A comparison of exclusive breastfeeding in Belgian maternity facilities with and without Baby‐friendly Hospital status

A retrospective cross‐sectional study was carried out in Wallonia (the southern region of Belgium) in which a 20‐question breastfeeding (BF) module was included in an immunization survey. The purpose of this paper is to compare exclusive breastfeeding (EBF) prevalences and BF practices for mothers giving birth in Baby‐friendly Hospital Initiative (BFHI) and non‐BFHI maternity facilities. A total of 557 mothers responded to BF questions when their child was 18–24 months old; 26.7% of them delivered in a BFHI maternity facility. At discharge, a larger proportion of children were exclusively breastfed if they were born in a BFHI maternity facility (76.5% vs. 65.8%, p = .02). The median duration of EBF (15.0 vs. 12.9 weeks, p = .3), and the proportion of children exclusively breastfed at 5 months (16.8% vs 15.8%, p = 1.0) were similar in both groups. Few mothers knew that EBF was recommended for the first 6 months of life (28.6% in BFHI vs 23.1% in non‐BFHI, p = .2). For most groups of the population examined, the rates of BF tended to be higher in BFHI facilities, but many differences were not significant. More specifically, BFHI seemed to boost BF practices among mothers more likely to breastfeed, but the Initiative did not seem to trigger enhanced BF practices in mothers traditionally less likely to breastfeed (except for indifferent/negative partner's attitude and mothers of Belgian origin). Influencing the BF practices of mothers less likely to breastfeed requires a special attention with complementary actions in maternity facilities as well as in community services.     

Friendly骨水泥股骨假体在老年股骨颈骨折假体置换术中的应用

目的探讨使用Friendly骨水泥股骨假体在老年股骨颈骨折假体置换中的应用。方法2002年6月～2004年6月我科因股骨颈骨折使用Friendly股骨假体行髋关节假体置换的老年患者(68～85岁)共31例,股骨假体固定采用第四代骨水泥技术,分析其临床效果。结果术后随访3个月,根据髋关节X线片,评价骨水泥质量A级29例、B级2例、无C、D级。所有患者均无髋关节脱位发生。所有患侧髋关节Trende-lenburg试验均为阴性。双下肢长度差异为(3.4±1.8)mm。术后3个月髋关节Harris评分为85±10。结论Friendly骨水泥股骨假体通过其在假体设计和假体固定上的改进可以比较好地解决老年人股骨颈骨折假体置换中所遇到的软组织平衡困难和假体固定困难等问题。     

The Baby Friendly Hospital Initiative in Canada: Some Observations

There are now approximately 8,000 hospitals around the world which have been accredited as Baby Friendly.¹ There are approximately 30 in Norway and around 50 in Turkey and in Sweden. Over 170 countries around the world have embraced the movement.Canada endorses the Baby Friendly Hospital Initiative (BFHI) as well as the Code of Marketing of Breastmilk Substitutes, and there are several organizations, hospitals, and groups trying to achieve this recognition. Yet there is still not one Baby Friendly Hospital in Canada.This commentary reflects questions raised during the Society of Obstetricians and Gynaecologists of Canada 1996 Conference in Quebec City on the current state of breastfeeding promotion in Canada in relation to world trends. It is not a formal review (although available Canadian reviews are acknowledged) but a comment which highlights some challenges faced by breastfeeding advocates in the Canadian setting.     

思密达治疗新生儿母乳性黄疸的研究

目的:探索出一种不中断母乳喂养、不需住院、简便有效的治疗母乳性黄疸的方法。方法:将84例足月正常体重、中度母乳性黄疸的患儿随机分成3个治疗亚组,思密达组、光疗组、鲁米那一可拉明组对照比较其疗效和对母乳喂养的影响,并检测母乳和新生儿粪便中β-葡萄糖醛酸苷酶(β-GD)的活性浓度,探讨思密达治疗母乳性黄疸的机理。结果:思密达治疗母乳性黄疸的疗效介于光疗与鲁米那一可拉明之间。每日平均胆红素下降的幅度36.36±10.12μmol／L,平均疗程为4.82±1.10 d,7 d治愈率为100％。结论:思密达治疗母乳性黄疸,安全有效,不需中断母乳喂养,有利于巩固爱婴医院成果。β-GD不是母乳性黄疸发病的主要机制,也不是通过影响β-GD而起作用。     

青少年生育健康友好服务方式探讨及效果评价

目的探讨发展以青少年为中心的适宜服务方式，评价青春期门诊服务的实际利用情况及效果。方法采用定性与定量研究相结合方法，对青少年门诊就诊和咨询的人数、年龄、性别、文化程度的分布，分析就诊和咨询原因及咨询者满意度进行调查。结果就诊和咨询人数以女性为主，占90．1％(2878／5897)，年龄以15岁～、20岁～组为主，分别占40．3％(2638／6542)、45．6％(2981／6542)。随文化程度增高，就诊和咨询人数增加，就诊和咨询者80．0％以上是学生；就诊和咨询原因前三位为月经问题，生殖器宫疾病及早孕和流产；99．0％(107／108)的就诊和咨询者对服务和环境表示满意。结论有效地改善青少年门诊的服务内容、服务程序以及服务环境，可以明显增进青少年对门诊服务的利用，应结合中国国情推广青少年友好服务的理念与模式。     

政府行为是爱婴行动成功的保证

大连市政府以政府行为组织、实施创建爱婴市活动，为“母亲安全，儿童健康”营造良好的社会氛围。在爱婴行动中，以政府行为为保障，成立了由大连市妇女儿童工作委员会牵头的市创建爱婴市领导小组，市长亲自题词，主管副市长多次召开专题会议，协调、解决实践中的问题，落实政策；以创建爱婴医院为切入点，全市３６家有产科的二级以上医疗保健机构均通过国家级评估，成为爱婴医院，同时创建爱婴医院活动向乡镇发展，为创建爱婴市奠定了坚实的基础；以部门协调为先导，在政府的协调下，大连市形成了政府牵头，卫生、计生、妇联、工会、工商等部门“共同参与、统筹规划、各司其职、条块结合、综合服务”的社会卫生管理与服务模式；采用技术保障体系和社区支持组织两个网络为纽带，开展爱婴活动；以执法监督为手段，做到执法监督经常化、规范化、制度化，对妇幼卫生工作依法行政、依法管理     

Baby‐Friendly: snappy slogan or standard of care?

Breastfeeding offers significant protection against illness for the infant and numerous health benefits for the mother, including a decreased risk of breast cancer. In 1991, UNICEF and WHO launched the Baby-Friendly Hospital Initiative with the aim of increasing rates of breastfeeding. "Baby-Friendly" is a designation a maternity site can receive by demonstrating to external assessors compliance with the Ten Steps to Successful Breastfeeding. The Ten Steps are a series of best practice standards describing a pattern of care where commonly found practices harmful to breastfeeding are replaced with evidence based practices proven to increase breastfeeding outcome. Currently, approximately 19,250 hospitals worldwide have achieved Baby-Friendly status, less than 500 of which are found in industrialised nations. The Baby-Friendly initiative has increased breastfeeding rates, reduced complications, and improved mothers' health care experiences.     

The revitalization and scale‐up of the Baby‐Friendly Hospital Initiative in Malawi

The Baby‐Friendly Hospital Initiative (BFHI) has shown to strengthen health providers' skills in the provision of breastfeeding counselling and support, which have led to improvements in breastfeeding outcomes. In Malawi, where BFHI was introduced in 1993 but later languished due to losses in funding, the Maternal and Child Survival Program supported the Malawi Ministry of Health (MOH) in the revitalization and scale‐up of BFHI in 54 health facilities across all 28 districts of the country. This paper describes the revitalization and scale‐up process within the context of an integrated health project; successes, challenges, and lessons learned with BFHI implementation; and the future of BFHI in Malawi. More than 80,000 mothers received counselling on exclusive breastfeeding following childbirth prior to discharge from the health facility. Early initiation of breastfeeding was tracked quarterly from baseline through endline via routine MOH health facility data. Increases in early initiation of breastfeeding were seen in two of the three regions of Malawi: by 2% in the Central region and 6% in the Southern region. Greater integration of BFHI into Malawi's health system is recommended, including improved preservice and in‐service trainings for health providers to include expanded BFHI content, increased country financial investments in BFHI, and integration of BFHI into national clinical guidelines, protocols, and nutrition and health policies.