Breastfeeding in Hospitals: Factors Influencing Maternal Choice in Italy

Monitoring the prevalence of breastfeeding is one of the actions provided for in Italian National Health System. This study aims to observe the prevalence of breastfeeding in a representative set of birthing hospitals in the province of Catania, in Sicily, Italy, to assess the factors influencing women in their decisions to breastfeed during hospitalization after delivery. We conducted an observational study on 3813 questionnaires administered to mothers of newborns during their hospital stay from the years 2016 to 2018 in eight hospitals of various types. The average maternal age was 31.3 years ± 5.8. Sixty-nine percent of women did not attend a prenatal course. From childbirth to discharge, the percentage of women who breastfed was 88%, of whom 45% did exclusive breastfeeding. Only 35% of women who had a caesarean section adopted exclusive breastfeeding. In our experience, rooming-in was not associated with an increase in breastfeeding. We observed that both attendance to prenatal courses and the mother’s education level played a minor role in influencing the mother’s decision in breastfeeding A fairly high percentage of exclusive breastfeeding, 75%, was attained just in one hospital, where dedicated staff was deployed to encourage breastfeeding. The lowest percentage (12%) of exclusive breastfeeding was observed in a large private accredited health facility. Hospital presence of professionals trained in human lactation is a smart investment for society.

Assessing Barriers to Implement Birth Kangaroo Care in Kentucky Birthing Hospitals

IntroductionKentucky continues to have one of the lowest state breastfeeding rates in the country. In 2014, the majority of the birthing hospitals in Kentucky implemented a practice change to the healthcare model known as Birth Kangaroo Care (BKC) as an effort to increase breastfeeding initiation. The goal of this study was to identify current practices and barriers to implementing BKC.MethodsAn evaluation/surveillance study that incorporated an Internet survey to collect information about the practices and policies of BKC in birthing hospitals in Kentucky was completed.FindingsThe response rate was 54% (n = 25). The birthing hospitals responders to the survey (84%) reported that a BKC policy was established after the educational intervention. Data identified two perceived barriers regarding uninterrupted BKC. One barrier was the interruption by family members to hold the newborn, and the second was a delay in BKC for medical evaluations of the baby by staff members.ConclusionBreastfeeding rates after implementation of the BKC policy in Kentucky birthing hospitals showed a statistically significant (p = .02) improvement of “ever breastfed” infants.

Safe Sleep Practices of Kansas Birthing Hospitals

Introduction. Sleep-related death is tied with congenital anomaliesas the leading cause of infant mortality in Kansas, and externalrisk factors are present in 83% of these deaths. Hospitals can impactcaregiver intentions to follow risk-reduction strategies. This projectassessed the current practices and policies of Kansas hospitals withregard to safe sleep. Methods. A cross-sectional survey of existing safe sleep practicesand policies in Kansas hospitals was performed. Hospitals were categorizedbased on reported delivery volume and data were comparedacross hospital sizes. Results. Thirty-one of 73 (42%) contacted hospitals responded. Individualsurvey respondents represented various hospital departmentsincluding newborn/well-baby (68%), neonatal intensive care unit(3%) and other non-nursery departments or administration (29%).Fifty-eight percent of respondents reported staff were trained oninfant safe sleep; 44% of these held trainings annually. High volumehospitals tended to have more annual training than low or mid volumebirth hospitals. Thirty-nine percent reported a safe sleep policy,though most of these (67%) reported never auditing compliance. Thetop barrier to safe sleep education, regardless of delivery volume, wasconflicting patient and family member beliefs. Conclusions. Hospital promotion of infant safe sleep is being conductedin Kansas to varying degrees. High and mid volume birthhospitals may need to work more on formal auditing of safe sleeppractices, while low volume hospitals may need more staff training.Low volume hospitals also may benefit from access to additional caregivereducation materials. Finally, it is important to note hospitalsshould not be solely responsible for safe sleep education.KS J Med 2018;11(1):1-4.

Baby-Friendly Hospital Initiative and Breastfeeding Among WIC-Participating Infants in Los Angeles County

Background: Breastfeeding rates among low-income infants lag behind national rates. Policies such as the Baby-Friendly Hospital Initiative (BFHI) improve breastfeeding and may benefit low-income populations such as those who participate in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). A recent effort exists to increase the number of Baby-Friendly designated hospitals in Los Angeles County (LAC). Research aim: This study aimed to determine whether the BFHI effort has had a beneficial effect on Baby-Friendly hospital practices in LAC hospitals and to determine if birthing hospitals’ Baby-Friendly designation status is associated with breastfeeding outcomes among WIC-participating children in LAC. Methods: Data came from the Los Angeles County WIC Survey (2008, 2011, 2014), which is conducted on a random sample of approximately 5,000 WIC families living in LAC. The prevalence of three Baby-Friendly hospital practices was examined between 2008 and 2014. Logistic regression was used to examine the association of birthing hospitals’ Baby-Friendly designation status with any breastfeeding and exclusive breastfeeding at 1, 3, and 6 months. Results: The rates of Baby-Friendly hospital practices have improved since 2008. Although no association existed with rates of any breastfeeding, being born in a hospital designated Baby-Friendly or in the process of obtaining this designation was significantly associated with an increased odds of exclusive breastfeeding at 1 and 3 months. Conclusion: The BFHI may help achieve recommended exclusive breastfeeding rates, especially for low-income populations. Additional strategies are needed to support low-income mothers in LAC with all levels of breastfeeding.