Improving breastfeeding support through the implementation of the Baby-Friendly Hospital and Community Initiatives: a scoping review

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Abstract

Background

Improved breastfeeding practices have the potential to save the lives of over 823,000 children under 5 years old globally every year. The Baby-Friendly Hospital Initiative (BFHI) is a global campaign by the World Health Organization and the United Nations Children’s Fund, which promotes best practice to support breastfeeding in maternity services. The Baby-Friendly Community Initiative (BFCI) grew out of step 10, with a focus on community-based implementation. The aim of this scoping review is to map and examine the evidence relating to the implementation of BFHI and BFCI globally.

Methods

This scoping review was conducted according to the Joanna Briggs Institute methodology for scoping reviews. Inclusion criteria followed the Population, Concepts, Contexts approach. All articles were screened by two reviewers, using Covidence software. Data were charted according to: country, study design, setting, study population, BFHI steps, study aim and objectives, description of intervention, summary of results, barriers and enablers to implementation, evidence gaps, and recommendations. Qualitative and quantitative descriptive analyses were undertaken.

Results

A total of 278 articles were included in the review. Patterns identified were: i) national policy and health systems: effective and visible national leadership is needed, demonstrated with legislation, funding and policy; ii) hospital policy is crucial, especially in becoming breastfeeding friendly and neonatal care settings iii) implementation of specific steps; iv) the BFCI is implemented in only a few countries and government resources are needed to scale it; v) health worker breastfeeding knowledge and training needs strengthening to ensure long term changes in practice; vi) educational programmes for pregnant and postpartum women are essential for sustained exclusive breastfeeding. Evidence gaps include study design issues and need to improve the quality of breastfeeding data and to perform prevalence and longitudinal studies.

Conclusion

At a national level, political support for BFHI implementation supports expansion of Baby-Friendly Hospitals. Ongoing quality assurance is essential, as is systematic (re)assessment of BFHI designated hospitals. Baby Friendly Hospitals should provide breastfeeding support that favours long-term healthcare relationships across the perinatal period. These results can help to support and further enable the effective implementation of BFHI and BFCI globally.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13006-023-00556-2.

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Most cited references 182

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Scoping studies: towards a methodological framework

Lisa O'Malley, Hilary Arksey (2005)

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Scoping studies: advancing the methodology

Danielle Levac, Heather Colquhoun, Kelly K. O’Brien (2010)

Background Scoping studies are an increasingly popular approach to reviewing health research evidence. In 2005, Arksey and O'Malley published the first methodological framework for conducting scoping studies. While this framework provides an excellent foundation for scoping study methodology, further clarifying and enhancing this framework will help support the consistency with which authors undertake and report scoping studies and may encourage researchers and clinicians to engage in this process. Discussion We build upon our experiences conducting three scoping studies using the Arksey and O'Malley methodology to propose recommendations that clarify and enhance each stage of the framework. Recommendations include: clarifying and linking the purpose and research question (stage one); balancing feasibility with breadth and comprehensiveness of the scoping process (stage two); using an iterative team approach to selecting studies (stage three) and extracting data (stage four); incorporating a numerical summary and qualitative thematic analysis, reporting results, and considering the implications of study findings to policy, practice, or research (stage five); and incorporating consultation with stakeholders as a required knowledge translation component of scoping study methodology (stage six). Lastly, we propose additional considerations for scoping study methodology in order to support the advancement, application and relevance of scoping studies in health research. Summary Specific recommendations to clarify and enhance this methodology are outlined for each stage of the Arksey and O'Malley framework. Continued debate and development about scoping study methodology will help to maximize the usefulness and rigor of scoping study findings within healthcare research and practice.

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Guidance for conducting systematic scoping reviews.

Micah D.J. Peters, Christina M Godfrey, Hanan Khalil … (2015)

Reviews of primary research are becoming more common as evidence-based practice gains recognition as the benchmark for care, and the number of, and access to, primary research sources has grown. One of the newer review types is the 'scoping review'. In general, scoping reviews are commonly used for 'reconnaissance' - to clarify working definitions and conceptual boundaries of a topic or field. Scoping reviews are therefore particularly useful when a body of literature has not yet been comprehensively reviewed, or exhibits a complex or heterogeneous nature not amenable to a more precise systematic review of the evidence. While scoping reviews may be conducted to determine the value and probable scope of a full systematic review, they may also be undertaken as exercises in and of themselves to summarize and disseminate research findings, to identify research gaps, and to make recommendations for the future research. This article briefly introduces the reader to scoping reviews, how they are different to systematic reviews, and why they might be conducted. The methodology and guidance for the conduct of systematic scoping reviews outlined below was developed by members of the Joanna Briggs Institute and members of five Joanna Briggs Collaborating Centres.

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Author and article information

Contributors

Aisling Walsh: aislingwalsh@rcsi.ie

Journal

Journal ID (nlm-ta): Int Breastfeed J

Journal ID (iso-abbrev): Int Breastfeed J

Title: International Breastfeeding Journal

Publisher: BioMed Central (London )

ISSN (Electronic): 1746-4358

Publication date (Electronic): 15 April 2023

Publication date PMC-release: 15 April 2023

Publication date Collection: 2023

Volume: 18

Electronic Location Identifier: 22

Affiliations

[1 ]GRID grid.4912.e, ISNI 0000 0004 0488 7120, RCSI, University of Medicine and Health Sciences, ; Dublin, Ireland

[2 ]GRID grid.15596.3e, ISNI 0000000102380260, Dublin City University, ; Dublin, Ireland

[3 ]GRID grid.10049.3c, ISNI 0000 0004 1936 9692, University of Limerick, ; Limerick, Ireland

[4 ]GRID grid.517969.5, Kamuzu University of Health Sciences, ; Blantyre, Malawi

Article

Publisher ID: 556

DOI: 10.1186/s13006-023-00556-2

PMC ID: 10105160

PubMed ID: 37061737

SO-VID: 797d4f35-b9c9-45a2-b94e-e661c2a3d4e4

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 11 January 2023

Date accepted : 26 March 2023

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100009099, Irish Aid;

Award ID: COALESCE/2019/89

Custom metadata

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: breastfeeding,baby-friendly hospital initiative,baby-friendly community initiative,scoping review

Data availability:

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: breastfeeding, baby-friendly hospital initiative, baby-friendly community initiative, scoping review

Improving breastfeeding support through the implementation of the Baby-Friendly Hospital and Community Initiatives: a scoping review

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Conclusion

Supplementary Information

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Most cited references 182

Scoping studies: towards a methodological framework

Scoping studies: advancing the methodology

Guidance for conducting systematic scoping reviews.

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