Assessing health staff practices that influence continuity of breastfeeding

Summary: Baby Friendly practices that support breastfeeding initiation and continuity save lives. The aim of this study is to assess the factors affecting the warm chain for supporting breastfeeding continuity. A survey for Baby Friendly practices was conducted in 7 maternity services, 5 of which were previously designated as Baby friendly in the early 1990s. Both staff and mother were interviewed. The results showed that although some practices related to early separation and prelacteal feeding have been maintained, yet they do not fully meet the global BFHI criteria. Absence of prolonged skin to skin contact and prevailing infant milk formula feeding practices in neonatal and pediatrics wards are the challenges that face success in these hospitals. It is concluded that achievement of full support for successful breastfeeding depends on identifying the loops in the warm chain for breastfeeding support. This chain begins with antenatal preparation in primary health care then initiation in maternity wards and continues to the support provided in neonatal and pediatric wards then in primary care during vaccination and growth monitoring. The chain can break at any point by the uncontrolled marketing practices of infant milk formula companies

assessment of mother friendly in maternity services in Egypt

The aim of the study was to assess mother friendly practices and satisfaction of mothers with services they received in maternity facilities. The study was conducted in 5 hospitals with 1145 mothers and 120 staff who attend labor. Overall findings revealed that mothers were not allowed to have preferred family companion at birth, non-pharmacological pain relief methods were ho encouraged and mothers were not allowed to assume position of her choice at birth. This reflected on mothers1 dissatisfaction with the quality of services. It is concluded that there is a need to encourage mother friendly practices at birth

An evaluation of the effectiveness of skin-to-skin care for low-birth-weight in Egypt

Kangaroo Mother Care [KMC] or Skin-to-skin care [SSC] is a universal model of care for preterms. It involves continued skin-to-skin contact between mother and baby for 24 hours a day. Baby is placed in an upright position up on the mother's chest between her breasts and inclined in a position so as to facilitate breastfeeding. It is evidence based medical practice that has been shown to be safe and highly beneficial for the growth and development of babies, in addition to being cost-effective as apposed to incubators and nursing care. It place mothers at the center of care for her baby, enhances recovery and promotes breastfeeding thus reduces the cost of medications and long term complications. However this method is poorly accepted and not implemented in Egypt. Aim: The aim of this study was to assess the knowledge, attitudes and skills [KAS] of health staff with regards KMC; to identify ways to facilitate its introduction in Egypt and to assess the outcome of this intervention on the growth and health states of'infants exposed to this technique of care as compared to traditional care by incubators. Person to person interviews were conducted with 57 physicians and nurses in two neonatal intensive care units [NICUs] in a urban [Cairo University] and 2 regional situated university hospitals [Zagazig and Benha] before and after the intervention. The intervention in the urban university consisted of orientation seminars and on the job training by exposure to a trial of the procedure with 20 mothers-infant pairs. In the intervention unit staff showed a statistically significant improvement in relation to knowledge and attitudes at P<0.05 but not in practice of skills [P>0.05]. Babies exposed to KMC doubled their weights faster, shortened their stay in the NICU and had fewer morbidity problems. KMC is a safe and beneficial technique. Hands-on training of staff, mothers and families can make them more accepting to the technique and promote its implementation in NICUs and in the community

Effectiveness of a computerized monitoring tool for the baby friendly hospital initiative in Egyptian settings

This study is an intervention study aimed at promoting the quality of Services delivered to mothers and babies in birthing facilities, by monitoring the Global Criteria set for the Baby Friendly Hospital Initiative [BFHI]. This study was carried out in Damanhour Teaching Hospital. The obstetric and neonatal intensive care [NICU] practices were periodically assessed by sampling twenty mother-infant pairs at three weeks intervals over 6 monitoring Sessions with a total of 120 mother-infant Pairs over the entire period of study from August to November 2008. Two weeks after the last monitoring session, we sampled a total of 80 mother- infant pairs from maternity services of four neighboring hospitals as a Comparison group with the intervention hospital. The results showed that there was a significant improvement in the practice of the Ten Steps using the monitoring technique. We recommend that future BFHI implementation in Egypt should adopt monitoring as a tool to reinforce training and ensure sustainability

Practices in child growth monitoring in the countries of the Eastern Mediterranean Region

Growth reference charts are among the most sensitive and valuable tools for assessing the health and development of children. A questionnaire survey was answered by 16 of the 21 ministries of health in the Eastern Mediterranean Region countries [EMR] about their use of growth charts for children under 5 years. Most of the countries [13/16] used the NCHS/WHO charts and weight-for-age was the most commonly used. Charts for height-for-age and head circumference-for-age were less commonly used. Problems in the use of charts were identified. The introduction of the new WHO Child Growth Standards, based on exclusively breastfed babies, is a unique opportunity to support growth monitoring and optimal feeding practices in EMR

Breast feeding practices in home versus institutional delivaries

A cross-sectional study was conduced on 180 lactating mothers attending MCHC in Benha city to illustrate the effect of place of delivery [home or institutional] on breast feeding practices in neonates and post neonates. Analysis of data reveals that mothers of institutional deliveries were superior to those of home deliveries in adoption of some of the steps required to achieve successful breast feeding, reflecting the successful educational role carried out by health staff Mothers of institutional deliveries show statistically significant lower rates for bottle use in neonates and pacifier use in neonates and postneonates. Those mothers show statistically significant higher rates for proper positioning and attachment. However, mothers of home deliveries reflecting cultural and traditional believes concerning breast feeding show statistically significant higher rates of timely 1st suckle in neonates. In post-neonates those mothers show statistically significant higher rate of breastfeeding on both sides and statistically significant lower bottle use rate. There is statistically significant positive linear correlation between supplementation at birth with bottle use at birth, supplementation in post- neonates as well as with acute respiratory infections. Also, the same relation is found between supplementation of in neonates with diarrhoeal diseases as well as ARI There is statistically significant positive linear correlation between bottle use at birth with pacifier use at birth, bottle use in postneonate as well as with ARI. The same relation is found between bottle use after 6 weeks following birth with dehydration and ARI. It is recommended to create a conducive environment for successful breastfeeding via a well organized community oriented breast feeding education to motivate the whole culture to be mother baby friendly culture through active community participation and intersectoral collaboration. Effective legislative issues for protection of lactating mothers in home and at work