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J Pediatr (Rio J). 2005 Nov-Dec;81(6):471-7.

[The impact of training based on the Baby-Friendly Hospital Initiative on breastfeeding practices in the Northeast of Brazil].

[Article in Portuguese]

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  • 1Departamento Materno Infantil, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil. soniabechara@terra.com.br



To evaluate the impact of training based on the Baby Friendly Hospital Initiative on breastfeeding practices in maternity wards and during the first 6 months of life.


Ninety percent of nursing auxiliaries and midwives were trained at two institutions (A and B) in Palmares, Pernambuco state. Three hundred and thirty-four mothers were interviewed within the first 48 hours and 10 days after childbirth to evaluate breastfeeding practices at the maternities and fulfillment of steps 4 through 10 of the Baby Friendly Hospital Initiative. A subset of 166 mothers received seven home visits to evaluate breastfeeding practices throughout the first 6 months of life and to compare results with those of a cohort study conducted in the area in 1998.


The performance of maternity B was significantly better than that of maternity A, from steps 4 to 10 and also in terms of exclusive breastfeeding and offering less water or tea to infants (p < 0.001). The comparison with a previous cohort study demonstrated an improvement in breastfeeding practices at the maternity wards and an increase of exclusive breastfeeding prevalence (from 21.2 to 70%), during the first 48 hours after delivery and throughout the first six months.


The training promoted partial change to some practices related to breastfeeding, having a positive effect on total and exclusive breastfeeding at the maternity wards. However, there was no significant change to these practices over the first 6 months of life, suggesting the need for effective interventions to support exclusive breastfeeding in the health sector and in the community.

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