title: Audit of the support for breastfeeding mothers in Fife maternity hospitals using adapted 'Baby Friendly Hospital' materials.
abstract: BACKGROUND
  The objective of this study was to assess the level of support given to breastfeeding mothers during their stay in maternity hospitals. The audit was carried out in maternity hospitals in Fife with the co-ordination of the Fife Joint Breastfeeding initiative.
  
  
  METHODS
  The subjects consisted of ten maternity hospital staff (medical and midwifery), and 12 antenatal and 21 postnatal women. The design of the study consisted of an audit of hospital policies and practices in comparison with ten internationally recognized standards. This was carried out by adapting the external evaluation instruments from the WHO-UNICEF "Baby Friendly Hospital" materials. Methods relied not only on reported practices but also on direct observation and enquiry.
  
  
  RESULTS
  Action was taken to address areas of practice which fell below the WHO-UNICEF standards: supplementary feeding of breastfed babies, particularly overnight, was reduced; discharge "bounty packs" advertising baby milk manufacturer products were discontinued; a hospital breastfeeding support group was established; the hypoglycaemia policy was revised; and the need for an orientation session on breastfeeding policies for medical staff was recognized.
  
  
  CONCLUSIONS
  This audit approach using "Baby Friendly Hospital' materials has helped to define policy, measure performance against recognized standards, identify quality specifications for maternity service agreements and has improved hospital support for breastfeeding mothers. This approach is suitable for maternity hospitals whose breastfeeding rates make them ineligible for "Baby Friendly Hospital" accreditation, and has the potential to be extended to encompass wider "health-promoting hospital" issues such as promotion of infant car seats.
authors.affiliation: Fife Joint Breastfeeding Initiative, Fife Health Board, Cupar.
authors.forename: H
authors.initials: H
authors.lastname: Campbell
authors.forename: D
authors.initials: D
authors.lastname: Gorman
authors.forename: A
authors.initials: A
authors.lastname: Wigglesworth
mesh_terms: D000328:Adult; D001942:Breast Feeding; D005260:Female; D006771:Hospitals, Maternity; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008485:Medical Audit; D008880:Midwifery; D010348:Patient Care Team; D010353:Patient Education as Topic; D011247:Pregnancy; D012606:Scotland