ABSTRACT
Objectives: The objectives of this study were to assess nursing staff knowledge; attitudes and practices regarding the Baby-Friendly Hospital Initiative (BFHI); to assess the knowledge of maternity obstetric unit (MOU) managers regarding BFHI principles and their attitude towards BFHI implementation; and to describe the barriers and constraints to the implementation of BFHI principles.Study design: Cross-sectional descriptive survey. Setting: The study was done in eight non-BFHI-accredited primary care maternity obstetric units in Cape Town.Subjects: The subjects were eight MOU managers and a random sample of 45 nursing staff.Outcomes measures: Knowledge; attitude and practices regarding BFHI and barriers to BFHI implementation were assessed by an intervieweradministered questionnaire.Results: The study demonstrated acceptable awareness and knowledge of the recommended BFHI principles. A total of 56.6 of the staff could define rooming-in; 47.2 could define the components of the BFHI; and 52.8 could name three baby-friendly care practices and routines. Eighty-nine per cent of the nursing staff were able to demonstrate correct positioning of the baby for breastfeeding; and 91.1 could demonstrate the correct attachment of the baby to the breast. Only 8.9 of the nursing staff were able to adequately demonstrate the correct hand milk-expressing technique; 35.6 knew about the correct management of painful nipples and 22.2 knew how to manage engorgement. Only 40could adequately describe the safe preparation of infant formula. The enrolled nursing assistants (ENA) were significantly less knowledgeable than the other cadres of nurses. The majority of the nurses had a positive attitude toward BFHI principles and practices