BACKGROUND: The purpose of this study was to describe breastfeeding policies and practices among hospitals in South Korea and the degree to which the hospitals are implementing the WHO/UNICEF Baby Friendly Hospital Initiative. METHODS: A cross-sectional survey of 34 hospitals was used to collect data. Quantitative and qualitative information and insights into current breastfeeding policies and practices were derived from responses of maternal and child health personnel at each hospital. One questionnaire per hospital was completed with personnel from all sections of maternity services, labor and delivery, nursery, and postpartum, contributing information needed to create a composite picture of the hospital's breastfeeding policies and practices. RESULTS: Most hospitals were classified as either high or moderately high implementers on four of the Ten Steps: printed information distributed to breastfeeding mothers, oral breastfeeding instruction given to mothers, infant supplementation, and infant feeding schedules. The remaining steps, including key practices like staff instruction, breastfeeding initiation, rooming-in, and hospital postpartum support are being partially implemented by the majority of hospitals in this study. CONCLUSIONS: Areas identified as needing the greatest attention by hospitals were health care staff training, breastfeeding initiation, supplementation, rooming-in, breastfeeding policy, and postpartum support for the breastfeeding mother.
Appointments and Schedules ; Arthritis, Rheumatoid ; Breast Feeding* ; Child ; Child Health ; Cross-Sectional Studies ; Delivery of Health Care ; Health Education ; Health Promotion ; Humans ; Infant ; Korea* ; Mothers ; Nurseries ; Postpartum Period ; Surveys and Questionnaires

BACKGROUND: Pediatric societies throughout the world recommend breastfeeding as the optimal form of infant nutrition. This recommendation is based on extensive epidemiologic research that documents the health, developmental, psychological, social, economic, and environmental benefits to infants, mothers, families, and society. The purpose of this study was to examine breastfeeding information and emotional support received by mothers prenatally, hospital breastfeeding practices, and the relationship between information and support received and breastfeeding initiation and planned feeding method post discharge from the hospital. METHODS: A 36-item questionnaire was distributed during the Spring 2000 to mothers who delivered babies at maternity centers in Seoul, South Korea. A sample of 52 mothers was surveyed at the time of hospital discharge. The questionnaire was developed based on the literature and reviewed by experts including internationally board certified lactation consultants, a nutritionist, and perinatal nurses. The survey instrument consists of five components: sociodemographic information, breastfeeding information received by mothers prenatally, emotional support regarding the mothers' infant feeding choice, breastfeeding initiation and supplementation, and hospital breastfeeding practices. RESULTS: Fifty-two breastfeeding mothers at three hospitals completed the survey. The majority of the mothers were 26 to 35 years of age, college graduates, married, had uncomplicated vaginal or planned cesarean deliveries, and primiparas. Forty-nine mothers responded that they decided to breastfeed during their pregnancy. Mothers reported that the information they received during pregnancy was provided primarily by their mothers, or friends and other relatives. The majority of mothers reported that others influenced their infant-feeding decision. Forty mothers reported receiving emotional support for their infant feeding choice during their pregnancy with mothers or mothers-in-law and friends providing the greatest support. DISCUSSION: Women obtain information prenatally about breastfeeding from many sources-family, friends, written materials, prenatal classes, and health care professionals. There are benefits and drawbacks to information received from multiple sources. Additionally, research has shown that a woman's infant-feeding decision is affected by the type of professional and social support the mother receives. Postpartum professional support for new breastfeeding mothers encompasses multiple dimensions ranging from a follow-up telephone call from the hospital nursing staff to referral to a community resource. Prenatal breastfeeding education on a community-wide basis can provide essential information for future mothers, families, and community support networks. Additional research needs to be done exploring the impact of prenatal, postpartum, and post-discharge support for women on breastfeeding initiation and duration rates.
Breast Feeding* ; Consultants ; Delivery of Health Care ; Education ; Feeding Methods ; Female ; Follow-Up Studies ; Friends ; Humans ; Infant ; Korea* ; Lactation ; Mothers* ; Nursing Staff, Hospital ; Nutritionists ; Postpartum Period ; Pregnancy ; Prenatal Education ; Surveys and Questionnaires ; Referral and Consultation ; Seoul* ; Telephone