Research published this week has found that UK mothers delivering in Baby Friendly accredited hospitals are 10% more likely to initiate breastfeeding (after adjustment for confounding variables) than those who deliver in non-accredited units or units with a Certificate of Commitment (1). The study, part of the Millennium Cohort Study of 18 819 children, concurs with routinely collected data from Scotland which found that Baby Friendly accreditation increases breastfeeding rates by 8% at 7 days post delivery (2). These findings confirm that the UNICEF Baby Friendly Initiative is the first ever national intervention to have a positive effect on breastfeeding rates in the UK. However, the study found that Baby Friendly hospital accreditation is not associated with an increase in breastfeeding at one month of age and the authors call for further interventions to help mothers sustain breastfeeding.
The Baby Friendly community service award was introduced in May 1998 in order to extend the principles of the programme and the Ten Steps to primary care facilities (3). Evidence from the PROBIT trial in Belarus suggests that a primary care component to the Baby Friendly programme is an important element in maintaining the increases in breastfeeding delivered by the maternity component (4). The extension of the initiative to the community services may therefore provide an essential structured breastfeeding support intervention beyond the hospital setting. Individual case studies from accredited primary care facilities report that increases in breastfeeding continuation are linked to gaining the Baby Friendly award (5). However, a full evaluation of the effectiveness of support provided by accredited community facilities is required. Full evaluation of the establishment of post-natal breastfeeding support groups (Step 10) and local peer support programmes and the effectiveness of ‘packages’ of interventions to increase breastfeeding duration are also required (6).
1. Bartington S, Griffiths L, Tate A, Dezateux C and the Millennium Cohort Study Child Health Group. Are breastfeeding rates higher among mothers delivering in Baby Friendly accredited maternity units in the UK? International Journal of Epidemiology. doi:10.1093/ije/dyl155 [Abstract]
2. Broadfoot M, Britten J, Tappin DM and MackKenzie JM. The Baby Friendly Initiative and breastfeeding rates in Scotland. Arch Dis Child Fetal Neonatal Ed. 2005;90:114-116 [Abstract]
3. UNICEF UK Baby Friendly Initiative. The Baby Friendly initiative in the community – an implementation guide. London: Unicef UK Baby Friendly, 1999 [Link]
4. Kramer M, Chalmers B, Hodnett E, Sevkovskaya E, Dzihovich I, Shapiro S, et al. The Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the republic of Belarus. JAMA 2001;285:413-20 [Abstract]
5. UNICEF UK Baby Friendly Initiative. The effectiveness of Baby Friendly accreditation in increasing breastfeeding rates [Link]
6. Dyson L, Renfrew M, McFadden A, McCormack F, Herbert G, Thomas J. Promotion of breastfeeding initiation and duration. Evidence into practice briefing. NICE, 2006 [Link]
