gms | German Medical Science

Background: Breastfeeding is the ideal, most natural and optimal nutrition for infants. Up to six months of age breastfeeding is recommended as an exclusive form of nutrition worldwide [1], [2]. Today 13% of all infants in 21 European countries were breastfed in the first six months [2]. In Germany there is no comprehensive monitoring for breastfeeding, therefore it ist not possible to give reliable statements on current breastfeeding data. On the basis of the latest data from 2012, a rate of 82.1% children in Germany were initially breastfed [3]. Even in the first week of life, this number falls rapidly [4]. In 1992, the "Babyfriendly Hospital Initiative" becomes generally known as the "WHO / UNICEF Initiative Baby-friendly Hospital" in Germany and was intended to promote breastfeeding [5]. To date, this quality seal has been valid for the implementation of the B.E.St.® criteria in certified clinics. B.E.St.® stands for Bonding (Bindung), Development (Entwicklung) and Breastfeeding (Stillen) [5]. The statistical data for breastfeeding in Germany is incomplete. Due to sample size or survey setting, the data are often not representative. With regard to the evaluation of baby-friendly measures and their effect on breastfeeding, there is almost no information from Germany. Only one study was published in 2002 which included one baby-friendly hospital in Hamburg.

Aim/research question: The primary objective of the clinical trial is to examine the effects of the special measures of baby-friendly certified hospitals compared to non-certified clinics. In particular, the effects on breastfeeding and mother-child attachment will be investigated three months postpartum. Especially a promotion of breastfeeding should be supported by the BaSti-study.

Methods: The study will be conducted in two comparable obstetrical clinics (Nordrhein-Westfalen, Perinatal Center, ca. 1300 births per year). One of these is certified as a baby-friendly hospital. In the delivery ward, on the puerperal ward, and at the consultation hours with the midwives or doctor, the pregnant women (>24. week of pregnancy) and mothers receive the study information and declaration of agreement. Three months after birth, the women are interviewed by phone for breastfeeding with the help of an questionnaire. This survey is carried out invariably by trained midwives (B.Sc.) and/or psychologists (B.Sc.) in order to ensure correct handling of the sensitive topics.

Results: Lead results are not available yet. On that account the expected results are described below. It is expected that the proportion of mothers, who gave birth in a hospital approved as a baby-friendly clinic has a higher initial breastfeeding rate. In addition, women who gave birth in a baby-friendly clinic to a higher percentage breastfeed their babies three months postpartum exclusively, than women who gave birth to their child in a non-certified clinic. Women who were cared for by a midwife at home during the puerperium breastfeed their children at a higher rate after three months.

Recommendations/conclusions: Due to lacking statistical data in Germany with regard to the effect of baby-friendly measures, the study is highly relevant. It is possible to establish a nationwide monitoring system of breastfeeding in Germany.

Ethical criteria and conflict of interests: The research was submitted to an ethics committee. It was financed from own resources. There is no conflict of interest.