Journal of human lactation : official journal of International Lactation Consultant Association
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Despite growing evidence for the positive impact of the Baby-Friendly Initiative (BFI) on breastfeeding outcomes, few studies have investigated the barriers and facilitators to the implementation of Baby-Friendly practices that can be used to improve uptake of the BFI at the local or country levels. This integrative review aimed to identify and synthesize information on the barriers, facilitators, and recommendations related to the BFI from the international, peer-reviewed literature. Thirteen databases were searched using the keywords Baby Friendly, Baby-Friendly Hospital Initiative, BFI, BFHI, Ten Steps, implementation, adoption, barriers, facilitators, and their combinations. ⋯ A wide variety of obstacles and potential solutions to BFI implementation were identified. Findings suggest some priority issues to address when pursuing Baby-Friendly designation, including the endorsements of both local administrators and governmental policy makers, effective leadership of the practice change process, health care worker training, the marketing influence of formula companies, and integrating hospital and community health services. Framing the BFI as a complex, multilevel, evidence-based change process and using context-focused research implementation models to guide BFI implementation efforts may help identify effective strategies for promoting wider adoption of the BFI in health services.
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The Baby-Friendly Hospital Initiative began in 1991. In 2010, approximately 3% of United States (US) hospitals were Baby-Friendly certified. When collecting data for related studies, we noted that many maternity staff erroneously claimed their hospital was Baby-Friendly.™ ⋯ Although the Baby-Friendly Hospital Initiative was established over 20 years ago, most US maternity staff responding to a telephone survey either incorrectly believed their hospital to be Baby-Friendly certified or were unaware of the meaning of "Baby-Friendly hospital."
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The Baby-Friendly Hospital Initiative (BFHI), developed by the World Health Organization and the United Nations Children's Fund (UNICEF) to promote breastfeeding in maternity facilities worldwide, has had a global impact on breastfeeding outcomes, but other interventions are needed both before and after hospital discharge to meet the recommended targets at 6 months. The Baby-Friendly Community Initiative (BFCI), a multifaceted program for community-based breastfeeding promotion that is complementary to the BFHI, addresses this challenge. ⋯ The BFCI, a complex program that involves participation, training, audits, a continuous flow of feedback, and provision of resources for health workers and families, is now a reality in Italy.
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In June 2010, the Communities Putting Prevention to Work program (Centers for Disease Control and Prevention) funded a New Jersey (NJ) Office on Nutrition and Fitness, Department of Health and Senior Services project to reduce obesity and increase exclusive breastfeeding by increased implementation of the Baby-Friendly Hospital Initiative in the state of NJ. At baseline, NJ had no Baby-Friendly hospitals and no hospital was using an infant feeding policy that conformed to standards required by Baby-Friendly USA for designation. ⋯ A collaborative initiative can use a single breastfeeding policy template as an aid toward Baby-Friendly designation. Such work streamlines the process and saves time and resources.
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Use of videoconferencing technology for healthcare intervention and support is an area of tremendous potential, especially in regard to application in rural or underserved communities. Potential for cost-savings, time-savings, and increased access to care are the ultimate driving force behind use of this technology, for both providers and recipients of healthcare services. Recently, the Federal Government has initiated rulings to support the increased use of computer technology in underserved areas. Therefore, exploring novel applications of the technology of videoconferencing is timely. Remote lactation consultation may be one such novel application. ⋯ Emergent themes were grounded in existing literature, and potential scales were identified to assist with development of a future tool to test the theoretical model. Responses to the videoconferencing experience were positive, but preferred use of the technology was situational.