No abstract

The authors used realistic evaluation to examine the real-world effectiveness of two 5-day training techniques on sustained optimal skin-to-skin practices that support Step 4 of the revised Baby-Friendly Hospital Initiative (BFHI). The authors found that education alone was insufficient to effect sustainable practice change. Exposure to the 5-day immersion model (Practice, Reflection, Education and training, Combined with Ethnography for Sustainable Success, or PRECESS) alone or combined with education was an effective strategy to change and sustain the standard of care for skin-to-skin practice (p , 0.00001). The intended outcome of sustained practice change toward implementation of skin-to-skin care through immersion or a combined approach shows promise and should be repeated in other localities.

To increase the impact of BFHI on community breastfeeding practices, BFHI should focus on involving the family members with the mother throughout the implementation of the Ten Steps while encouraging maternal support groups and taking cultural differences into account.

No abstract

195 pp, $34.95, pb With the explosion of knowledge about breastfeeding management over the last two decades, the help that mothers need to breastfeed their babies should be readily available. Happily, for many mothers this is the case. But others aren't helped as effectively as they ought to be because their health care providers don't know how to counsel well. This book is designed especially for breastfeeding specialists who are not "natural" counselors or who don't (yet) know how to transmit their fund of breastfeeding wisdom effectively. It provides, as the title suggests, strategies and skills for solving breastfeeding problems and brings them to life with illustrations from the authors' own practice.