Avaliação das boas práticas na implementação da Iniciativa Hospital Amigo da Criança antes e após a capacitação dos profissionais de saúde

Abstract

Introduction: The Baby­Friendly Hospital Initiative (BFHI) was created to encourage compliance with the “Ten Steps to Successful Breastfeeding” due to the decline in breastfeeding rates. It is known that breastfeeding is recommended until at least 2 years of age, being exclusive until 6 months of age. The role of the institution and health professionals linked to the mother­newborn (NB) binomial is crucial, especially when it comes to supporting breastfeeding in the first half hour of life and avoiding the prescription of food supplements. Following the steps recommended by the BFHI is essential for early stimulation of breastfeeding and for it to last. For this, training and qualification of health professionals linked to maternal and child care are necessary. Purpose: To compare the indicators of Steps 4 and 6 of the BFHI before and after the training of health professionals. Methods: Cross­sectional study with data collection from the medical records of NB who were born at the HCU­UFU and who remained in the Rooming­In until hospital discharge. Maternal and neonatal perinatal variables were compared and, in particular, the indicators of Steps 4 and 6 of the BFHI on breastfeeding in the first half hour, skin­to­skin contact, exclusive breastfeeding during hospitalization and discharge in 2017 and 2019, after the capacitation in 2018. For statistical analysis, the tests applied to compare the variables in the years 2017 and 2019 of Steps 4 and 6 were the Z test for proportions and Fischer's exact test. To compare maternal and neonatal variables, Fischer's exact test was used. To compare the weight of the newborns and the age of the mothers, the Student's T test was used. For all data, p<0.05 was considered statistically significant. Results: Data from 570 and 396 NB in 2017 and 2019, respectively, were evaluated. All variables showed statistically significant differences with improvement in indicators in the year 2019, compared to 2017, after training in 2018. Breastfeeding in the first half hour increased from 25% to 44.9% (p = 0.000), the skin­to­skin contact from 45.1% to 73.4% (p = 0.000), exclusive breastfeeding during hospitalization from 36.4% to 48.5% (p = 0.000) and exclusive breastfeeding at hospital discharge increased from 64.6% to 77.4% (p = 0.000). Conclusions: From the training of health professionals responsible for the care of the mother­NB binomial, an improvement was observed in the indicators of Steps 4 and 6 of the BFHI.