Evidence map›Paper›PMID 38857529›Full record

ArticleInternational journal of epidemiology2024

The impact of the Baby-Friendly Hospital Initiative on breastfeeding rates at maternity units in France.

Andrea Guajardo-Villar, Camille Pelat, Beatrice Blondel, Elodie Lebreton, Virginie Demiguel, Benoit Salanave, Ayoub Mitha, Hugo Pilkington, Nolwenn Regnault, ENP2021 Study Group

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In one paragraph

Article in International journal of epidemiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Breastfeeding rates in Israel and their health policy implications.Israel journal of health policy research · 2025
    Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Andrea Guajardo-VillarData Support, Processing and Analysis Department (DATA), French National Public Health Agency, Saint-Maurice, France.ORCID 0000-0002-4894-7864
Camille PelatData Support, Processing and Analysis Department (DATA), French National Public Health Agency, Saint-Maurice, France.
Beatrice BlondelObstetric, Perinatal and Pediatric Epidemiology Research Team, Center of Research in Epidemiology and Statistics (CRESS), INSERM, Université Paris Cité, Paris, France.
Elodie LebretonNon-Communicable Diseases and Trauma Department (DMNTT), French National Public Health Agency, Saint-Maurice, France.
Virginie DemiguelNon-Communicable Diseases and Trauma Department (DMNTT), French National Public Health Agency, Saint-Maurice, France.
Benoit SalanaveNon-Communicable Diseases and Trauma Department (DMNTT), French National Public Health Agency, Saint-Maurice, France.
Ayoub MithaObstetric, Perinatal and Pediatric Epidemiology Research Team, Center of Research in Epidemiology and Statistics (CRESS), INSERM, Université Paris Cité, Paris, France.ORCID 0000-0001-7203-3205
Hugo PilkingtonDépartement de Géographie, UMR7533 Ladyss, Université Paris, Saint-Denis, France.
Nolwenn RegnaultNon-Communicable Diseases and Trauma Department (DMNTT), French National Public Health Agency, Saint-Maurice, France.ORCID 0000-0002-0781-1450
ENP2021 Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Baby-Friendly Hospital Initiative (BFHI) is associated with improved breastfeeding outcomes in many high-income countries including the UK and the USA, but its effectiveness has never been evaluated in France. We investigated the impact of the BFHI on breastfeeding rates in French maternity units in 2010, 2016 and 2021 to assess if the BFHI aids to reduce inequalities in breastfeeding.

methodsWe examined breastfeeding in maternity units (exclusive, mixed and any breastfeeding) in mothers of singleton full-term newborns using the 2010 (n = 13 075), 2016 (n = 10 919) and 2021 (n = 10 209) French National Perinatal Surveys. We used mixed-effect hierarchical multinomial regression models adjusting for neonatal, maternal, maternity unit and French administrative department characteristics, and tested certain interactions.

resultsThe adjusted rate of exclusive breastfeeding was higher by +5.8 (3.4-8.1) points among mothers delivering in BFHI-accredited maternity units compared with those delivering in non-accredited units. When compared with average-weight newborns, this difference was sharper for infants with low birthweight: +14.9 (10.0-19.9) points when their birthweight was 2500 g. Mixed breastfeeding was lower by -1.7 points (-3.2-0) in BFHI-accredited hospitals, with no notable difference according to the neonatal or maternal characteristics.

conclusionMothers delivering in BFHI-accredited maternity units had higher exclusive breastfeeding rates and lower mixed breastfeeding rates than those delivering in non-accredited maternity units. The positive impact of the BFHI was stronger among low-birthweight neonates, who are less often breastfed, helping reduce the gap for this vulnerable group while favouring mothers with higher education levels.

Indexed as

Breast FeedingHealth PromotionAdolescentAdultFemaleFranceHumansInfant, Low Birth WeightInfant, NewbornMothersPregnancyYoung AdultBaby-Friendly Hospital InitiativeBreastfeedingFranceinequalities

Identifiers

PMID38857529
PMCPMC11164413

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.