The impact of the Baby-Friendly Hospital Initiative on breastfeeding rates at maternity units in France.

IF 6.4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH International journal of epidemiology Pub Date : 2024-04-11 DOI:10.1093/ije/dyae080
Andrea Guajardo-Villar, Camille Pelat, Beatrice Blondel, Elodie Lebreton, Virginie Demiguel, Benoit Salanave, Ayoub Mitha, Hugo Pilkington, Nolwenn Regnault
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Abstract

Background: The Baby-Friendly Hospital Initiative (BFHI) is associated with improved breastfeeding outcomes in many high-income countries including the UK and the USA, but its effectiveness has never been evaluated in France. We investigated the impact of the BFHI on breastfeeding rates in French maternity units in 2010, 2016 and 2021 to assess if the BFHI aids to reduce inequalities in breastfeeding.

Methods: We examined breastfeeding in maternity units (exclusive, mixed and any breastfeeding) in mothers of singleton full-term newborns using the 2010 (n = 13 075), 2016 (n = 10 919) and 2021 (n = 10 209) French National Perinatal Surveys. We used mixed-effect hierarchical multinomial regression models adjusting for neonatal, maternal, maternity unit and French administrative department characteristics, and tested certain interactions.

Results: The adjusted rate of exclusive breastfeeding was higher by +5.8 (3.4-8.1) points among mothers delivering in BFHI-accredited maternity units compared with those delivering in non-accredited units. When compared with average-weight newborns, this difference was sharper for infants with low birthweight: +14.9 (10.0-19.9) points when their birthweight was 2500 g. Mixed breastfeeding was lower by -1.7 points (-3.2-0) in BFHI-accredited hospitals, with no notable difference according to the neonatal or maternal characteristics.

Conclusion: Mothers delivering in BFHI-accredited maternity units had higher exclusive breastfeeding rates and lower mixed breastfeeding rates than those delivering in non-accredited maternity units. The positive impact of the BFHI was stronger among low-birthweight neonates, who are less often breastfed, helping reduce the gap for this vulnerable group while favouring mothers with higher education levels.

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爱婴医院倡议对法国产科医院母乳喂养率的影响。
背景:在包括英国和美国在内的许多高收入国家,"爱婴医院倡议"(BFHI)与母乳喂养效果的改善息息相关,但在法国却从未对其效果进行过评估。我们调查了 2010 年、2016 年和 2021 年 BFHI 对法国产科医院母乳喂养率的影响,以评估 BFHI 是否有助于减少母乳喂养中的不平等现象:我们利用 2010 年(n = 13 075)、2016 年(n = 10 919)和 2021 年(n = 10 209)法国全国围产期调查对产科医院中单胎足月新生儿母亲的母乳喂养情况(纯母乳喂养、混合母乳喂养和任何母乳喂养)进行了调查。我们使用了混合效应分层多项式回归模型,对新生儿、产妇、产科和法国行政部门的特征进行了调整,并检验了某些交互作用:调整后的纯母乳喂养率在获得 BFHI 认证的产科医院与未获得认证的产科医院相比高出 +5.8(3.4-8.1)个百分点。与平均体重的新生儿相比,低出生体重儿的这一差异更为明显:当新生儿出生体重为 2500 克时,差异为 +14.9(10.0-19.9)分。在通过 BFHI 认证的医院中,混合母乳喂养率较低,为-1.7 个点(-3.2-0),新生儿或产妇特征方面的差异并不明显:结论:与未通过 BFHI 认证的产科医院相比,在通过 BFHI 认证的产科医院分娩的母亲纯母乳喂养率较高,混合母乳喂养率较低。母乳喂养婴儿倡议对低体重新生儿的积极影响更大,因为这些新生儿较少接受母乳喂养,这有助于缩小这一弱势群体的差距,同时有利于教育水平较高的母亲。
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来源期刊
International journal of epidemiology
International journal of epidemiology 医学-公共卫生、环境卫生与职业卫生
CiteScore
13.60
自引率
2.60%
发文量
226
审稿时长
3 months
期刊介绍: The International Journal of Epidemiology is a vital resource for individuals seeking to stay updated on the latest advancements and emerging trends in the field of epidemiology worldwide. The journal fosters communication among researchers, educators, and practitioners involved in the study, teaching, and application of epidemiology pertaining to both communicable and non-communicable diseases. It also includes research on health services and medical care. Furthermore, the journal presents new methodologies in epidemiology and statistics, catering to professionals working in social and preventive medicine. Published six times a year, the International Journal of Epidemiology provides a comprehensive platform for the analysis of data. Overall, this journal is an indispensable tool for staying informed and connected within the dynamic realm of epidemiology.
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