Establishing Methods to Assess Baby-Friendly Hospital Initiative Compliance Using the Global Standards and Women's Self-Reported Experiences.
Laavanya Lokeesan, Elizabeth Martin, Yvette D Miller
PMID 38785274WHAT IT FOUND
Women's self-reported maternity care showed low compliance with immediate postnatal and general breastfeeding support steps.
Skin-to-skin within 5 minutes was 15.9%, and overall Step 4 compliance was 11.9%. This pilot audit tool may help nurses target gaps.
Key findings
01Overall compliance with immediate postnatal care was 11.9%, while skin-to-skin within 5 minutes was 15.9%, and placing the baby on the breast within one hour was 70.5%.
02Overall Step 5 compliance was 7.0%, even though support for breastfeeding difficulties was reported by 93.0%; positioning advice was 38.1%, latching advice was 22.2%, and advice to increase milk secretion was 66.2%.
03Rooming-in was reported by 100.0% of women, but advice about rooming-in was reported by 28.5%, giving overall Step 7 compliance of 28.5%.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The tool was face validated and pilot tested, so its measurement validity is not established. Women reported care from memory soon after birth, and some practices may not have had time to occur before discharge. If hospital staff ask the questions, women may under-report poor care; the pilot used an independent researcher. The estimates come from postpartum women in Sri Lankan government hospitals, so they may not apply to other settings. The study did not test whether using this audit improves breastfeeding support or outcomes.
Declared interests
The authors disclosed no conflicts of interest. Queensland University of Technology funded data collection by one author, and open access publication was supported by a Queensland University of Technology and SAGE publishing agreement.
The easy way to misread this
Do not treat these compliance rates as validated national performance measures. They come from a pilot self-report tool whose validity requires further research, and some practices may not have had time to occur before women were asked.