Impact of nurse-focused Baby-Friendly Hospital Initiative training program on mothers’ breastfeeding practices at hospital discharge: a quasi-experimental study

Abstract

Abstract Background Maternity nurses play a key role in supporting breastfeeding and implementing the Baby-Friendly Hospital Initiative (BFHI). However, many nurses lack adequate training, and evidence on the impact of Baby-Friendly Hospital Initiative training programs on mothers’ breastfeeding practices is limited. Hence, this study aimed to evaluate the impact of Baby-Friendly Hospital Initiative training for maternity nurses on mothers’ breastfeeding practices at hospital discharge. Methods A quasi-experimental non-equivalent two-group design was used, including a total of 94 postpartum mothers purposively assigned to the pre-intervention (n = 47) and post-intervention (n = 47) groups according to specific eligibility criteria at MansouraUniversityHospital,Egypt.Astructuredinterviewquestionnaire,whichincludedmothers’demographic characteristics and breastfeeding practices, was utilized in data collection. Mothers were interviewed individually at hospital discharge. The Baby-Friendly Hospital Initiative training program was delivered to maternity nurses working in postpartum wards and the delivery unit. The training was conducted from the beginning of November 2023 to the end of December 2023 and consisted of 10 sessions, each lasting approximately 30–45 min for a total duration of 5 to 7.5 h. Descriptive statistics, chi-square, and Monte Carlo tests were used in data analysis. Absolute risk differences and adjusted odds ratios with 95% confidence intervals were also calculated. Results The studied mothers in the post-intervention group exhibited highly statistically significant improvements in self-reported breastfeeding practices compared to the pre-intervention group (p < 0.001). Major improvements were observed in assisting mothers in early initiation of breastfeeding (53.2% vs. 12.8%), exclusive breastfeeding without non-breast milk feeds (68.1% vs. 14.9%), breastfeeding on demand (70.2% vs. 25.5%), and avoidance of pacifier use (74.5% vs. 38.3%). Conclusions This study underscores that implementing the Baby-Friendly Hospital Initiative training program for nurses was associated with improvements in mothers’ self-reported breastfeeding practices at hospital discharge and may contribute to enhancing practices aligned with the Baby-Friendly Hospital standards. These findings indicate that a continuous, comprehensive Baby-Friendly Hospital Initiative training program for all maternity staff is essential to maintain high competency and promote adherence to BFHI standards. Trial registration ClinicalTrials.gov, NCT06824597, retrospectively registered on 31 January 2025.