>The Kramer study in Belarus compared a group of 16 hospitals training their
>staff using an 18 hour course (Breastfeeding Management and Promotion in a
>Baby-Friendly Hospital) with another group of 15 which was discouraged from
>providing such training or making changes during the study period.
>
>But none of the hospitals in the intervention sought or achieved
>Baby-Friendly designation, and at present only 4 hospitals in Belarus are
>listed by UNICEF as having achieved this award. In their JAMA article
>Kramer et al were conscientious in not describing the intervention hospitals
>as Baby-Friendly.


Thanks, Helen - you're right, of course. I cited the article as
evidence of Baby-Friendly status improving bf long-term without
re-reading it, and just went on memory.  Apologies.

>
>Even so, this useful study shows quite dramatically the good effects of
>providing some training and making some improvements in observed
>practice, with measurable results even
>before fulfillment of the Global Criteria of the BFHI.

Indeed. I think the Baby Friendly training (even without Baby
Friendly status) is likely to be better than many other forms of
training in terms of challenging accepted practice, looking at
attitudes and using good research as the basis. I have seen real
changes in hospital practice in my own area after staff have done
this training - by no means the first breastfeeding training they
have done.

Heather Welford Neil
NCT bfc Newcstle upon Tyne UK

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