Clinical trial NCT06824597: Impact of Baby-friedly Hospital Initiative (BFHI) Training Program on Breastfeeding Practices
Official title: Impact of Baby Friendly Hospital Initiative Training Program on Nurses' and Mothers' Breastfeeding Practices and Experiences
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Breastfeeding Outcomes
Keywords: training program - breastfeeding- practices-experiences
Lead sponsor: Mansoura University
Sponsor class: OTHER
First posted: 2025-02-13
Enrollment: 142
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 50
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Intervention model description: A quasi-experimental research design will be utilized. A quasi-experimental design is often described as a non-randomized, pre-post-intervention study, in which patients self-select into different treatments instead of being randomized
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: This study aims to evaluate the impact of Baby Friendly Hospital Initiative training program on nurses' and mothers' breastfeeding practices and experiences.

Research Hypotheses

* Maternity nurses who participate in the Baby Friendly Hospital Initiative training program exhibit improvement in breastfeeding practice scores and more positive breastfeeding experiences after the training program than before.
* Breastfeeding mothers who receive Baby Friendly Hospital Initiative support have good breastfeeding practices and more positive breastfeeding experiences.

Detailed description: Breastfeeding is a long-time investment in women's and babies' lives, not just a personal decision. World Health Organization (WHO) recommends breast milk as the most appropriate food for infants under six months of age. Breast milk contains all the nutrients that babies need in the first six months of life, so it is an ideal food for infants . Children who were breastfed had a lower risk of obesity and chest problems. Furthermore, breastfeeding mothers also benefited from breastfeeding, with lower rates of breast cancer, ovarian cancer, type II diabetes, and postnatal depression.

Exclusive breastfeeding (EBF) has been identified as the single most effective intervention for child survival, with the potential to prevent 13% of under-five deaths annually in low- and middle-income settings . WHO and United Nations Children's Fund (UNICEF) recommend optimal infant and young child feeding as immediate and early initiation of breastfeeding within the first hour of birth, EBF for the first 6 months of life, and with complementary feeding up to 2 years of age.

Early cessation of breastfeeding is a public health concern, especially in high-income countries, where only 25% of children were breastfeeding at 12 months of age, far below the global average of 74%. Women often cited difficulties, including low milk supply, painful nipples, and latching problems, as reasons for breastfeeding cessation. In addition, other factors, including lack of support or feeding advice, formula use, and returning to work, also contributed to breastfeeding cessation.

Evidence-based breastfeeding support is important for achieving breastfeeding recommendations, preventing morbidity and mortality, and promoting sustainable development goals. Thus, WHO and UNICEF have set a goal to increase breastfeeding rates to 75% in early infancy, 50% at six months, and 25% at one year of age.The Baby Friendly Hospital Initiative (BFHI) is a global program launched in 1991 by UNICEF and WHO to protect, promote and support breastfeeding in all maternity services. It requires all facilities that apply for the status of "Baby-Friendly Hospital" to provide maternity care to follow the "Ten Steps for the Successful Promotion of Breastfeeding" .

One of the 10 steps in this initiative is to have a written infant feeding policy that is routinely communicated to staff and parents. Step 2 requires the training of all healthcare staff in skills that are necessary to implement the policy. Healthcare providers play a key role in the beginning and continuity of the correct applications in breastfeeding and "Baby Friendly Hospital" criteria in society.In controlled studies, it was seen that training the nurses about BFHI principles increases their breastfeeding knowledge and practice scores and exclusive breastfeeding rates.

Eligibility criteria: Inclusion Criteria:

For nurses: all nurses who were working at inpatient postpartum wards and the delivery unit in Mansoura University Hospital with at least one year of work experience and who were providing direct care to the mothers and their newborns

For mothers:

* Who had the intention to breastfeed.
* Primiparous women
* Age between 18 and 35 years.
* Who had given birth to a singleton baby.
* Free from serious medical or obstetrical complications.

Exclusion Criteria:

* Breastfeeding mothers will be excluded from the study if their baby had:

  * Born before 37 weeks of gestation.
  * An Apgar score of less than 8 at 5 minutes.
  * A birthweight of less than 2,500 g.
  * Born with severe medical conditions or congenital malformations.
  * Admitted to the neonatal intensive care unit.

Primary outcomes:
measure: Evaluating the nurses' experiences regarding baby-friendly hospital initiative training program
timeFrame: 3 months
measure: Evaluating the nurses' practices regarding BFHI principles
timeFrame: 3 months
Secondary outcomes:
measure: Evaluating the secondary outcome of the training program for nurses on breastfeeding mothers' self- reported practices regarding the baby-friendly hospital initiative principles before and after the program.
timeFrame: 6 months
measure: Evaluating the impact of the training program on mothers' experiences regarding breastfeeding
timeFrame: 6 months
Other outcomes:
Locations:
city: Mansoura
country: Egypt
facility: Faculty of Nursing, Mansoura University
state: Dakahlia
Study officials:
affiliation: Faculty of Nursing, Mansoura University, Egypt
name: Abeer Ali, Ass.lecturer
role: PRINCIPAL_INVESTIGATOR
References:
citation: Hawkins SS, Stern AD, Baum CF, Gillman MW. Compliance with the Baby-Friendly Hospital Initiative and impact on breastfeeding rates. Arch Dis Child Fetal Neonatal Ed. 2014 Mar;99(2):F138-43. doi: 10.1136/archdischild-2013-304842. Epub 2013 Nov 25.
citation: Ducharme-Smith K, Gross SM, Resnik A, Rosenblum N, Dillaway C, Orta Aleman D, Augustyn M, Silbert-Flagg J, Caulfield LE. Exposure to Baby-Friendly Hospital Practices and Breastfeeding Outcomes of WIC Participants in Maryland. J Hum Lact. 2022 Feb;38(1):78-88. doi: 10.1177/0890334421993771. Epub 2021 Feb 16.