The perceptions, attitudes and practices of postpartum nurses regarding the Baby Friendly Hospital initiative

Abstract

At the end of 1993 in response to the results reported in a National Breastfeeding Survey the Ministry of Health (MoH) of Armenia implemented policy changes in postpartum practice regarding breastfeeding promotion. These changes included the implementation of five steps from the UNICEF/WHO Baby Friendly Hospital Initiative's (BFHI) Ten Steps to Successful Breastfeeding. Currently, although, the majority of mothers have rooming-in experience and on-demand feeding is encouraged in delivery hospitals and in pediatric polyclinics in Armenia, the rates of exclusively breastfeeding in Armenia are still low [1]. The purpose of this research study was to explore the perceptions, attitudes and practices of postpartum nurses regarding BFHI and postpartum practices in general, in order to get information about potential problem sthat are happening as a result of the new policies. Two delivery hospitals in Yerevan were chosen based on the rates of the room ing-in practice from the National Breastfeeding Survey [1]. One hospital had a low rate (Hospital L-68.5 %), and the other hospital had the highest rate of rooming-in (Hospital H-100%). Qualitative research methodology has been selected. Study was done in 2 phases. The first phase was general and conducted in 4 delivery hospitals. The second phase focused specifically on 2 delivery hospitals with high and low rates of rooming-in. Qualitative research method included keyinformant interviews, free list and pile sort exercises, direct observations and semi-structured interviews with mothers. Data were collected from postpartum baby and mother nurses and mothers in delivery hospitals. Some variations in postpartum practices were discovered between hospitals L and H. There is a lack of training regarding BFHI among postpartum nurses. Attitudes of postpartum mother nurses in hospital L were negative regarding rooming-in and on demand breastfeeding practices. The presence of seven mothers with their infants in one mom's room in hospital L was too much. There is a need to increase health education of hospital staff, especially postpartum nurses through training regarding BFHI, because their role in the insuring of successful breastfeeding practices is crucial.