Objective: To examine the effect of the Baby Friendly Hospital Initiative on breast feeding rates in Scotland. Design: Observational study using an annual su rvey of progress towards the WHO/UNICEF Baby Friendly Hospi...Objective: To examine the effect of the Baby Friendly Hospital Initiative on breast feeding rates in Scotland. Design: Observational study using an annual su rvey of progress towards the WHO/UNICEF Baby Friendly Hospital Initiative and ro utinely collected breast feeding rates gathered on the Guthrie Inborn Errors Scr eening card at 7 days of postnatal age. Setting: Scotland, UK, population 5.1 mi llion, with about 53 000 births a year. Participants: All 33 maternity units wit h over 50 births per annum and 464 246 infants born in Scotland between 1995 and 2002. Main outcome measures: Baby Friendly status of each maternity unit at the time of an infant’s birth: certificate of commitment, UK standard award, and breast feeding at 7 days postnatal age. Results: Babies born in a hospital with the UK Baby Friendly Hospital Initiative standard award were 28% (p < 0.001) m ore likely to be exclusively breast fed at 7 days of postnatal age than those bo rn in other maternity units after adjustment for mother’s age, deprivation, ho spital size, and year of birth. From 1995, breast feeding rates had increased si gnificantly faster in hospitals with Baby Friendly status by 2002: 11.39% (95 % confidence interval 10.35 to 12.43) v 7.97% (95% confidence interval 7.2 1 to 8.73). Conclusion: Being born in a hospital that held the award increased t he chance of being breast fed. All maternity units should be encouraged to under take the significant strategic and prac tical changes required to achieve UK Baby Friendly Hospital Initiative standa rd status.展开更多
To examine the hypothesis that bedsharing with an infant is associated with an increased risk of sudden infant death syndrome (SIDS). Study design: A 1:2, case:control study in Scotland UK, population 5.1 million, inc...To examine the hypothesis that bedsharing with an infant is associated with an increased risk of sudden infant death syndrome (SIDS). Study design: A 1:2, case:control study in Scotland UK, population 5.1 million, including 123 infants who died of SIDS between January 1, 1996 and May 31, 2000, and 263 controls. The main outcome measure was sharing a sleep surface during last sleep. Results: Sharing a sleep surface was associated with SIDS (multivariate OR 2.89, 95% CI 1.40, 5.97). The largest risk was associated with couch sharing (OR 66.9, 95% CI 2.8, 1597). Of 46 SIDS infants who bedshared during their last sleep, 40 (87% ) were found in the parents’ bed. Sharing a bed when <11 weeks (OR 10.20, 95% CI 2.99, 34.8) was associated with a greater risk, P = .010, compared with sharing when older (OR 1.07, 95% CI 0.32, 3.56). The association remained if mother did not smoke (OR8.01, 95% CI 1.20, 53.3) or the infant was breastfed (OR 13.10, 95% CI 1.29, 133). Conclusions: Bedsharing is associated with an increased risk of SIDS for infants <11 weeks of age. Sharing a couch for sleep should be strongly discouraged at any age.展开更多
文摘Objective: To examine the effect of the Baby Friendly Hospital Initiative on breast feeding rates in Scotland. Design: Observational study using an annual su rvey of progress towards the WHO/UNICEF Baby Friendly Hospital Initiative and ro utinely collected breast feeding rates gathered on the Guthrie Inborn Errors Scr eening card at 7 days of postnatal age. Setting: Scotland, UK, population 5.1 mi llion, with about 53 000 births a year. Participants: All 33 maternity units wit h over 50 births per annum and 464 246 infants born in Scotland between 1995 and 2002. Main outcome measures: Baby Friendly status of each maternity unit at the time of an infant’s birth: certificate of commitment, UK standard award, and breast feeding at 7 days postnatal age. Results: Babies born in a hospital with the UK Baby Friendly Hospital Initiative standard award were 28% (p < 0.001) m ore likely to be exclusively breast fed at 7 days of postnatal age than those bo rn in other maternity units after adjustment for mother’s age, deprivation, ho spital size, and year of birth. From 1995, breast feeding rates had increased si gnificantly faster in hospitals with Baby Friendly status by 2002: 11.39% (95 % confidence interval 10.35 to 12.43) v 7.97% (95% confidence interval 7.2 1 to 8.73). Conclusion: Being born in a hospital that held the award increased t he chance of being breast fed. All maternity units should be encouraged to under take the significant strategic and prac tical changes required to achieve UK Baby Friendly Hospital Initiative standa rd status.
文摘To examine the hypothesis that bedsharing with an infant is associated with an increased risk of sudden infant death syndrome (SIDS). Study design: A 1:2, case:control study in Scotland UK, population 5.1 million, including 123 infants who died of SIDS between January 1, 1996 and May 31, 2000, and 263 controls. The main outcome measure was sharing a sleep surface during last sleep. Results: Sharing a sleep surface was associated with SIDS (multivariate OR 2.89, 95% CI 1.40, 5.97). The largest risk was associated with couch sharing (OR 66.9, 95% CI 2.8, 1597). Of 46 SIDS infants who bedshared during their last sleep, 40 (87% ) were found in the parents’ bed. Sharing a bed when <11 weeks (OR 10.20, 95% CI 2.99, 34.8) was associated with a greater risk, P = .010, compared with sharing when older (OR 1.07, 95% CI 0.32, 3.56). The association remained if mother did not smoke (OR8.01, 95% CI 1.20, 53.3) or the infant was breastfed (OR 13.10, 95% CI 1.29, 133). Conclusions: Bedsharing is associated with an increased risk of SIDS for infants <11 weeks of age. Sharing a couch for sleep should be strongly discouraged at any age.
