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Adherence to the Ten Steps of the Baby-Friendly Hospital Initiative in Minnesota Hospitals

Authors

  • Joan E. Dodgson PhD, RN, IBCLC,

    1. Joan E. Dodgson is Assistant Professor of Nursing, University of Hong Kong, and was previously a doctoral candidate at the School of Nursing, University of Minnesota, Minneapolis; Cheryl J. Allard-Hale is School Nurse at Inver Grove Heights Middle School, Inver Grove Heights; Adrienne Bramscher is Medical-Surgical Staff Nurse, Minneapolis VA Medical Center, Minneapolis; Faye Brown is Staff Nurse at Fairview-University Medical Center, Minneapolis; and Laura Duckett is Associate Professor, School of Nursing, University of Minnesota, Minneapolis, Minnesota.
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  • Cheryl J. Allard-Hale BSN, RN,

    1. Joan E. Dodgson is Assistant Professor of Nursing, University of Hong Kong, and was previously a doctoral candidate at the School of Nursing, University of Minnesota, Minneapolis; Cheryl J. Allard-Hale is School Nurse at Inver Grove Heights Middle School, Inver Grove Heights; Adrienne Bramscher is Medical-Surgical Staff Nurse, Minneapolis VA Medical Center, Minneapolis; Faye Brown is Staff Nurse at Fairview-University Medical Center, Minneapolis; and Laura Duckett is Associate Professor, School of Nursing, University of Minnesota, Minneapolis, Minnesota.
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  • Adrienne Bramscher BSN, RN,

    1. Joan E. Dodgson is Assistant Professor of Nursing, University of Hong Kong, and was previously a doctoral candidate at the School of Nursing, University of Minnesota, Minneapolis; Cheryl J. Allard-Hale is School Nurse at Inver Grove Heights Middle School, Inver Grove Heights; Adrienne Bramscher is Medical-Surgical Staff Nurse, Minneapolis VA Medical Center, Minneapolis; Faye Brown is Staff Nurse at Fairview-University Medical Center, Minneapolis; and Laura Duckett is Associate Professor, School of Nursing, University of Minnesota, Minneapolis, Minnesota.
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  • Faye Brown BSN, RN,

    1. Joan E. Dodgson is Assistant Professor of Nursing, University of Hong Kong, and was previously a doctoral candidate at the School of Nursing, University of Minnesota, Minneapolis; Cheryl J. Allard-Hale is School Nurse at Inver Grove Heights Middle School, Inver Grove Heights; Adrienne Bramscher is Medical-Surgical Staff Nurse, Minneapolis VA Medical Center, Minneapolis; Faye Brown is Staff Nurse at Fairview-University Medical Center, Minneapolis; and Laura Duckett is Associate Professor, School of Nursing, University of Minnesota, Minneapolis, Minnesota.
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  • Laura Duckett PhD, RN

    1. Joan E. Dodgson is Assistant Professor of Nursing, University of Hong Kong, and was previously a doctoral candidate at the School of Nursing, University of Minnesota, Minneapolis; Cheryl J. Allard-Hale is School Nurse at Inver Grove Heights Middle School, Inver Grove Heights; Adrienne Bramscher is Medical-Surgical Staff Nurse, Minneapolis VA Medical Center, Minneapolis; Faye Brown is Staff Nurse at Fairview-University Medical Center, Minneapolis; and Laura Duckett is Associate Professor, School of Nursing, University of Minnesota, Minneapolis, Minnesota.
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Address correspondence to Laura Duckett, PhD, RN, Associate Professor, School of Nursing, University of Minnesota, 6101 Weaver-Densford Hall, 308 Harvard Street, SE, Minneapolis, MN 55455.

Abstract

Background:A worldwide campaign has been initiated to improve the in-hospital care of mothers and babies through increased breastfeeding. The four objectives of the current investigation were to determine the in-hospital breastfeeding rate for Minnesota hospitals, to analyze the relationship between the in-hospital breastfeeding rates and selected hospital demographic characteristics, to determine the rate of adherence to each of the Baby-Friendly Hospital Initiative (BFHI) Ten Steps, and to analyze the relationship between the adherence rates for each of the Ten Steps and selected demographic characteristics.Methods:A descriptive survey was conducted and analyzed for the year of 1994 from 79 (83%) Minnesota hospitals. Respondents were directors of nursing, nursing managers, or other staff familiar with their hospital's breastfeeding policies and practices.Results:The average breastfeeding initiation rate was 59 percent. Four of the Ten Steps were implemented with a low adherence rate (0–49%), five were implemented with a moderate rate (50–89%), and none was implemented with a high rate (90–100%). Breastfeeding initiation rates and adherence to the Ten Steps varied with the size of the city and the number of births per year.Conclusions:Improvements in breastfeeding policies, practices, and staff education are needed if Minnesota hospitals are to provide care consistent with the Ten Steps of the BFHI. The results provide baseline information to guide institutional change that could promote successful breastfeeding experiences for postpartum families. This survey instrument could be used easily by researchers in other sites to assess nine of the Ten Steps.

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