and focal points (persons representing countries with no official BFHI organizations) from up to 47 industrialized countries. The Network has shared mutual information through an informal survey every 2 years since 2006. Representatives from Australia, Belarus, Belgium, Canada, Croatia, Denmark, Estonia, Finland, France, Georgia, Germany, Greece, Hong Kong, Ireland, Israel, Italy, Japan, Kazakhstan, Korea (Republic), Kosovo, Kuwait, Lithuania, Luxembourg, Macedonia, Malta, The Netherlands, New Zealand, Norway, Poland, Portugal, Qatar, Romania, Russian Federation, Serbia, Singapore, Slovenia, Spain, Sweden, Switzerland, Taiwan, Turkey, Ukraine, United Kingdom, USA, and Uzbekistan have shared and exchanged experiences, barriers and achievements in the implementation of the Baby-Friendly Initiative to further promote BFHI and support each other. This article presents some of the results of the 2018 survey that collected data from 30 of those countries. The countries in The Network are in the medium-high gross domestic product range. They differ on many aspects but share similar challenges related to infant nutrition. The delivery of health services is national in 57% of the countries, regional in 23%, and 13% have both. Total annual births vary from 4000 in Malta to nearly four million in the USA. Most births occur in hospital maternities (number of facilities ranging from three to 3,100). Few women give birth in non-hospital maternities (number of birthing centers ranging from 0 to 125). The mean duration of hospital stay is 2.39 days (range 1 to 5.8) for vaginal births and 3.8 days (range 2 to 7.8 days) for caesareans. Surveillance data on infant feeding is collected periodically in 94% (29/31) of the countries, 73% of them collecting national data and two collecting data only at facility level. Periods between data collection vary from 1 to 10 years. However, recommended WHO global breastfeeding indicators are not available in many countries. Twenty-three countries (74%) reported first-hour breastfeeding initiation rate (range 11 to 99%) and only 17 (54%) knew their exclusive breastfeeding (EBF) from birth-to-discharge rate (range 31 to 94% with a mean of 64%). Some countries report “at 6 months” EBF rates while others report “from birth-to-6 months” EBF rates; an average of these was calculated resulting in a 24% average EBF rate “at or for the first 6 months” (range 0.8 to 54.7%). The average for breastfeeding mean duration was 7 months (range 4 to 9.5 months) among the 14 countries collecting this data. These data show that there is still work to be done to achieve recommended breastfeeding rates. Furthermore, tracking progress for the BFHI and other global breastfeeding initiatives is difficult unless unified breastfeeding indicators are collected worldwide. This brief summary shows the diversity within industrialized countries which otherwise seem to share many similarities in how they protect and promote mother and infant health through the implementation of the BFHI. More results pertaining to the implementation of the BFHI will be shared in the next report.