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Management a barrier to baby friendly healthcare

Hospital management and policy is hindering Australian hospitals from promoting and supporting breastfeeding, according to a new study.

Looking specifically at what stopped hospitals from gaining Baby Friendly Health Initiative (BFHI) accreditation, the University of South Australia study involved focus groups with 31 midwifery, medical, nursing and ancillary staff in differing levels of employment.

BFHI accreditation, administered by the Australian College of Midwives, is given only to health care centres that are assessed as promoting breastfeeding as the norm and where practices known to promote the health and wellbeing of mothers and infants are followed.
At present, only 21 per cent of Australian Hospitals are accredited.

Lack of funding, limited top level support and a lack of sufficient staff and mother education about the importance of breastfeeding were identified as significant barriers to attaining such accreditation.

The staffs’ understanding and personal views are often discordant with BFHI aims, said Ava Walsh, PhD candidate from UniSA’s school of nursing and midwifery.

“Ultimately, it seems that the BFHI is valued by those who use it and misunderstood by those who do not,” she said.

“Many respondents believed that the accreditation process itself was too difficult in their current hospital environment, taking into account hospital dynamics, attitudes of upper management and a lack of specific policies that promote breastfeeding within the hospital.

Lack of support of breastfeeding once the mothers were out of the hospital environment – through the need to return to work and a bottle feeding culture within the community, were also perceived barriers.

“The development of a specific breastfeeding policy that incorporates various disciplines and staff, and that contains detailed protocols that comply with the International Code of Marketing of Breast

Milk Substitutes and subsequent World Health Assembly (WHA) resolutions needs to be considered.

“In addition, staff and mothers require multiple modes of education to understand the BFHI, including sponsorship for training of lactation consultants,” she says.

BFHI accreditation will have positive outcomes for mothers, infants and maternity staff and that understanding the barriers to its implementation is an important step forward, Walsh said.

“Full implementation of BFHI across Australia will assist the development of nationally accepted breastfeeding definitions, improve monitoring and evaluation of rates and practices, and improve breastfeeding outcomes,” she said.

“Implementation requires a conscientious understanding of the BFHI principles by all healthcare staff and dissemination of this information into the community.”

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