Effectiveness of the Baby Friendly Community Initiative in Italy: a non-randomised controlled study
ObjectiveTo assess the effectiveness of the Baby Friendly Community Initiative (BFCI) on exclusive breast feeding at 6 months.DesignControlled, non-randomised trial.Setting18 Local Health Authorities in 9 regions of Italy.Participants5094 mother/infant dyads in 3 cohorts were followed up to 12 month...
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| Veröffentlicht in: | BMJ open 2016-05, Vol.6 (5), p.e010232-e010232 |
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| creator | Cattaneo, Adriano Bettinelli, Maria Enrica Chapin, Elise Macaluso, Anna Córdova do Espírito Santo, Lílian Murante, Anna Maria Montico, Marcella |
| description | ObjectiveTo assess the effectiveness of the Baby Friendly Community Initiative (BFCI) on exclusive breast feeding at 6 months.DesignControlled, non-randomised trial.Setting18 Local Health Authorities in 9 regions of Italy.Participants5094 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.InterventionImplementation of the 7 steps of the BFCI.Main outcome measuresThe rate of exclusive breast feeding at 6 months was the primary outcome; breast feeding at discharge, 3 and 12 months was also measured.ResultsThe 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.ConclusionsThe 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. |
| doi_str_mv | 10.1136/bmjopen-2015-010232 |
| format | Article |
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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.ConclusionsThe 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.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2015-010232</identifier><identifier>PMID: 27154476</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adult ; Babies ; Breast Feeding - psychology ; Breast Feeding - statistics & numerical data ; Breast Feeding - trends ; Breastfeeding & lactation ; Community ; Community Participation ; Data collection ; Drug stores ; Early intervention ; Families & family life ; Female ; Food ; Health facilities ; Health Policy ; Health Promotion ; Health Services Research ; Humans ; Infant ; Infant Care ; Infant Nutritional Physiological Phenomena ; Infant, Newborn ; Initiatives ; Interviews ; Italy - epidemiology ; Male ; Maternal Health Services - organization & administration ; Mothers ; Mothers - education ; Mothers - psychology ; Organizational Policy ; Pharmacy ; Professionals ; Program Development ; Program Evaluation ; Social Support ; Support groups ; Working groups</subject><ispartof>BMJ open, 2016-05, Vol.6 (5), p.e010232-e010232</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2016 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b472t-d476f0f4f16e6a21ca1da92f63fae2a05e9ec9fc688ad0baddd9182256da22743</citedby><cites>FETCH-LOGICAL-b472t-d476f0f4f16e6a21ca1da92f63fae2a05e9ec9fc688ad0baddd9182256da22743</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmjopen.bmj.com/content/6/5/e010232.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://bmjopen.bmj.com/content/6/5/e010232.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27526,27527,27901,27902,53766,53768,77344,77375</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27154476$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cattaneo, Adriano</creatorcontrib><creatorcontrib>Bettinelli, Maria Enrica</creatorcontrib><creatorcontrib>Chapin, Elise</creatorcontrib><creatorcontrib>Macaluso, Anna</creatorcontrib><creatorcontrib>Córdova do Espírito Santo, Lílian</creatorcontrib><creatorcontrib>Murante, Anna Maria</creatorcontrib><creatorcontrib>Montico, Marcella</creatorcontrib><creatorcontrib>BFCI Study Group</creatorcontrib><title>Effectiveness of the Baby Friendly Community Initiative in Italy: a non-randomised controlled study</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><description>ObjectiveTo assess the effectiveness of the Baby Friendly Community Initiative (BFCI) on exclusive breast feeding at 6 months.DesignControlled, non-randomised trial.Setting18 Local Health Authorities in 9 regions of Italy.Participants5094 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.InterventionImplementation of the 7 steps of the BFCI.Main outcome measuresThe rate of exclusive breast feeding at 6 months was the primary outcome; breast feeding at discharge, 3 and 12 months was also measured.ResultsThe 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.ConclusionsThe 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.</description><subject>Adult</subject><subject>Babies</subject><subject>Breast Feeding - psychology</subject><subject>Breast Feeding - statistics & numerical data</subject><subject>Breast Feeding - trends</subject><subject>Breastfeeding & lactation</subject><subject>Community</subject><subject>Community Participation</subject><subject>Data collection</subject><subject>Drug stores</subject><subject>Early intervention</subject><subject>Families & family life</subject><subject>Female</subject><subject>Food</subject><subject>Health facilities</subject><subject>Health Policy</subject><subject>Health Promotion</subject><subject>Health Services Research</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant Care</subject><subject>Infant Nutritional Physiological Phenomena</subject><subject>Infant, Newborn</subject><subject>Initiatives</subject><subject>Interviews</subject><subject>Italy - epidemiology</subject><subject>Male</subject><subject>Maternal Health Services - organization & administration</subject><subject>Mothers</subject><subject>Mothers - education</subject><subject>Mothers - psychology</subject><subject>Organizational Policy</subject><subject>Pharmacy</subject><subject>Professionals</subject><subject>Program Development</subject><subject>Program Evaluation</subject><subject>Social Support</subject><subject>Support groups</subject><subject>Working groups</subject><issn>2044-6055</issn><issn>2044-6055</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkUFv1DAQhSMEolXpL0BClrhwSbEd20k4IMGqhZUqcYGzNbHH1KvEXuykUv493u5SFU74YI_kb97M06uq14xeMdao98O0i3sMNadM1pRR3vBn1TmnQtSKSvn8SX1WXea8o-UI2UvJX1ZnvGVSiFadV-baOTSzv8eAOZPoyHyH5DMMK7lJHoMdV7KJ07QEP69kW24PB5r4QLYzjOsHAiTEUCcINk4-oyUmhjnFcSxlnhe7vqpeOBgzXp7ei-rHzfX3zdf69tuX7ebTbT2Ils-1LQs56oRjChVwZoBZ6LlTjQPkQCX2aHpnVNeBpQNYa3vWcS6VBc5b0VxUH4-6-2WY0Bosa8Co98lPkFYdweu_f4K_0z_jvRadYrRXReDdSSDFXwvmWRdDBscRAsYla9Z2bd8o-jDr7T_oLi4pFHsPlJCib2ihmiNlUsw5oXtchlF9yFGfctSHHPUxx9L15qmPx54_qRXg6giU7v9S_A3eY6tw</recordid><startdate>20160506</startdate><enddate>20160506</enddate><creator>Cattaneo, Adriano</creator><creator>Bettinelli, Maria Enrica</creator><creator>Chapin, Elise</creator><creator>Macaluso, Anna</creator><creator>Córdova do Espírito Santo, Lílian</creator><creator>Murante, Anna Maria</creator><creator>Montico, Marcella</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160506</creationdate><title>Effectiveness of the Baby Friendly Community Initiative in Italy: a non-randomised controlled study</title><author>Cattaneo, Adriano ; Bettinelli, Maria Enrica ; Chapin, Elise ; Macaluso, Anna ; Córdova do Espírito Santo, Lílian ; Murante, Anna Maria ; Montico, Marcella</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b472t-d476f0f4f16e6a21ca1da92f63fae2a05e9ec9fc688ad0baddd9182256da22743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Babies</topic><topic>Breast Feeding - psychology</topic><topic>Breast Feeding - statistics & numerical data</topic><topic>Breast Feeding - trends</topic><topic>Breastfeeding & lactation</topic><topic>Community</topic><topic>Community Participation</topic><topic>Data collection</topic><topic>Drug stores</topic><topic>Early intervention</topic><topic>Families & family life</topic><topic>Female</topic><topic>Food</topic><topic>Health facilities</topic><topic>Health Policy</topic><topic>Health Promotion</topic><topic>Health Services Research</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant Care</topic><topic>Infant Nutritional Physiological Phenomena</topic><topic>Infant, Newborn</topic><topic>Initiatives</topic><topic>Interviews</topic><topic>Italy - epidemiology</topic><topic>Male</topic><topic>Maternal Health Services - organization & administration</topic><topic>Mothers</topic><topic>Mothers - education</topic><topic>Mothers - psychology</topic><topic>Organizational Policy</topic><topic>Pharmacy</topic><topic>Professionals</topic><topic>Program Development</topic><topic>Program Evaluation</topic><topic>Social Support</topic><topic>Support groups</topic><topic>Working groups</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cattaneo, Adriano</creatorcontrib><creatorcontrib>Bettinelli, Maria Enrica</creatorcontrib><creatorcontrib>Chapin, Elise</creatorcontrib><creatorcontrib>Macaluso, Anna</creatorcontrib><creatorcontrib>Córdova do Espírito Santo, Lílian</creatorcontrib><creatorcontrib>Murante, Anna Maria</creatorcontrib><creatorcontrib>Montico, Marcella</creatorcontrib><creatorcontrib>BFCI Study Group</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cattaneo, Adriano</au><au>Bettinelli, Maria Enrica</au><au>Chapin, Elise</au><au>Macaluso, Anna</au><au>Córdova do Espírito Santo, Lílian</au><au>Murante, Anna Maria</au><au>Montico, Marcella</au><aucorp>BFCI Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of the Baby Friendly Community Initiative in Italy: a non-randomised controlled study</atitle><jtitle>BMJ open</jtitle><addtitle>BMJ Open</addtitle><date>2016-05-06</date><risdate>2016</risdate><volume>6</volume><issue>5</issue><spage>e010232</spage><epage>e010232</epage><pages>e010232-e010232</pages><issn>2044-6055</issn><eissn>2044-6055</eissn><abstract>ObjectiveTo assess the effectiveness of the Baby Friendly Community Initiative (BFCI) on exclusive breast feeding at 6 months.DesignControlled, non-randomised trial.Setting18 Local Health Authorities in 9 regions of Italy.Participants5094 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.InterventionImplementation of the 7 steps of the BFCI.Main outcome measuresThe rate of exclusive breast feeding at 6 months was the primary outcome; breast feeding at discharge, 3 and 12 months was also measured.ResultsThe 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.ConclusionsThe 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.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>27154476</pmid><doi>10.1136/bmjopen-2015-010232</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Babies Breast Feeding - psychology Breast Feeding - statistics & numerical data Breast Feeding - trends Breastfeeding & lactation Community Community Participation Data collection Drug stores Early intervention Families & family life Female Food Health facilities Health Policy Health Promotion Health Services Research Humans Infant Infant Care Infant Nutritional Physiological Phenomena Infant, Newborn Initiatives Interviews Italy - epidemiology Male Maternal Health Services - organization & administration Mothers Mothers - education Mothers - psychology Organizational Policy Pharmacy Professionals Program Development Program Evaluation Social Support Support groups Working groups |
| title | Effectiveness of the Baby Friendly Community Initiative in Italy: a non-randomised controlled study |
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