爱婴医院举措对母乳喂养结果的影响：系统回顾和荟萃分析

IF 4.4 2区医学 Q1 NURSING

Women and Birth Pub Date : 2025-02-06 DOI:10.1016/j.wombi.2025.101881

Ying Wei Fan , Heidi Sze Lok Fan , Jeffery Sheung Yu Shing , Hoi Lam Ip , Daniel Yee Tak Fong , Kris Yuet Wan Lok

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引用次数: 0

摘要

爱婴医院倡议（BFHI）是一项全球性努力，旨在促进在妇幼保健设施中支持母乳喂养的十项步骤。目的本研究探讨了BFHI对母乳喂养结果的影响，重点是开始率、纯母乳喂养持续时间和影响其效果的因素。方法检索1991年至2024年2月的9个数据库，进行系统评价和meta分析。纳入的研究包括实验性、准实验性或观察性研究，研究地点实施了完整的BFHI或至少三个步骤。两位审稿人独立筛选研究，评估偏倚风险，并提取数据。随机效应模型用于汇总结果，并根据BFHI状况和国家收入水平进行亚组分析。讨论纳入了86项研究。BFHI医院的婴儿在≤ 3个月时更有可能接受纯母乳喂养(OR= 1.77；95 % CI: 1.37-2.29)和3-6个月(OR= 1.82；95 % ci: 1.26-2.61)。在≤ 3个月时观察到任何母乳喂养率较高(OR= 1.48；95 % CI: 1.17-1.87)， 3-6个月(OR= 1.75；95 % CI: 1.18-2.61)和在>； 6个月时(OR= 2.34；95 % ci: 1.04-5.27)。结论实施bfhi对母乳喂养结果有积极影响，既有短期影响，也有长期影响。部分实施也与更高的纯母乳喂养率相关。收入水平之间的不显著差异可能反映了低收入和中等收入国家的研究数量有限。需要进一步的长期随访研究来确认长期影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Impact of baby-friendly hospital initiatives on breastfeeding outcomes: Systematic review and meta-analysis

Background

The Baby-Friendly Hospital Initiative (BFHI) is a global effort promoting the Ten Steps to support breastfeeding in maternity-care facilities.

Aim

This study examined the effect of BFHI on breastfeeding outcomes, focusing on initiation rates, exclusive breastfeeding durations, and factors influencing its effectiveness.

Methods

A systematic review and meta-analysis were conducted by searching nine databases (1991 to February 2024). Included studies were experimental, quasi-experimental, or observational studies, with sites implementing the full BFHI or at least three steps. Two reviewers independently screened studies, assessed risk of bias, and extracted data. Random-effects models were used for pooled results, with subgroup analyses based on BFHI status and country income level.

Discussion

Eighty-six studies were included. Infants in BFHI hospitals were more likely to be exclusively breastfed at ≤ 3 months (OR= 1.77; 95 % CI: 1.37–2.29) and 3–6 months (OR= 1.82; 95 % CI: 1.26–2.61). Higher rates of any breastfeeding were observed at ≤ 3 months (OR= 1.48; 95 % CI: 1.17–1.87), 3–6 months (OR= 1.75; 95 % CI: 1.18–2.61) and at > 6 months (OR= 2.34; 95 % CI: 1.04–5.27).

Conclusions

BFHI implementation positively impacts breastfeeding outcomes, with both short- and long-term effects. Partial implementation also correlates with higher exclusive breastfeeding rates. Insignificant differences across income levels may reflect the limited number of studies in low-and middle- income countries. Further research with longer-term follow up is needed to confirm long-term effects.

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来源期刊

Women and Birth NURSING-OBSTETRICS & GYNECOLOGY

CiteScore

7.20

自引率

13.20%

发文量

371

审稿时长

27 days

期刊介绍： Women and Birth is the official journal of the Australian College of Midwives (ACM). It is a midwifery journal that publishes on all matters that affect women and birth, from pre-conceptual counselling, through pregnancy, birth, and the first six weeks postnatal. All papers accepted will draw from and contribute to the relevant contemporary research, policy and/or theoretical literature. We seek research papers, quality assurances papers (with ethical approval) discussion papers, clinical practice papers, case studies and original literature reviews. Our women-centred focus is inclusive of the family, fetus and newborn, both well and sick, and covers both healthy and complex pregnancies and births. The journal seeks papers that take a woman-centred focus on maternity services, epidemiology, primary health care, reproductive psycho/physiology, midwifery practice, theory, research, education, management and leadership. We also seek relevant papers on maternal mental health and neonatal well-being, natural and complementary therapies, local, national and international policy, management, politics, economics and societal and cultural issues as they affect childbearing women and their families. Topics may include, where appropriate, neonatal care, child and family health, women’s health, related to pregnancy, birth and the postpartum, including lactation. Interprofessional papers relevant to midwifery are welcome. Articles are double blind peer-reviewed, primarily by experts in the field of the submitted work.