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Baby-friendly hospitals: only the better, but not the best

European Journal of Clinical Nutrition volume 66, page 1078 (2012)Cite this article

Subjects

We appreciate the interest and the comments expressed in response to our article.1, 2 We are in agreement with the author’s viewpoint that the lack of commitment to implement the 10 steps of the Baby-Friendly Hospital Initiative, and specifically those that require staff skills and time may be the key reason why early complementary feeding is observed even in baby-friendly hospitals (BFH) and that these deserve special mention. Our study, which objectively assessed the compliance to exclusive breastfeeding (EBF), drew the same conclusion, and objectively showed that even BFH may not necessarily have improved rates of EBF. We therefore emphasize the need to monitor and reassess the functioning of BFH in India.

In addition, the authors have emphasized the lack of commitment, inadequate counselling during antenatal, perinatal and postnatal period, as well as inadequate training in terms of fewer health professional receiving training, as key drawbacks. These are the important factors to consider; nevertheless, there may be other crucial areas, such as support from the family and community that may be equally important to address, if compliance to EBF needs to be improved. For example, all the mothers in our cohort reported having received counselling during pregnancy and immediately after birth while at the hospital; however when they were back at home, these instructions were not followed. This raises two important questions: first, if counselling was given, why was it ineffective, and second, what were the home barriers that prevented mothers from implementing the hospital-based training they had received.

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References

  1. Das RR, Naik SS . Baby-friendly hospitals: only the better, but not the best. Eur J Clin Nutr 2012; 66: 1077.

    Article  CAS  Google Scholar 

  2. Samuel TM, Thomas T, Bhat S, Kurpad AV . Are infants born in baby-friendly hospitals being exclusively breastfed until 6 months of age? Eur J Clin Nutr 2012; 66: 459–465.

    Article  CAS  Google Scholar 

  3. Mclnnes RJ, Chambers JA . Supporting breastfeeding mothers: qualitative synthesis. J Adv Nurs 2008; 62: 407–427.

    Article  Google Scholar 

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Acknowledgements

This research was supported by the Coordinated Research Program (13319/RO) of International Atomic Energy Agency, Vienna.

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Authors and Affiliations

  1. Division of Nutrition, St John’s Research Institute, St John’s National Academy of Health Sciences, Bangalore, India

    T M Samuel, T Thomas & A V Kurpad

  2. Department of Pediatrics, St John’s Medical College, Bangalore, India

    S Bhat

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  1. T M Samuel
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  2. T Thomas
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  3. S Bhat
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  4. A V Kurpad
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Corresponding author

Correspondence to A V Kurpad.

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Competing interests

Dr Anura V Kurpad is a member of the Kraft Health and Wellness Board. His honoraria go entirely to charity. The remaining authors declare no conflict of interest.

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Samuel, T., Thomas, T., Bhat, S. et al. Baby-friendly hospitals: only the better, but not the best. Eur J Clin Nutr 66, 1078 (2012). https://doi.org/10.1038/ejcn.2012.65

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