BACKGROUND The 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. METHODS We 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. RESULTS The 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. CONCLUSION Mothers 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.

中文翻译：

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爱婴医院计划对法国妇产科母乳喂养率的影响。


背景爱婴医院计划（BFHI）与包括英国和美国在内的许多高收入国家改善母乳喂养结果有关，但其有效性从未在法国得到评估。我们调查了 BFHI 对 2010 年、2016 年和 2021 年法国产科单位母乳喂养率的影响，以评估 BFHI 是否有助于减少母乳喂养的不平等。方法 我们使用 2010 年 (n = 13 075)、2016 年 (n = 10 919) 和 2021 年 (n = 10 209) 法国国家数据对单胎足月新生儿母亲的母乳喂养情况（纯母乳喂养、混合母乳喂养和任何母乳喂养）进行了调查。围产期调查。我们使用混合效应分层多项回归模型调整新生儿、孕产妇、产科单位和法国行政部门的特征，并测试了某些交互作用。结果 与在未经 BFHI 认可的产科单位分娩的母亲相比，在 BFHI 认可的产科单位分娩的母亲的调整后纯母乳喂养率高出 +5.8 (3.4-8.1) 分。与平均体重新生儿相比，低出生体重婴儿的这种差异更为明显：当出生体重为 2500 克时，+14.9 (10.0-19.9) 分。在 BFHI 认可的医院中，混合母乳喂养率降低了 -1.7 分 (-3.2-0)，但根据新生儿或产妇特征，没有显着差异。结论 与在未经 BFHI 认可的产科单位分娩的母亲相比，在 BFHI 认可的产科单位分娩的母亲纯母乳喂养率较高，混合母乳喂养率较低。 BFHI 对母乳喂养频率较低的低出生体重新生儿的积极影响更大，有助于缩小这一弱势群体的差距，同时有利于受教育程度较高的母亲。