title: Hospital Staff's Perceptions with Regards to the Baby-Friendly Initiative.
abstract: BACKGROUND
  Adherence to Baby Friendly Initiative (BFI) practices is low in Canadian hospitals, despite evidence showing a positive impact of BFI practices on breastfeeding rates and duration. In 2012, the provincial Ontario Ministry of Health and Long Term Care added BFI status to its progress indicators for Public Health Units, which are now required to begin BFI implementation.
  
  
  OBJECTIVE
  This study aims to explore health care workers' self-reported knowledge of the BFI and their perceptions of the importance of its components.
  
  
  METHODS
  A questionnaire was electronically sent to 2237 employees working at our institution.
  
  
  RESULTS
  Questionnaires were completed by 651 participants, of which 110 (16.9%) and 87 (13.5%) participants reported having good knowledge of the BFI and the Ten Steps to Successful Breastfeeding, respectively. Multiple logistic regression showed that having children and having received formal breastfeeding education were associated with higher self-reported knowledge. Additionally, 481 (75%) participants reported that it was important or very important to them that the institution adopt the BFI. Having children and being an allied health professional were associated with perceiving the implementation of the BFI as important.
  
  
  CONCLUSIONS
  The results of our study have allowed us to identify potential barriers to implementation of the BFI, which can be targeted through system changes and staff education. Through this approach, we hope to facilitate acceptance of the BFI at our institution and increase support for optimal breastfeeding practices among our patients.
authors: 1 Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada.
authors: Catherine
authors: C
authors: Pound
authors: 2 School of Sociological and Anthropological Studies, University of Ottawa, Canada.
authors: Natalie
authors: N
authors: Ward
authors: 3 University of Pharmacy, Montpellier, France.
authors: Marine
authors: M
authors: Freuchet
authors: 4 Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
authors: Salwa
authors: S
authors: Akiki
authors: 4 Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
authors: Jason
authors: J
authors: Chan
authors: 5 Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada.
authors: Stuart
authors: S
authors: Nicholls
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000379:methods* / Q000523:psychology; D002983:Clinical Competence / Q000592:standards*; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D016134:Organizational Policy; D010465:Perception; D010564:Personnel, Hospital / Q000523:psychology*; D015397:Program Evaluation / Q000379:methods; D036301:Qualitative Research; D011795:Surveys and Questionnaires
keywords: Baby-Friendly Hospital Initiative (BFHI); Canada; Ten Steps to Successful Breastfeeding; breastfeeding; hospital practices; survey