The Association between a Novel Baby-Friendly Hospital Program and Equitable Support for Breastfeeding in Vietnam

Abstract

Background: Rates of early initiation of breastfeeding are low in Southeast Asia, despite evidence that increased initiation of early breastfeeding would lead to better long-term infant and child health and decrease inequities in long-term health and well-being. In response, a novel performance-based, baby-friendly hospital program designates hospitals that adhere to evidence-based early essential newborn care (EENC) and breastfeeding interventions as Centers of Excellence for Breastfeeding (COE). This study examined whether hospital participation in the program was associated with better breastfeeding outcomes. Methods: Hospitals (n = 28) were invited into the program in December 2018. Hospitals developed an improvement plan for promoting a breastfeeding-friendly environment and meeting the standards of the COE accreditation process and were enrolled on a rolling basis over the course of a year. Post-partum surveys were conducted with parents (n = 9585) from January 2019 through April 2020 to assess their breastfeeding and post-partum experience. Segmented regression models were used to assess how breastfeeding outcomes evolved before and after hospital enrollment in the COE program. Results: Enrollment was associated with a 6 percentage-point (95% CI: 3, 9) increase in the level of early initiation of breastfeeding, which continued to increase in the post-enrollment period, and a 5 percentage-point (95% CI: 2, 9) increase in the level of exclusive breastfeeding during hospital stay. We did not observe evidence that enrollment was immediately associated with receipt of lactation counseling or exclusive breastfeeding at survey time. Conclusion: The prevalence of early and exclusive breastfeeding increased after enrollment in the COE program, suggesting that the program has the potential to improve breastfeeding initiation rates and longer-term child health and well-being. Further research should be conducted to examine whether the program has an impact on the overall duration of breastfeeding.

Intention to Exclusively Breastfeed Is Associated with Lower Rates of Cesarean Section for Nonmedical Reasons in a Cohort of Mothers in Vietnam

“…Reasons for loss to follow-up included wrong or unavailable phone number—4.9%, the mother declined to continue or was too busy—7.1%, and stillbirth or infant died—0.5%. The loss to follow-up rate and reasons were similar to previous phone surveys among mothers after 10 and 45 days after discharge from the hospitals in Vietnam [ 25 ].…”

What makes a city ‘breastfeeding‐friendly’? A scoping review of indicators of a breastfeeding‐friendly city

“…We found two hospital accreditation systems that were expanded beyond the BFHI accreditation. They were Breastfeeding Centre of Excellence in Vietnam (Joyce et al, 2021 ) and the UK UNICEF Gold Award (Entwistle, 2018 ). Although both were grounded in the original 10‐steps of BFHI accreditation, they were modified and expanded to include additional items such as the role of champions and physical facilities.…”

Characteristics and factors influencing the volume of breastmilk donated by women to the first human milk bank in Vietnam

“…The neonatal unit admitted approximately 4,000 newborns with more than 30% being preterm. The hospital is recognized nationally and internationally as a center of excellence for the implementation of Ten Steps to Successful Breastfeeding, early essential newborn care, and kangaroo mother care (KMC) ( 12 , 13 ). The inclusion criteria for human milk donors include passing a questionnaire for medical history screening, general health status, and lifestyle ( 6 ).…”