In order to determine the effect of feeding glucose water on breastfeeding newborns, we randomly distributed 180 normal newborns into two groups: a glucose water group (GW), fed 5% glucose solution during the first 3 days of life in addition to being breastfed; and an exclusively breastfed nonglucose water group (NGW). The following data were evaluated: weight at 6, 12, 24, 48, and 72 hours of life; temperature during the first 72 hours of life; serum glucose level at 6, 12, 24, and 48 hours; total duration of breastfeeding and age at introduction of infant formulas. In the NGW, there was a greater weight loss at 48 hours but not at 72 hours, temperatures higher than 37.5 degrees C were more frequent, and the mean serum glucose levels at 6, 12, and 24 hours were lower. This group also had more serum glucose level determinations under 2.2 mmol/l (40 mg/dL). However, no infants exhibited hypoglycemic symptoms. Infants in the GW received twice as many formulas during the first month and had a shorter duration of any breastfeeding. Our results suggest that the suppression of feedings with glucose water in the first days of life increases the probability of successful breastfeeding. However, infants who do not receive glucose water in the first few days of life may require greater supervision and close monitoring of blood glucose and body temperature, particularly in the first 24 hours of life.

Human milk is the best way to nurture the human infant. By breast-feeding their babies, mothers provide them with the best opportunities to wholly develop their potential, while protecting the infants and themselves from a whole range of diseases in the near future and in the years to come. Even though these benefits are widely known and there is ample scientific evidence on the topic, it seems from published data that Spanish women are not breastfeeding their babies as much and for as long as they should. Less than 90% start breast-feeding, at 1 month there is already an attrition of 30%, at 3 months more than half of the infants are taking artificial milk and by 6 months only 10% continue to breast-feed their infants. Low birth weight, Caesarean section and low study level are among the more significant factors that negatively affect breast-feeding. There is still work to do to improve this situation. Promotion of breast-feeding among the general population, mothers and health professionals is needed.

The Baby-Friendly Initiative (BFI-Spain) was founded in 1995 by members of key professional associations (pediatricians, midwives, obstetricians, and nurses) and some mother-to-mother support groups. The United Nations International Children's Fund was instrumental in supporting the establishment of BFI-Spain as a not-for-profit organization. In 2007, the need for change was identified. A detailed analysis of BFI-Spain identified its main strengths, weaknesses, opportunities, and threats. A new strategic plan was devised that included the adoption of a staged accreditation system, a new website, expanding the initiative into the community, consolidating working teams to distribute tasks and responsibilities, and trying to involve the national health authorities. This article describes the analysis that was undertaken, the strategies implemented, and some of the outcomes observed 4 years later. The aim of the article is to support BFI teams in other countries who might be facing similar challenges.