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Annelerin, anne sütü ve emzirme ile ilgili bilgi eksikleri anne sütüyle beslenen bebek sayısında azalmalara sebep olduğundan doğum sonrası emzirmenin ilk bir saat içinde başlatılması ve anneye doğru emzirme tekniklerinin öğretilmesi önemlidir. Bu nedenle hemşireler annelerin emzirme davranışlarını olumlu yönde etkilemeli, emzirmeyi yönetmeli, desteklemeli, yetersizlik hisseden anneleri belirlemeli, onlara çözüm aramalı ve annelerin bebeklerini ilk altı ay sadece anne sütü ile beslemesini sağlamalıdır. Hemşirelerin bu rollerini gerçekleştirebilmesi için anne sütü ve emzirme ile ilgili bilgi düzeyleri yeterli olmalıdır. Bu çalışma ile çocuk hemşirelerinin anne sütü ve emzirme ile ilgili bilgi düzeylerini belirlemek amaçlanmıştır. Bu çalışma tanımlayıcı-kesitsel olup, Ocak -Haziran 2022 tarihleri arasında Orta Karadeniz Bölgesindeki bir il merkezi ve ilçelerinde bulunan, bebek dostu hastanelerde çalışan 166 hemşire ile yürütülmüştür. Veriler "Hemşire tanımlayıcı bilgi formu" ve "Anne sütü ve emzirme ile ilgili bilgi düzeylerini belirleme formu" ile toplanmıştır. Kırk maddeden oluşan formdan alınabilecek en düşük puan 0, en yüksek puan 40'tır. İstatistiksel analizlerde SPSS paket programı kullanılmış, tanımlayıcı bilgi formundan elde edilen veriler, sayı ve yüzde (%), anne sütü ve emzirme ile ilgili bilgi düzeylerini belirleme formundan elde edilen veriler ortalama±standart sapma ile raporlanmıştır. Bağımsız iki grup arasındaki verilerin karşılaştırılmasında Mann Whitney U testi, bağımsız ikiden fazla grup için Kruskal Wallis testi kullanılmıştır. İstatistiksel anlamlılık p

Exclusive breastfeeding is the feeding method recommended by WHO and UNICEF for infants during the first 6 months of ther life. Rates of initiation and continuation of breastfeeding in France are among the worst in developed countries. The Baby Friendly Hospital Initiative (IHAB) label was launched to promote, encourage and support breastfeeding. Are maternal breastfeeding established in the labeled Bagatelle Maternity lasting longer than in other maternity hospitals in France, thanks to the policy of the label? The main objective is to study the duration of exclusive and mixed breastfeeding implemented at the maternity of Bagatelle labeled IHAB, up to six months. The primary endpoint is the date of discontinuation of exclusive and mixed breastfeeding. All patients who has initiated breastfeeding from March 31, 2017 to May 15, 2017 were included in the study. The datas were collected by written surveys at the maternity and then by phone at 2 and 6 months. 94 patients were included in the study. Of the 94 patients included in the study, 37 were still breastfeeding at 6 months, ie 39%. The median for stopping breastfeeding (exclusive and mixed) is 18 and a half weeks. It’s 15 weeks for exclusive breastfeeding. The most important factor influencing the continuation of breastfeeding is the initial breastfeeding project. In France, according to the EPIFANE study, the median duration of breastfeeding is 15 weeks and 24 days for exclusive breastfeeding. 23% of children were still breastfed at 6 months compared to 39% in our study. The duration of breastfeeding set up at the maternity of Bagatelle is longer, especially for exclusive breastfeeding., L'allaitement maternel exclusif est le mode d'alimentation préconisé par l'OMS et l'UNICEF chez le nourrisson pendant les 6 premiers mois de vie. Les taux d’initiation et de poursuite d’allaitement en France sont parmi les plus mauvais des pays développés. Le label IHAB a été lancé pour promouvoir, encourager et accompagner l'allaitement maternel. Les allaitements maternels instaurés dans la Maternité de Bagatelle labellisée durent-ils plus longtemps que dans d’autres Maternités en France, grâce à la politique du label ? L’objectif principal est d’étudier les durées des allaitements maternels exclusifs et mixtes mis en place à la Maternité de Bagatelle labellisée IHAB, jusqu’à six mois. Le critère de jugement principal est la date d’arrêt de l’allaitement exclusif et mixte. Toutes les patientes ayant initié un allaitement du 31 mars 2017 au 15 mai 2017 ont été incluses dans l’étude. Les données ont été recueillies par questionnaire écrit à la maternité puis téléphoniques à 2 et 6 mois. 94 patientes ont été incluses dans l’étude. Sur les 94 patientes incluses dans l’étude, 37 allaitaient encore à 6 mois soit 39%. La médiane de l’arrêt de l’allaitement maternel (exclusif et mixte) est de 18.5 semaines. Elle est de 15 semaines pour l’allaitement exclusif. Le facteur qui influe le plus sur la poursuite de l’allaitement maternel est le projet initial d’allaitement. En France, d’après l’étude EPIFANE, la durée médiane d’allaitement est de 15 semaines et 24 jours pour l’allaitement exclusif. 23% des enfants étaient encore allaités à 6 mois contre 39% dans notre étude. Les durées des allaitements mis en place à la Maternité de Bagatelle sont plus longues surtout celle des allaitements exclusifs.

Decrease of maternal and infant mortality as well as increasing of the exclusive breastfeeding are major public health priorities in Indonesia. In decreasing the maternal and infant mortality, the government developed a program for the community as Baby Friendly Hospital (BFH) to prevent the effects, to support, and to promote breastfeeding. PKU Muhammadiyah hospital in Yogyakarta was one of the BFH program managers. The purpose of this study was to determine the breastfeeding promotion activities as part of BFH at PKU Muhammadiyah Hospital in Yogyakarta.This was a qualitative descriptive study. The findings of this study were inputs consisting of 1) the knowledge and skills to better convey information indicates the quality of human resources. 2) promotion of the policies for all workers to reach the goal. 3) financial promotion is supported by the operating system in the hospital. 4) supporting facility to promote lactation leaflets, posters, ANC class, a breastfeeding counselor and nursing areas. Implementation of lactation promotion was conducted in accordance with program planning of BFH.

World Health Organisation

AIM: Low level of knowledge and practice of exclusive breast feeding have been reported in Nigeria especially in rural communities. The purpose of this study is to identify factors contributing to low knowledge and practice of exclusive breast feeding (E B F) in rural communities of Abia State, Nigeria and apply health promotion intervention (H P I) to address these factors in order to increase knowledge and practice of E B F. METHOD: A quasi-experimental study design was used. Four communities formed the unit of allocation to experimental and control groups for the purpose of introducing health promotion intervention. A multi-stage sampling procedure was used in selecting the study sample. A sample size of 400 households out of 1978 enumerated from the four communities was used for the survey, two as experimental and two as control. Data were collected using a pretested structured questionnaire that was interviewer administered. Data were analyzed quantitatively and qualitatively. Chi-square statistic was used in determining statistical significance. Analysis of knowledge and practice of EBF was taken before and after H P I and compared in both experimental and control groups.\ RESULT: The results indicated increase in knowledge of E B F from 28(14%) to 200(98.5%). Correspondingly, practice of E B F increased from 21 (10%) to 162(80%) in the experimental group. No significant increase was made in the control group both in knowledge and practice of EBF. Factors contributing to low level of practice of EBF in the study area included low level of knowledge about ten steps to successful breast feeding, illusory fears about EBF, ignorance, resistance to change, cultural imperatives and medical reasons. Health promotion intervention directed at the rural women helped to scale up the practice of EBF to 70% within nine months. CONCLUSION: The study recommends health promotion intervention as a proven method for scaling up knowledge and practice of EBF in rural communities. [TAF Prev Med Bull 2011; 10(6.000): 657-664]

OBJETIVO: Avaliar as taxas e o padrão de aleitamento materno dos recém-nascidos internados em berçário de alto risco no momento de sua alta hospitalar e analisar os potenciais fatores que interferem na prática do aleitamento materno exclusivo. MÉTODOS: Foram estudados prontuários médicos de 495 recém-nascidos internados no berçário de alto risco da Maternidade Odete Valadares, Minas Gerais, antes e após receber o título de Hospital Amigo da Criança. Foram excluídos os nascidos fora da maternidade e durante o período de transição, crianças ou mães que foram a óbito ou transferidas da instituição e crianças abandonadas e/ou de mães com contra-indicação para amamentar. Foram calculadas razões de chance (odds ratio, OR) e intervalos de confiança de 95% a partir de análises bivariadas e multivariadas utilizando a técnica da regressão logística. RESULTADOS: A taxa de aleitamento materno exclusivo na alta passou de 36% no período anterior para 54,6% no período posterior à implementação da Iniciativa Hospital Amigo da Criança. Os fatores de risco independentemente associados com ausência de aleitamento exclusivo foram: uso da dieta por sonda (OR = 3,01), número de consultas pré-natais menor que seis (OR = 2,21), uso de translactação (OR = 2,66), peso ao nascer < 2.500 g (OR = 2,64) e internação em período anterior ao recebimento do título de Hospital Amigo da Criança pela maternidade (OR = 2,75). CONCLUSÃO: Este estudo mostra que, entre outros fatores, as mudanças nas práticas hospitalares com a implementação da Iniciativa Hospital Amigo da Criança foram determinantes para o aumento das taxas de aleitamento materno exclusivo na alta em crianças de alto risco. OBJECTIVE: To study the rate of exclusive breastfeeding at the moment of hospital discharge of newborns admitted to a neonatal Intensive Care Unit and to analyze potential risk factors. METHODS: Four hundred and ninety-five medical records were studied, pertaining to neonates born between 1998 and 1999, admitted to a neonatal intensive care unit, before and after the implementation of the Baby Friendly Hospital Initiative policies. Babies born during the Baby Friendly Hospital Initiative transition period and outside the Maternity ward were excluded from the study, as were children or mothers who were transferred from the institution, abandoned children and also mothers unfit to breastfeed. Risk factors for non-exclusive breast-feeding at discharge were studied. Odds ratio and 95% confidence intervals were calculated using multivariate logistic regression. RESULTS: The exclusive breastfeeding rate increased from 36% at discharge (before the Baby Friendly Hospital Initiative) to 54.7% (after CFHI). The independent risk factors associated with non-exclusive breastfeeding were the use of enteral feeding (OR = 3.01), ante-natal consultations < 6 (OR = 2.75), relactation use (OR = 2.66), birth weight < 2,500 g (OR = 2.64) and being born during the period before Baby-Friendly policies were implemented (OR = 2.75) CONCLUSION: This research shows the potential efficiency of adopting Baby-Friendly policies to increase the chance of successful breastfeeding at the point of discharge for high-risk newborns.

É realizada uma análise descritiva do programa de incentivo ao aleitamento materno denominado de "Iniciativa Hospital Amigo da Criança, IHAC", idealizada pela OMS e UNICEF em 1990, Florença, Itália, com a participação do Brasil. O objetivo básico consiste na mobilização de profissionais de saúde, funcionários de hospitais e maternidades para mudanças em rotinas e condutas, visando prevenir o desmame precoce. Para esta finalidade, criou-se os "dez passos para o sucesso do aleitamento Materno", um conjunto de metas elaborado por um grupo de especialistas de saúde e nutrição. No Brasil, a IHAC é coordenado pelo Ministério da Saúde (MS), Programa Nacional de Incentivo ao Aleitamento Materno (PNIAM). Os estabelecimentos de saúde para se tornarem Hospitais Amigos da Criança precisam preencher critérios estabelecidos pelo PNIAM e cumprir 80% do conjunto de metas no processo de avaliação, envolvendo várias etapas. A instituição credenciada IHAC vinculada ao SUS, recebe pagamento diferenciado: 40% a mais em atendimentos pré-natal e 10% na assistência ao parto. Em 1998 no Brasil existem 103 hospitais credenciados: 68% Nordeste; 9,7% Sul, 10,6% Centro-Oeste, 8,7% Sudeste, 2,9% Norte. Ainda é pequeno o número de instituições credenciadas, representando apenas 1,7%. Proporcionalmente, os índices de HIAC são: 3,78% Nordeste, 1,89% Centro-Oeste, 0,89% Sul, 0,53% Sudeste, 0,73% Norte. Resultados da IHAC têm sido um aumento dos índices de amamentação. Para ampliar o número de HIAC no país, é necessário empenho dos profissionais de saúde, vontade e decisão política do governo para investir em programas de incentivo, promoção e apoio ao aleitamento materno. In the study is analyzed and described the initiative called "Initiative Baby Friendly Hospitals", a program which started in Brazil, 1992. This initiative intends to support, to protect and to promote the breastfeeding as proposed in a meeting in 1990 in Florence, Italy, which was promoted by WHO and UNICEF. The basic goal of this initiative is to mobilize health professionals and hospital or maternity workers for changing their routines and conducts aiming to prevent the early wean. The health establishments are evaluated based on the "ten steps for success of breastfeeding, a group of goals created in the same meeting. In Brazil, the evaluation is coordinated by the Federal Government through the PNIAM (Programa Nacional de Incentivo ao Aleitamento Materno). A baby friendly hospital, if approved, receives from the Minister of Health, a Federal Governmental Agency (SUS) a differential payment for childbirth assistance and prenatal accompaniment, 10% and 40%, more respectively. Until 1998 year there were 103 baby friendly hospitals in Brazil, with the majority of them located in the northeast area (68,1%). However, taking in accounting the number of 5650 hospitals linked to SUS in the country, less than 2.0% are baby friendly hospitals. On the basis of the experience and according with PNIAM data the implementation of the ten steps and the incentive to breastfeeding through baby friendly hospitals have resulted in a significant increase of breastfeeding incidence and duration in Brazil.