337804
Baby Friendly Hospital Initiative and breastfeeding duration: An analysis of the Pregnancy Risk Assessment Monitoring System
Baby Friendly Hospital Initiative (BFHI) certified hospitals meet specific criteria to enable successful breastfeeding. While BFHI is associated with increased breastfeeding rates, its various constructs have not been studied. This study examined the underlying factor structure of BFHI and its association with duration of any breastfeeding among infants who were ever breastfed.
METHODS
We analyzed data on seven of the ten steps of BFHI using 12,436 infants from the 2009-2011 Pregnancy Risk Assessment Monitoring System. Analyses included exploratory factor analysis (EFA) using varimax orthogonal transformation and weighted crude and multivariable linear regression.
RESULTS
EFA yielded a factor structure for two constructs – staff and hospital. The staff factor loaded highest for: staff providing breastfeeding information (0.58), helping mothers with breastfeeding (0.55), giving mothers a number to call for help with breastfeeding (0.38), and infant being breastfed on demand (0.32). The hospital factor had highest loadings for: infant being fed only breastmilk at the hospital (0.64), breastfeeding being initiated within an hour after birth (0.54), infant being breastfed in mother’s room (0.44), and hospital not providing gift packs with formula (0.37). Adjusted weighted linear regression analyses revealed a positive association between hospital factor (β coefficient = 6.86, p <0.001) with duration of any breastfeeding, but no significant association of staff factor with duration of any breastfeeding (β coefficient = -0.51, p = 0.38).
CONCLUSIONS
The success of implementing the steps of BFHI may require more support at the organizational level practices and policies rather than at the level of individual staff members.
Learning Areas:
Public health or related researchLearning Objectives:
Identify the factor structure of the Baby Friendly Hospital Initiative (BFHI)
Assess whether the factors for BFHI are independently associated with duration of any breastfeeding among infants who were ever breastfed
Keyword(s): Breastfeeding
Qualified on the content I am responsible for because: I have experience in clinical pediatrics, an MPH degree in maternal and child health, and have authored a paper on breastfeeding.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.