Baby-friendly hospital initiative: evaluation of the ten steps to successful breastfeeding.
OBJECTIVE
To asses the performance of the Ten Steps to Successful Breastfeeding in an university hospital.


METHODS
Descriptive and quantitative research, in which 103 people were interviewed in the outpatient prenatal clinic, in the maternity-ward and in the Neonatal Intensive Care Unit of a university hospital in Vitória, Southeast Brazil. The "Institutional Self-Evaluation Questionnaire" of the Baby Friendly Hospital Initiative was applied. Using this tool, the outcome was measured by the concordance index (CI) proposed by the World Health Organization and by the United Nations Children's Fund.


RESULTS
Although the hospital does not have a policy that addresses promotion, protection and support for breastfeeding, 93.3% of the mothers had contact with their babies immediately after birth (step 4), 83.3% of the professionals guided mothers how to breastfeed (step 5), 86.6% of the neonates did not receive any food or drink other than breast milk (step 6), 100% of babies were housed together with their mothers (step 7), 83.3% of the women were encouraged for breastfeeding on demand (step 8) and 100% of the infants did not use bottles or pacifiers (step 9).


CONCLUSIONS
60% of the steps were completed by the hospital. The greatest difficulty was to inform pregnant women about the importance and the management of breastfeeding (step 3). Therefore, visits to pregnant women are recommended, in order to prepare them for breastfeeding and to explain about the infants' healthy feeding habits.
Hospital Geral de Linhares, LinharesES, Brasil.
Soraia da Silva
Sda S
Lopes
Departamento de Enfermagem, Universidade Federal do Espírito Santo, VitóriaES, Brasil.
Mariana Rabello
MR
Laignier
Departamento de Enfermagem, Universidade Federal do Espírito Santo, VitóriaES, Brasil.
Cândida Caniçali
CC
Primo
Departamento de Enfermagem, Universidade Federal do Espírito Santo, VitóriaES, Brasil.
Franciéle Marabotti C
FM
Leite
D001942:Breast Feeding; D006293:Health Promotion; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D008430:Maternal-Child Health Centers; D017410:Practice Guidelines as Topic