Breast Feeding: One Goal, Many Challenges

Background: Breast feeding is considered a cornerstone for children’s health all over the world. Despite its high prevalence in the immediate post childbirth, high abandonment rates have been registered early in life. World Health Organization (WHO) and The United Nations Children’s Fund (UNICEF) recommend six-first months’ exclusive breast feeding and have been promoting the Baby Friendly Hospital Initiative (BFHI) since 1992, already counting on fifteen accredited Hospitals.

Objective and Methods: “Centro Hospitalar do Baixo Vouga” (CHBV) has been intending to take part in BFHI since 2012. Therefore, we aim to analyse and compare newborns’ feeding practices since birth till maternity leave from 2012 to 2018, using a retrospective study based on surveys completed during maternity stay. Our sample consisted in a variable number of surveys between 1307 and 1474 per year, of approximately 1700 annual live births.

Results: We verified oscillatory exclusive breast feeding rates, maximum in 2015 (80%). Partial breast feeding rates have been increasing since 2015, maximum of 31% in 2018, while exclusive formula feeding rates remained steady around 1%. In what concerns first-hour breast feeding, the rate prowled 85%.

Conclusion: Although several efforts in order to fulfil the criteria, CHBV is not an accredited institution yet. We have been facing many difficulties in achieving optimal long-term exclusive breast feeding rates, despite initial high levels of contact with breast milk.

In fact, breast feeding duration depends on several multifactorial determinants, only some of which are modifiable, such as the availability of pre-birth training. Furthermore, it is mandatory some investment in mothers’ formation about lactation and its technical difficulties, as well as optimization of health care professionals’ training. It is also important to understand the main reasons for breast feeding abandonment and develop strategies to provide support within reach for every mother.