Laura N. Haiek, MD, MSc, Dany L. Gauthier, IBCLC, Dominique Brosseau, BSc, and Lydia Rocheleau, BSc, MSc. Department of Public Health, Monteregie Regional Board of Health and Social Services, 1255, rue Beauregard, Longueuil, QC J4K2M3, Canada, 450-928-6777, l.haiek@rrsss16.gouv.qc.ca

Background: The Monteregie Breastfeeding Regional Program has adopted the Baby Friendly Hospital Initiative (BFHI) as its main strategy to promote breastfeeding (BF) initiation, duration and exclusivity in the region. Objective: Based on the Precede-Proceed theoretical model, an assessment of the BFHI implementation in each of the Monteregie hospitals was performed in order to diagnose organizational behavior regarding the initiative’s proposed evidence-based policies and practices. Methods: The study examined the implementation level of the Ten Steps to Successful BF and of the International Code of Marketing of Breastmilk Substitutes in all 9 hospitals offering obstetrical care in the region, including one already accredited Baby Friendly. Using as data sources for each hospital the perspective of mothers (N=15), professionals (N=10) and external observers (N=2), 3 to 14 indicators were measured for each step and the Code. In order to provide hospitals with a summary measure, two synthetic indexes were constructed: the Ten Steps implementation score ranging between 0 and 10 and the Code implementation score ranging between 0 and 5. Results: Among participating hospitals, the Ten Steps scores varied between 2.1 and 7.2 (region’s score: 3.8) and the Code scores varied between 0.5 and 4.5 (region’s score: 2.4). Variation in score was not related to annual number of births, ward size or cesarean rate. Score construction and results interpretation will be illustrated during the presentation. Conclusions: Study results acted as a catalyst to bring about organizational changes that are helping Monteregie hospitals and their local partners progress towards achieving Baby Friendly certification.

Learning Objectives: At the end of the presentation the participant will be able to

(
• outline the steps needed to measure the implementation level of policies and practices proposed by the Baby Friendly Hospital Initiative, (
• understand how a summary measure of this implementation level was constructed, (
• discuss the impact of diffusing the findings on health planning at the hospital and regional level.

Keywords: Breast Feeding, Practice Guidelines

Related Web page: www.rrsss16.gouv.qc.ca

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.