Breastfeeding policies and practices in healthcare facilities in the Western Cape Province, South Africa

  • Debbi Marais Stellenbosch University (currently University of Aberdeen)
  • Elizabeth H Koornhof Stellenbosch University
  • Lisanne M du Plessis Stellenbosch University
  • Celeste E Naude Stellenbosch University
  • Karlien Smit Stellenbosch University
  • Retha Treurnicht Stellenbosch University
  • Estelle Hertzog Stellenbosch University
  • Michelle Alexander Stellenbosch University
  • Ingrid Kosaber Stellenbosch University
  • Lizette Cruywagen Stellenbosch University
Keywords: BFHI, Ten Steps to Successful Breastfeeding, Exclusive Breastfeeding, Maternity facilities

Abstract

The Baby-Friendly Hospital Initiative is a global effort to improve the role of maternity services and enable mothers to breastfeed infants, ensuring the best start in life. The foundation for the BFHI is the Ten Steps to Successful Breastfeeding (BF). It has been shown that selective implementation of only some of the steps may be ineffective and discouraging to successful BF practices. An initial study was conducted to assess the extent of implementation of the Ten Steps in both public and private maternity facilities. The poor performance for some steps led to a follow-up study to investigate the knowledge and attitudes of healthcare workers (HCW) and mothers and to evaluate exclusive BF practices in private BF clinics. Both studies followed descriptive, cross-sectional designs, set in the Cape Metropole, Western Cape. Twenty-six maternity facilities participated in the initial study, for which observation lists were completed and verified by interviewer-administered questionnaires to mothers and HCW. Eighteen private BF clinics participated in the follow-up study and included observations and interviewer-administered questionnaires to 64 mothers and 25 HCW. During the initial study, lower mean scores were noted for Steps 1, 2, 6 and 10 and overall the implementation of the Ten Steps was average. The findings highlight the importance of the establishment and implementation of BF policies, appropriate and continuous BF training and better referral systems to ensure initiation and establishment of early BF, exclusive BF practices and support on an ongoing basis to ensure that infants get the best start in life.

Author Biographies

Debbi Marais, Stellenbosch University (currently University of Aberdeen)
PhD MSc Coordinator: Population Health Division of Applied Health Sciences University of Aberdeen AB25 2ZD, Scotland, United Kingdom
Elizabeth H Koornhof, Stellenbosch University
Bsc Dietetics Division of Human Nutrition Dept Interdisciplinary Health Sciences Faculty of Health Sciences, Stellenbosch University
Lisanne M du Plessis, Stellenbosch University
M Nutr Division of Human Nutrition Dept Interdisciplinary Health Sciences Faculty of Health Sciences, Stellenbosch University
Celeste E Naude, Stellenbosch University
M Nutr Division of Human Nutrition Dept Interdisciplinary Health Sciences Faculty of Health Sciences, Stellenbosch University
Karlien Smit, Stellenbosch University
BSc Diet Division of Human Nutrition Dept Interdisciplinary Health Sciences Faculty of Health Sciences, Stellenbosch University
Retha Treurnicht, Stellenbosch University
BSc Diet Division of Human Nutrition Dept Interdisciplinary Health Sciences Faculty of Health Sciences, Stellenbosch University
Estelle Hertzog, Stellenbosch University
BSc Diet Division of Human Nutrition Dept Interdisciplinary Health Sciences Faculty of Health Sciences, Stellenbosch University
Michelle Alexander, Stellenbosch University
BSc Diet Division of Human Nutrition Dept Interdisciplinary Health Sciences Faculty of Health Sciences, Stellenbosch University
Ingrid Kosaber, Stellenbosch University
BSc Diet Division of Human Nutrition Dept Interdisciplinary Health Sciences Faculty of Health Sciences, Stellenbosch University
Lizette Cruywagen, Stellenbosch University
BSc Diet Division of Human Nutrition Dept Interdisciplinary Health Sciences Faculty of Health Sciences, Stellenbosch University
Published
2009-11-16
How to Cite
Marais, D., Koornhof, E., du Plessis, L., Naude, C., Smit, K., Treurnicht, R., Hertzog, E., Alexander, M., Kosaber, I., & Cruywagen, L. (2009). Breastfeeding policies and practices in healthcare facilities in the Western Cape Province, South Africa. South African Journal of Clinical Nutrition, 23(1), 40-45. Retrieved from http://sajcn.co.za/index.php/SAJCN/article/view/335
Section
Original Research