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CONFERENCE PROCEEDING
Baby-Friendly Hospital Initiative: Analysis of perinatal practices of French BFHI-accredited maternity units
1
CRESS OPPaLE, University Paris City, Paris, France
Eur J Midwifery 2026;10(Supplement 1):A148
ABSTRACT
BACKGROUND:
The Baby-Friendly Hospital Initiative (BFHI), launched by WHO and UNICEF in 1990, was initially designed to promote breastfeeding. In France, the program has since evolved to benefit all newborns, regardless of feeding method. The proportion of BFHI-accredited maternity units increased from 2% in 2010 to 12% in 2021. While its positive effect on breastfeeding is well documented, its broader impact on perinatal care practices remains underexplored.
OBJECTIVES:
To assess whether BFHI-accreditation in France is associated with improved adherence to recommended perinatal care practices, beyond breastfeeding support.
METHODS:
We analyzed data from the 2021 French National Perinatal Survey, including women who gave birth to a live singleton at ≥36 weeks’ gestation in mainland France. Facilities in the process of BFHI accreditation were excluded. The final sample comprised 412 maternity units, 9,504 women, and 9,599 newborns, classified according to BFHI accreditation status. A multilevel multivariate logistic regression model was used to evaluate compliance with recommended practices: reduced use of oxytocin during spontaneous labor, immediate skin-to-skin contact, companion presence during delivery, and avoidance of routine gastric aspiration.
RESULTS:
BFHI-accredited units accounted for 12% of births and demonstrated better adherence to evidence-based practices compared to non-accredited units: Less oxytocin use during spontaneous labor (27% vs. 32%, aOR = 0.6 [0.4–0.9]); Greater companion presence, especially during cesarean delivery (86% vs. 70%, aOR = 4.1 [2.2–7.8]); More frequent immediate skin-to-skin, especially during cesarean delivery (57% vs. 29%, aOR = 4.5 [2.7–7.4]); Reduced use of gastric aspiration (4% vs. 11%, aOR = 0.3 [0.01–1.2]).
CONCLUSIONS:
In France, BFHI accreditation is associated with improved compliance with evidence-based perinatal care practices, extending beyond its original focus on breastfeeding. These findings support the potential of BFHI as a broader model for quality improvement in perinatal care.
KEY MESSAGE:
BFHI's potential as a broader model for quality improvement in perinatal care. French - equity & breastfeeding (including three-minute presentation competition)
The Baby-Friendly Hospital Initiative (BFHI), launched by WHO and UNICEF in 1990, was initially designed to promote breastfeeding. In France, the program has since evolved to benefit all newborns, regardless of feeding method. The proportion of BFHI-accredited maternity units increased from 2% in 2010 to 12% in 2021. While its positive effect on breastfeeding is well documented, its broader impact on perinatal care practices remains underexplored.
OBJECTIVES:
To assess whether BFHI-accreditation in France is associated with improved adherence to recommended perinatal care practices, beyond breastfeeding support.
METHODS:
We analyzed data from the 2021 French National Perinatal Survey, including women who gave birth to a live singleton at ≥36 weeks’ gestation in mainland France. Facilities in the process of BFHI accreditation were excluded. The final sample comprised 412 maternity units, 9,504 women, and 9,599 newborns, classified according to BFHI accreditation status. A multilevel multivariate logistic regression model was used to evaluate compliance with recommended practices: reduced use of oxytocin during spontaneous labor, immediate skin-to-skin contact, companion presence during delivery, and avoidance of routine gastric aspiration.
RESULTS:
BFHI-accredited units accounted for 12% of births and demonstrated better adherence to evidence-based practices compared to non-accredited units: Less oxytocin use during spontaneous labor (27% vs. 32%, aOR = 0.6 [0.4–0.9]); Greater companion presence, especially during cesarean delivery (86% vs. 70%, aOR = 4.1 [2.2–7.8]); More frequent immediate skin-to-skin, especially during cesarean delivery (57% vs. 29%, aOR = 4.5 [2.7–7.4]); Reduced use of gastric aspiration (4% vs. 11%, aOR = 0.3 [0.01–1.2]).
CONCLUSIONS:
In France, BFHI accreditation is associated with improved compliance with evidence-based perinatal care practices, extending beyond its original focus on breastfeeding. These findings support the potential of BFHI as a broader model for quality improvement in perinatal care.
KEY MESSAGE:
BFHI's potential as a broader model for quality improvement in perinatal care. French - equity & breastfeeding (including three-minute presentation competition)
| eISSN: | 2585-2906 |
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