Assessment of Baby-Friendly Hospital Initiative and the International Code of Marketing of Breastmilk Substitutes implementation at Ain Shams University Maternity Hospital. A CROSS SECTIONAL STYDY

The Baby-Friendly Hospital Initiative (BFHI) is a powerful tool to improve global breastfeeding rates. Objective: To assess the degree of adherence to the ten steps of the BFHI and the International Code of Marketing of Breastmilk Substitutes (BMS), as well as to identify factors affecting compliance to the BFHI in Ain Shams University Maternity Hospital. Methods: A cross-sectional study was carried out on a systematic sample; data was collected from the hospital on two alternating days each week. The sample was 350 mothers and 100 healthcare workers (HCWs) at Ain Shams University Maternity Hospital. Two validated interview closed-ended questionnaires assessed sociodemographic data, maternal experiences during pregnancy, birth, and the maternity period, as well as HCWs’ training and knowledge of the hospital's breastfeeding policy and barriers to implementing the BFHI. Additionally, an observational checklist evaluated the presence of a written policy in appropriate locations. Results: the mean age of mothers was 29±6 years and HCW at the hospital was 33.7±8 years. Ain Shams University Maternity Hospital adhered only to step 7 of the BFHI and the Code of marketing of BMS with high overall compliance to the Code (96.9%) and overall moderate compliance to BFHI (to be mentioned). HCWs identified several key barriers affecting compliance to BFHI including lack of a clear and written breastfeeding policy (90%), insufficient staff training (90%), excessive workload (94%), mother-related factors (50%).Conclusions and recommendations: Ain Shams University Maternity Hospital adhered to the code. However, there's a need for improvement regarding the BFHI Ten Steps.