Adherence to Baby Friendly Hospital Initiative Global Standards During the COVID-19 Pandemic: A Nationwide, Cross-Sectional Study.

AIM: The COVID-19 pandemic caused considerable organisational changes in maternity facilities. We investigated adherence to the Baby Friendly Hospital Initiative (BFHI) standards in Croatian maternity hospitals.

METHODS

A cross-sectional online survey targeted participants of the only Croatian antenatal course available during the pandemic. Women aged 18+ years, resident in Croatia, who had given birth in a Croatian maternity facility between February 2020 and December 2021 were eligible. A 75-item questionnaire was created including BFHI adherence statements and open-ended items. Quantitative data were analysed descriptively and content analysis was used for qualitative data.

RESULTS

Out of 3288 responses from across Croatia, 2130 were valid. Two-thirds (1473; 69%) had skin-to-skin contact (SSC) within 5 min of birth. Only 45% (795) held their baby for an hour, and 49% (1047) of babies latched during SSC. Just 29% (558) received breastfeeding help within 6 h, and 27% (582) exclusively breastfed in the first 2 days. Only 42% (886) were with their baby 24/7. Four qualitative themes are reported.

CONCLUSION

BFHI standards were not followed during the pandemic, leading to unnecessary separations and low exclusive breastfeeding rates. Prioritising breastfeeding is essential for the optimal health of mothers and newborns.