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Controlled Clinical Trial
. 2013 Apr;8(2):198-204.
doi: 10.1089/bfm.2012.0130. Epub 2013 Feb 11.

A controlled study on baby-friendly communities in Italy: methods and baseline data

Anna Macaluso  1 , Maria Enrica Bettinelli, Elise M Chapin, Lílian Córdova do Espírito Santo, Rita Mascheroni, Anna Maria Murante, Marcella Montico, Adriano Cattaneo
Affiliations
Controlled Clinical Trial

A controlled study on baby-friendly communities in Italy: methods and baseline data

Anna Macaluso et al. Breastfeed Med. 2013 Apr.

Abstract

Aim: This study reports the research methods and baseline data of a project aimed at assessing the effect of an intervention based on the 7 Steps of the Baby Friendly Community Initiative (BFCI) on the rate of exclusive breastfeeding at 6 months in Italy.

Subjects and methods: In this controlled, nonrandomized study, nine Local Health Authorities were assigned to an early and nine to a late intervention group. Data on breastfeeding in infants followed up from birth to 12 months were gathered at baseline and in two subsequent rounds, after the 7 Steps were implemented in the early and late intervention groups, respectively. Step-down logistic regression analysis, corrected for the cluster effect, was used to compare breastfeeding rates between groups.

Results: At baseline, there were no significant differences in breastfeeding rates at birth (n=1,781) and at 3 (n=1,854), 6 (n=1,601), and 12 (n=1,510; loss to follow-up, 15.2%) months between groups. At birth, 96% of mothers initiated breastfeeding, 72% exclusively (recall from birth). At 3 months, 77% of infants were breastfed, 54% exclusively with 24-hour and 46% with 7-day recall. At 6 months, the rate of any breastfeeding was 62%, with 10% and 7% exclusive breastfeeding with 24-hour and 7-day recall, respectively. At 12 months, 31% of the children continued to breastfeed.

Conclusions: The project is ongoing and will allow estimation of the effect of the BFCI.

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Figures

FIG. 1.
FIG. 1.
The location of the 18 Local Health Authorities included in the project. Members of the early intervention group are indicated in bold type.
FIG. 2.
FIG. 2.
Rates of any breastfeeding and of exclusive breastfeeding at enrollment (recall from birth), by Local Health Authority (LHA).
FIG. 3.
FIG. 3.
Rates of any breastfeeding (ABF), exclusive breastfeeding with 24-hour recall (EBF 24-h), exclusive breastfeeding with 7-day recall (EBF 7-d), and no breastfeeding (no BF) at 3 months, by Local Health Authority (LHA).
FIG. 4.
FIG. 4.
Rates of any breastfeeding (ABF), exclusive breastfeeding with 24-hour recall (EBF 24-h), exclusive breastfeeding with 7-day recall (EBF 7-d), and no breastfeeding (no BF) at 6 months, by Local Health Authority (LHA).
See this image and copyright information in PMC

References

    1. Kramer MS. Chalmers B. Hodnett ED, et al. Promotion of Breastfeeding Intervention Trial (PROBIT): A randomized trial in the Republic of Belarus. JAMA. 2001;285:413–420. - PubMed
    1. Cattaneo A. Buzzetti R. Effect on rates of breast feeding of training for the Baby Friendly Hospital Initiative. BMJ. 2001;323:1358–1362. - PMC - PubMed
    1. World Health Organization. World Health Organization; Geneva: 2002. Global Strategy for Infant and Young Child Feeding.
    1. Ministry of Health; Gazzetta Ufficiale, Numero 32. Ministero della Salute; Rome: Feb 7, 2008. Linee di indirizzo nazionali sulla protezione, la promozione ed il sostegno dell'allattamento al seno.
    1. International Lactation Consultant Association. International Lactation Consultant Association; Raleigh, NC: 2000. Position Paper on Infant Feeding.

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