UNICEF / Breastfeeding: Girl- and child-friendly hospitals had better results during the first wave of COVID-19

According to the study carried out by the Istituto Superiore di Sanità and the Italian Committee of UNICEF, the Amici delle Bambine e dei Bambini hospitals have achieved better results in some WHO / UNICEF standards and according to the guidelines of the Istituto Superiore di Sanità, compared to other hospitals in time with or interested in accreditation in the first months of the pandemic.

07 JUL

According to a study conducted by the Istituto Superiore di Sanità and the Italian Committee of UNICEF at 68 hospitals (26 of which are already accredited as Friends of Children Hospitals, 14 on the way, 28 interested in the course) in the network led by the coordination of the Together for Breastfeeding program under UNICEF Italy, the hospitals already accredited as Friends of Girls and Children have achieved better results than the others, in some WHO / UNICEF standards and in accordance with the guidelines of the Istituto Superiore di Sanità in force at the time of the study[i],[ii].

The analysis examined in relation to the first pandemic wave (March-April 2020): 1) compliance with some standards of the Baby-Friendly Hospital Initiative (BFHI) during the COVID-19 emergency; 2) differences in compliance with the practice recommended by the BFHI accreditation process; 3) how clinical care practices have changed and what were the challenges and strengths of using BFHI.

According to the study:
– Being a recognized Hospitalsven was significantly associated with the presence of a person of the mother’s choice during labor and skin-to-skin contact for at least one hour both in positive asymptomatic or paucisymptomatic women and in negative women.

– Rooming-in (the boy’s or girl’s stay in the mother’s room from birth and throughout the hospital stay) has reached 100% in the Friends Hospitals. On the other hand, in the facilities that were not on the way, this percentage reached 86.7% for COVID-positive women who had a caesarean section.

– In some cases, these forms of assistance have led to an increase in the number of births of women from other areas, making the management of a larger number of families more complex.

BFHI is a structured, evidence-based organizational and clinical model with an important focus on collaboration, coherence and the creation of a common vision for care centered on the mother-father-infant triad.

“In a moment of sparse or controversial data, the recognized Amici Hospitals – reads a note from the initiators of the study – have tried to maintain WHO / UNICEF standards by applying COVID-19 precautions for professionals, mothers, fathers and children and little girls. The authors of the study supports the idea that investment in collaborative care, which includes all relevant interest groups, contributes to management and is an essential element of preparedness ”.

“These indications – the note continues – are also supported by the operational guidance on infant and toddler feeding in emergencies[iii]. Furthermore, the study found that separation from the partner (from prenatal visits to hospitalization after birth) was experienced as a “destructive” experience. This confirms that the scientific indications that then, as now, recommend the presence of a person chosen by the woman during the entire birth process are not sufficient in themselves, and greater efforts are needed to translate them into clinical practice “.

Note:
[i] Giusti A, Zambri F, Marchetti F, Corsi E, Preziosi J, Sampaolo L, Pizzi E, Taruscio D, Salerno P, Chiantera A, Colacurci N, Davanzo R, Mosca F, Petrini F, Ramenghi L, Vicario M, Villani A , Viora E, Zanetto F, Chapin EM, Donati S. COVID-19 and Pregnancy, childbirth and breast-feeding: the provisional guidance of the Italian National Institutes of Health. Epidemiol Previous 2021 Jan-Apr., 45 (1-2): 14-16. English. doi: 10.19191 / EP21.1-2.P014.030. PMID: 33884834.

[ii] Temporary indications for pregnancy, childbirth, breastfeeding and care of the very young at 0-2 years in response to the COVID-19 emergency. Version 31 May 2020. Angela Giusti, Francesca Zambri, Francesca Marchetti, Letizia Sampaolo, Domenica Taruscio, Paolo Salerno, Antonio Chiantera, Nicola Colacurci, Riccardo Davanzo, Fabio Mosca, Flavia Petrini, Luca Ramenghi, Maria Vicario, Albertoro Villa, Federica Zanetto , Serena Donati 2020, ii, 18 pp. ISS COVID-19 Report No. 45/2020

[iii] Infant nutrition in acute core group. Infants and toddlers feeding in emergencies. Operational Guidance for Emergency Response Staff and Program Managers Developed by IFE Core Group. 3rd ed. Oxford: Emergency Nutrition Network; 2017.

July 7, 2022
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