Self Reported Breastfeeding Practices and the Baby Friendly Hospital Initiative in Riyadh, Saudi Arabia: Prospective Cohort Study
Mosher, Cynthia, et.al
The Baby Friendly Hospital Initiative (BFHI) team, mentioned below, is pleased to announce the publication of the clinical study entitled: Self Reported Breastfeeding Practices and the Baby Friendly Hospital Initiative in Riyadh, Saudi Arabia: Prospective Cohort Study, by the BMJ Open, after having presented the preliminary findings at the university and at national and international conferences and symposiums.
Under the dedicated guidance of Dr. Abiola Senok, and great support and encouragement by Prof. Khaled Al Kattan,, the team worked extremely hard through each and every phase of the study. It was well worth the effort to be able to produce such a wonderful study and gain this publication achievement.
Study team involved:
Cynthia Mosher College of Medicine Alfaisal University
Abdullah Sarkar College of Medicine Alfaisal University
Alaa AbouBakr Hashem College of Medicine Alfaisal University
Reem E. Hamadah College of Medicine Alfaisal University
Asma Alhoulan College of Medicine Alfaisal University
Yosra AlMakadma College of Medicine Alfaisal University
Tehreem A. Khan College of Medicine Alfaisal University
Abdurahman K. Al-Hamdani Department of Emergency Medicine King Abdulaziz Medical City
Senior Investigator: Abiola Senok Department of Microbiology and Immunology
Biostatician: Peter Cahusac Associate Professor, Pharmacology & Biostatistics
Assistant Investigators: Rasha Alshawaf, Ranim Chamseddin, Ghadah Albulayhid, and Razan Alhadlaq
Background: The Baby Friendly Hospital Initiative (BFHI) is a practice guideline for healthcare providers to promote breastfeeding and increase breastfeeding rates.
Objective: This study aimed to examine reported experiences and views on breastfeeding of women using pre- and postnatal services, and opinions of staff, in the context of the BFHI program in Riyadh, Saudi Arabia.
Design: Prospective cohort study
Setting: This prospective, longitudinal study was conducted from December 2013-September 2015 at two healthcare facilities (BFHI and non-BFHI) in Riyadh Saudi Arabia.
Methods: Women 36-40 weeks gestation receiving antenatal care at the hospitals were enrolled. Questionnaires were administered prenatally, at one, three and six months postnatal and to administrator and maternity staff.
Results: 277 women were recruited with an estimated 80% response rate. 156 (BFHI=78/139, non-BFHI=78/138, 56%) participants completed all questionnaires. Most BFHI-hospital participants (77.9%, n=8 for this question) acknowledged seeing the breastfeeding policy compared to 23.5% (n=23) at the non-BFHI-hospital (p<0.01). Breastfeeding education and encouragement was higher at the BFHI-hospital (93.3%) compared to the non-BFHI-hospital (48.2%; p<0.01). At postpartum discharge, 51% (n=53) of mothers in the BFHI-hospital were breastfeeding exclusively versus 29.6% (n=29) at the non-BFHI-hospital. Where formula feed was introduced, women in the BFHI-hospital more often practiced mixed feeding rather than exclusive formula feeding with some switching from mixed feeding to exclusive breastfeeding between 3 and 6 months postpartum. Exclusive breastfeeding rates declined in both hospitals at 3 and 6 months postpartum with lack of community services for lactation being a major reason. Although BFHI-hospital staff (n=9) were more conversant with BFHI principles, defects in adherence to the BFHI Ten Steps were identified.
Conclusion: This is the first study assessing the effectiveness of BFHI implementation in Saudi Arabia. Although women reported increased breastfeeding rates, the study identified important weaknesses that could be improved through strict compliance with BFHI practices.