{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T22:18:53Z","timestamp":1792016333111,"version":"4.4.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2017,6,11]],"date-time":"2017-06-11T00:00:00Z","timestamp":1497139200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hum Lact"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The primary goal of the Baby-Friendly Hospital Initiative (BFHI) is to create conditions in maternity facilities that enable women to initiate and sustain the practice of breastfeeding exclusively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research aim:<\/jats:title>\n                    <jats:p>This study aimed to determine hospital practices and breastfeeding rates before and after BFHI implementation and assess compliance with UNICEF\/World Health Organization (WHO) standards for seven of the BFHI\u2019s Ten Steps to Successful Breastfeeding ( Ten Steps).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Mothers of healthy, term infants ( N = 1,115) were recruited from the postnatal ward of the University Hospital of Split, Croatia, between February 2008 and July 2011 and followed for 12 months in a repeated-measures, prospective, longitudinal, three-group, nonequivalent, cohort study. Breastfeeding rates, hospital practices\u2014including seven of the Ten Steps\u2014and maternal sociodemographic data were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Parts of all seven Ten Steps that were assessed improved significantly post-BFHI. Step 3 (\u201cantenatal education\u201d) showed the least improvement, whereas Step 7 (\u201crooming-in\u201d; 2.6% pre-BFHI vs. 98.5% post-BFHI) and Step 9 (\u201cno pacifiers\/teats\u201d; 21.8% pre-BFHI vs. 99.4% post-BFHI) showed the greatest improvement. Six months after Baby-Friendly designation, only Steps 7 and 9 were in full compliance with UNICEF\/WHO standards. In-hospital, exclusive-breastfeeding rates rose markedly ( p &lt; .001), but no change occurred in breastfeeding rates at 3, 6, or 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Full implementation of the BFHI was associated with significant improvement in hospital practices and in-hospital, exclusive-breastfeeding rates, but it did not affect breastfeeding rates postdischarge, emphasizing the vital role of community support. Baby-Friendly Hospital Initiative standards declined rapidly post-hospital designation, indicating the need for regular monitoring and reassessment as well as ongoing, effective training for hospital staff.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0890334417703367","type":"journal-article","created":{"date-parts":[[2017,6,11]],"date-time":"2017-06-11T15:49:48Z","timestamp":1497196188000},"page":"106-115","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Compliance With WHO\/UNICEF BFHI Standards in Croatia After Implementation of the BFHI"],"prefix":"10.1177","volume":"34","author":[{"given":"Irena","family":"Zakarija-Grkovi\u0107","sequence":"first","affiliation":[{"name":"Departments of Family Medicine and Clinical Skills, University of Split School of Medicine, Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marija","family":"Boban","sequence":"additional","affiliation":[{"name":"Health Centre of Split and Dalmatia County, Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun\u010dana","family":"Jankovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University Hospital Zagreb, Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anamarija","family":"\u0106u\u017ee","sequence":"additional","affiliation":[{"name":"Health Centre of Split and Dalmatia County, Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tea","family":"Burmaz","sequence":"additional","affiliation":[{"name":"Department of Prevention, Local Health Unit of Venice, Hygiene and Public Health Service, Venezia-Mestre, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,6,11]]},"reference":[{"key":"bibr1-0890334417703367","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001318"},{"key":"bibr2-0890334417703367","doi-asserted-by":"publisher","DOI":"10.1177\/0890334412447994"},{"key":"bibr3-0890334417703367","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-2556"},{"key":"bibr4-0890334417703367","doi-asserted-by":"publisher","DOI":"10.1177\/0890334415625872"},{"key":"bibr5-0890334417703367","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2013-304842"},{"key":"bibr6-0890334417703367","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980014000238"},{"key":"bibr7-0890334417703367","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-1248"},{"key":"bibr8-0890334417703367","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2012.0066"},{"key":"bibr9-0890334417703367","doi-asserted-by":"publisher","DOI":"10.1177\/0890334412447788"},{"key":"bibr10-0890334417703367","doi-asserted-by":"publisher","DOI":"10.1186\/1746-4358-8-15"},{"key":"bibr11-0890334417703367","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01044-2"},{"key":"bibr12-0890334417703367","doi-asserted-by":"publisher","DOI":"10.1097\/ANC.0000000000000029"},{"key":"bibr13-0890334417703367","doi-asserted-by":"publisher","DOI":"10.1111\/apa.13127"},{"key":"bibr14-0890334417703367","doi-asserted-by":"publisher","DOI":"10.1177\/0890334415599399"},{"key":"bibr15-0890334417703367","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.2011.00483.x"},{"key":"bibr16-0890334417703367","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2011-200332"},{"key":"bibr17-0890334417703367","author":"United Nations International Children\u2019s Emergency Fund\/ World Health Organization","year":"2006","journal-title":"Section 4: Hospital Self-Appraisal and Monitoring"},{"key":"bibr18-0890334417703367","unstructured":"World Health Organization. (1981). International code of marketing of breast-milk substitutes. Retrieved December 27, 2016, from http:\/\/www.who.int\/nutrition\/publications\/infantfeeding\/9241541601\/en\/"},{"key":"bibr19-0890334417703367","unstructured":"World Health Organization. (1991). Indicators for assessing breastfeeding practices. Retrieved December 27, 2016, from http:\/\/www.who.int\/maternal_child_adolescent\/documents\/cdd_ser_91_14\/en\/"},{"key":"bibr20-0890334417703367","volume-title":"Evidence for the ten steps to successful breastfeeding.","author":"World Health Organization","year":"1998"},{"key":"bibr21-0890334417703367","doi-asserted-by":"publisher","DOI":"10.1177\/0890334412447079"},{"key":"bibr22-0890334417703367","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckv203"}],"container-title":["Journal of Human Lactation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0890334417703367","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0890334417703367","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0890334417703367","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:32:16Z","timestamp":1777501936000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0890334417703367"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6,11]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1177\/0890334417703367"],"URL":"https:\/\/doi.org\/10.1177\/0890334417703367","relation":{},"ISSN":["0890-3344","1552-5732"],"issn-type":[{"value":"0890-3344","type":"print"},{"value":"1552-5732","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6,11]]}}}