Prevalence of breastfeeding and birth practices during the first wave of the COVID-19 pandemic within the Italian Baby- Friendly Hospital network. What have we learned?
Authors
Angela Giusti, Elise M. Chapin, Stefania Spila Alegiani, Francesca Marchetti, Stefania Sani, Jessica Preziosi, Sofia Colaceci, Francesca Zambri
Abstract
Background. At the beginning of the COVID-19 pandemic, healthcare workers were faced with difficult decisions about maternity care practices. The evidence-based practices recommended by the WHO/UNICEF Baby Friendly Hospital Initiative (BFHI) were confirmed by Italian national guidance.
Aim. To describe, in a number of facilities that are part of a national Baby-Friendly network, the adherence to some steps of BFHI standards during the COVID-19 emergency.
Methods. We conducted a cross-sectional online survey, inviting all hospitals interested in the Initiative, to fill out a semi-structured questionnaire.
Results. Out of the 68 participating hospitals, 30.9% were hubs and 69.1% spokes. During May 2020, 61.8% of hospitals had COVID-19 and non-COVID-19 clinical pathways, while 38.8% were only non-COVID-19. None was dedicated exclusively to COVID-19 pathways. The BFHI was effective in guaranteeing ≥80% exclusive breastfeeding, the presence of companion of mother’s choice, skin-to-skin and rooming-in. The type of accreditation was associated with the presence of a companion of the mother’s choice during labour (p=0.022) and with skin-to-skin (p<0.001). According to the narratives, increased interpersonal distance made interactions with mothers difficult and the absence of a birth companion was reported as a major issue.
Discussion and conclusions. The BFHI is a highly-structured, evidence-based care
model. Investing in strong collaborative care approaches contributes to hospitals’ preparedness.
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