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Controlled Clinical Trial
. 2016 May 6;6(5):e010232.
doi: 10.1136/bmjopen-2015-010232.

Effectiveness of the Baby Friendly Community Initiative in Italy: a non-randomised controlled study

Adriano Cattaneo  1 , Maria Enrica Bettinelli  2 , Elise Chapin  3 , Anna Macaluso  1 , Lílian Córdova do Espírito Santo  4 , Anna Maria Murante  5 , Marcella Montico  6 ; BFCI Study Group
Collaborators, Affiliations
Controlled Clinical Trial

Effectiveness of the Baby Friendly Community Initiative in Italy: a non-randomised controlled study

Adriano Cattaneo et al. BMJ Open. .

Abstract

Objective: To assess the effectiveness of the Baby Friendly Community Initiative (BFCI) on exclusive breast feeding at 6 months.

Design: Controlled, non-randomised trial.

Setting: 18 Local Health Authorities in 9 regions of Italy.

Participants: 5094 mother/infant dyads in 3 cohorts were followed up to 12 months after birth in 3 rounds of data collection: at baseline, after implementation of the intervention in the early intervention group and after implementation in the late intervention group. 689 (14%) dyads did not complete the study.

Intervention: Implementation of the 7 steps of the BFCI.

Main outcome measures: The rate of exclusive breast feeding at 6 months was the primary outcome; breast feeding at discharge, 3 and 12 months was also measured.

Results: The crude rates of exclusive breast feeding at discharge, 3 and 6 months, and of any breast feeding at 6 and 12 months increased at each round of data collection after baseline in the early and late intervention groups. At the end of the project, 10% of infants were exclusively breast fed at 6 months and 38% were continuing to breast feed at 12 months. However, the comparison by adjusted rates and logistic regression failed to show statistically significant differences between groups and rounds of data collection in the intention-to-treat analysis, as well as when compliance with the intervention and training coverage was taken into account.

Conclusions: The study failed to demonstrate an effect of the BFCI on the rates of breast feeding. This may be due, among other factors, to the time needed to observe an effect on breast feeding following this complex intervention.

Keywords: Baby-Friendly Initiatives; Breastfeeding; Italy.

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Figures

Figure 1
Figure 1
A sketch of the study design. LHA, Local Health Authority.
Figure 2
Figure 2
Rates of exclusive breast feeding at discharge (recall from birth) by site, group and round of data collection. LHA, Local Health Authority.
Figure 3
Figure 3
Rates of exclusive breast feeding at 3 months (recall 7 days) by site, group and round of data collection. LHA, Local Health Authority.
Figure 4
Figure 4
Rates of exclusive breast feeding at 6 months (recall 7 days) by site, group and round of data collection. LHA, Local Health Authority.
Figure 5
Figure 5
Rates of any breast feeding at 6 months (recall 24 h) by site, group and round of data collection. LHA, Local Health Authority.
Figure 6
Figure 6
Rates of any breast feeding at 12 months (recall 24 h) by site, group and round of data collection. LHA, Local Health Authority.
See this image and copyright information in PMC

References

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    1. Cattaneo A, Buzzetti R. Effect on rates of breast feeding of training for the Baby Friendly hospital initiative. BMJ 2001;323:1358–62. 10.1136/bmj.323.7325.1358 - DOI - PMC - PubMed
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    1. International Lactation Consultant Association. Position paper on infant feeding. Raleigh, NC: ILCA, 2000.

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