CHANGING HOSPITAL PRACTICES TO INCREASE THE DURATION OF BREAST-FEEDING

Objective. To change the breastfeeding policy in a university teaching hospital in accord with the Ten Steps to Successful Breastfeeding of the United Nations Children's Fund and World Health Organization and t o assess the impact of hospital practices on the duration of breastfee ding. Methods. One hundred ninety-two and 392 postpartum women in a ma ternity ward were interviewed in 1990 and 1993, respectively, regardin g how they were feeding their infants and feeding practices in the hos pital. Between these two periods, the hospital infant-feeding policy w as reviewed and revised in accord with the Ten Steps. Two hundred seve nty of the mothers interviewed in 1993 were interviewed again when the ir infants were 4 months old regarding the duration of full and partia l breastfeeding. Results. By 1993, more newborns were put to the breas t in the first hour of life (63.2% vs 24.8%); fewer breastfed infants were fed foods other than breast milk (27.9% vs 46.7%); and more mothe rs received breastfeeding guidance from hospital staff (81.9% vs 61.3% ). The duration of breastfeeding in 1993 was longer for women who did not receive formula in the hospital, who were not given discharge pack s containing formula and/or coupons, and who roomed-in more than 60% o f the time. These associations persisted after controlling for confoun ding. Conclusion. Infant-feeding policies and practices are amenable t o change, and policies such as the Baby-Friendly Hospital Initiative m ay contribute to an increase in the duration of breastfeeding.