Breastfeeding promotion plan in Madrid, Spain.
BACKGROUND
Promotion and protection of breastfeeding is a public health objective. In April 2009, health authorities in the Madrid region in central Spain signed a collaboration agreement with The United Nations Children's Fund and created a breastfeeding committee.


OBJECTIVE
To report the creation and implementation of a plan to promote and improve the quality of breastfeeding care in public hospitals in the region of Madrid, according to the Baby-Friendly Hospital Initiative (BFHI) standards.


METHODS
The action plan included institutional commitment; creation of a breastfeeding committee in each hospital; outcome analyses, staff training, creation of educational materials; and dissemination of activities. The plan was adopted by the 19 non-BFHI-designated public maternity units in the Madrid region. Each hospital completed a modified version of the World Health Organization self-assessment questionnaire in 2009 (pre-intervention) and again in 2011.


RESULTS
Thirteen maternity units (68.4%) established a breastfeeding committee, and 32 months after implementation of the plan, the other 6 hospitals have created one. Nine training courses have been carried out to train professional experts on breastfeeding as trainers. The 271 trainers provided 18-hour breastfeeding courses for 1423 professionals. In 2009, there was only 1 BFHI-accredited hospital. Currently, 52.6% of the other 19 hospitals have some level of accreditation, and 2 are fully accredited.


CONCLUSIONS
An intervention to improve the quality of breastfeeding care based on an organized regional approach to the BFHI was useful for BFHI implementation.
Hospital de Fuenlabrada, BFHI Hospital, Madrid, Spain. befloan@gmail.com
Beatriz
B
Flores-Antón
Maria Carmen
MC
Temboury-Molina
Susana
S
Ares-Segura
Celina
C
Arana-Cañedo-Argüelles
Concepción
C
Nicolás-Bueno
Cristina
C
Navarro-Royo
Alberto
A
Pardo-Hernández
Carmen Rosa
CR
Pallás-Alonso
D000068:Accreditation; D001942:Breast Feeding / Q000706:statistics & numerical data; D003696:Delivery Rooms / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006293:Health Promotion / Q000379:methods / Q000458:organization & administration*; D006801:Humans; D007224:Infant Care / Q000379:methods / Q000458:organization & administration / Q000592:standards*; D007231:Infant, Newborn; D018743:Perinatal Care / Q000379:methods / Q000458:organization & administration / Q000592:standards*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D016730:Program Development / Q000379:methods*; D015397:Program Evaluation; D058996:Quality Improvement; D013030:Spain; D014480:United Nations; D014944:World Health Organization