Effectiveness of the Baby Friendly Hospital Initiative on neonatal units - Neo-BFHI implementation in the prevalence of breastfeeding in premature infants

Abstract

The Baby Friendly Hospital Initiative (BFHI) has been widely adopted in Brazil, however, does not consider the complex and highly technological context of the neonatal intensive care unit and the difficulties of breastfeeding premature infants. Thus, it has been hypothesized that the intervention BFHI adapted to neonatal units is effective for the increased prevalence of Exclusive Breastfeeding (EBF) in premature infants at discharge, in the first month after discharge and at six months chronological age of premature infants. The aim of this project is to evaluate the effectiveness of implementation the Baby Friendly Hospital Initiative for neonatal units (neo-BFHI), guided by knowledge translation to increase early initiation of breastfeeding, to increase the EBF rates at discharge, in the first month after discharge and at six months of chronological age of premature infants, and to enhance premature health outcomes related to EBF during hospitalization. It is a interventional study, with mixed design, not randomized simultaneously with before and after study, conducted in two hospitals in the Southeast accredited as Baby Friendly Hospital, with the intervention unit in Ribeirão Preto-SP and control unit in Rio de Janeiro-RJ. The neo-BFHI will be implemented guided by the PARIHS (Promoting Action on Research Implementation in Health Services) knowledge translation model and the EPIC (Evidence Based Practice Identification and Change) strategy. Three steps are essential for the development of the project: data collection before the intervention; implementation of the intervention and evaluation of the implementation and comparison with the control unit. This project is part of a multicenter project entitled "Breastfeeding of preterm infants: impact of the neo-BFHI on neonatal units" funded by the MS/Decit/CNPq/Bill & Melinda Gates Foundation, case n° 401628/2013-2, which was approved by the Ethics Research Committee at University of São Paulo at Ribeirão Preto College of Nursing. (AU)