The Baby Friendly Hospital Initiative and breast feeding rates in Scotland.
OBJECTIVE
To examine the effect of the Baby Friendly Hospital Initiative on breast feeding rates in Scotland.


METHODS
Observational study using an annual survey of progress towards the WHO/UNICEF Baby Friendly Hospital Initiative and routinely collected breast feeding rates gathered on the Guthrie Inborn Errors Screening card at 7 days of postnatal age.


METHODS
Scotland, UK, population 5.1 million, with about 53 000 births a year.


METHODS
All 33 maternity units with over 50 births per annum and 464,246 infants born in Scotland between 1995 and 2002.


METHODS
Baby Friendly status of each maternity unit at the time of an infant's birth: certificate of commitment, UK standard award, and breast feeding at 7 days postnatal age.


RESULTS
Babies born in a hospital with the UK Baby Friendly Hospital Initiative standard award were 28% (p<0.001) more likely to be exclusively breast fed at 7 days of postnatal age than those born in other maternity units after adjustment for mother's age, deprivation, hospital size, and year of birth. From 1995, breast feeding rates had increased significantly faster in hospitals with Baby Friendly status by 2002: 11.39% (95% confidence interval 10.35 to 12.43) v 7.97% (95% confidence interval 7.21 to 8.73).


CONCLUSIONS
Being born in a hospital that held the award increased the chance of being breast fed. All maternity units should be encouraged to undertake the significant strategic and practical changes required to achieve UK Baby Friendly Hospital Initiative standard status.
Broadfoot
M
M
Paediatric Epidemiology and Community Health (PEACH) Unit, Department of Child Health, Royal Hospital for Sick Children, Glasgow G3 8SJ, Scotland, UK.
Britten
J
J
Tappin
D M
DM
MacKenzie
J M
JM
D000068:Accreditation; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000379:methods; D006761:Hospitals; D006801:Humans; D008297:Male; D008427:Maternal Health Services / Q000379:methods; D012606:Scotland
JAMA. 2001 Jan 24-31;285(4):413-20
11242425
BMJ. 2001 Jun 2;322(7298):1335-6
11387179
Mod Midwife. 1994 May;4(5):32-3
7788385
Health Bull (Edinb). 2000 Jan;58(1):11-9
12813847
BMJ. 1989 Oct 7;299(6704):886-9
2510878
Health Bull (Edinb). 2001 Mar;59(2):102-13
12664724