The Impact of the Baby-Friendly Hospital Initiative on Breastfeeding Rates at Maternity Units in France

Overview

Journal Int J Epidemiol

Specialty Public Health

Date 2024 Jun 10

PMID 38857529

Authors

Andrea Guajardo-Villar

Camille Pelat

Beatrice Blondel

Elodie Lebreton

Virginie Demiguel

Benoit Salanave

Ayoub Mitha

Hugo Pilkington

Nolwenn Regnault

Affiliations

Soon will be listed here.

Abstract

Background: The Baby-Friendly Hospital Initiative (BFHI) is associated with improved breastfeeding outcomes in many high-income countries including the UK and the USA, but its effectiveness has never been evaluated in France. We investigated the impact of the BFHI on breastfeeding rates in French maternity units in 2010, 2016 and 2021 to assess if the BFHI aids to reduce inequalities in breastfeeding.

Methods: We examined breastfeeding in maternity units (exclusive, mixed and any breastfeeding) in mothers of singleton full-term newborns using the 2010 (n = 13 075), 2016 (n = 10 919) and 2021 (n = 10 209) French National Perinatal Surveys. We used mixed-effect hierarchical multinomial regression models adjusting for neonatal, maternal, maternity unit and French administrative department characteristics, and tested certain interactions.

Results: The adjusted rate of exclusive breastfeeding was higher by +5.8 (3.4-8.1) points among mothers delivering in BFHI-accredited maternity units compared with those delivering in non-accredited units. When compared with average-weight newborns, this difference was sharper for infants with low birthweight: +14.9 (10.0-19.9) points when their birthweight was 2500 g. Mixed breastfeeding was lower by -1.7 points (-3.2-0) in BFHI-accredited hospitals, with no notable difference according to the neonatal or maternal characteristics.

Conclusion: Mothers delivering in BFHI-accredited maternity units had higher exclusive breastfeeding rates and lower mixed breastfeeding rates than those delivering in non-accredited maternity units. The positive impact of the BFHI was stronger among low-birthweight neonates, who are less often breastfed, helping reduce the gap for this vulnerable group while favouring mothers with higher education levels.

Citing Articles

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Fan H, Leung E, Lau K, Wong J, Choi E, Lam C JMIR Form Res. 2025; 9():e64191.

PMID: 39803717 PMC: 11741636. DOI: 10.2196/64191.

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