The BFHI's Ten Steps to Successful Breastfeeding and percentage of mothers who reported hospital practices according to BFHI accreditation, Pregnancy Risk Assessment Monitoring System (N=1935)*
| Non-BFHI % (N=1099) | Pre-BFHI accreditation % (N=487) | Post-BFHI accreditation % (N=349) | p Value | |
|---|---|---|---|---|
| Statements from PRAMS questionnaire (yes/no) as numbered in BFHI Ten Steps | ||||
| 3. Hospital staff gave me information about breast feeding | 91.9 | 90.6 | 96.0† | 0.01 |
| 4. I breastfed in the first hour after my baby was born | 56.8 | 57.5 | 57.2 | 1.0 |
| 5. Hospital staff helped me learn how to breastfeed | 69.0 | 68.8 | 72.2 | 0.5 |
| 6. My baby was fed only breast milk at the hospital | 51.8 | 61.1 | 58.8 | 0.001 |
| 7. My baby stayed in the same room with me at the hospital | 90.5 | 89.1 | 86.5 | 0.1 |
| 8. Hospital staff told me to breastfeed whenever my baby wanted | 72.8 | 71.8 | 73.0 | 0.9 |
| 9. My baby (did not) use a pacifier in the hospital‡ | 61.0 | 74.3 | 71.4 | <0.001 |
| BFHI practices summarised | ||||
| Mean number of practices (SD) (range 0–7)‡ | 4.9 (2.0) | 5.1 (2.0) | 5.3 (1.9) | |
| 0–2 practices | 18.1 | 16.6 | 12.1 | 0.001 |
| 3–5 practices | 32.4 | 25.2 | 32.3 | |
| 6 practices | 22.4 | 23.3 | 21.0 | |
| 7 practices | 27.1 | 34.9 | 34.6 | |
| Other practices to support breast feeding | ||||
| The hospital gave me a gift pack with formula | 69.0 | 34.6 | 28.4§ | <0.001 |
| The hospital gave me a telephone number to call for help with breast feeding | 76.6 | 79.4 | 79.4 | 0.4 |
*Excludes mothers from BFHI Hospital A with no ‘before’ data available.
†p≤0.05 comparison of BFHI facilities before and after accreditation.
‡Pacifier use was reverse-coded to indicate ‘did not use a pacifier in the hospital’.
§p=0.06 comparison of BFHI facilities before and after accreditation.
BFHI, Baby-Friendly Hospital Initiative; PRAMS, Pregnancy Risk Assessment Monitoring System.