TIGLAO Kayla Marie D. BSN2G D - Journal

TIGLAO, Kayla Marie D.
DR/NR VD March 1-3, 2021

BSN 2G-Group D Clinical Instructor: Ms. Beth B. Viduya
I. Title: Impact of mother-baby friendly hospital initiative in a tertiary hospital on

success of breastfeeding: A prospective cohort study
Edition: Volume 43, Number 1, PJOG January-February 2019
Publisher: Philippine Journal of Obstetrics and Gynecology
Author: Holgado, P. MD & Mercado, W. MD - Department of Obstetrics and
Gynecology, University of Santo Tomas Hospital
II. Summary
Early initiation of breastfeeding is one of the time-bound interventions of the

Essential Intrapartum and Newborn Care (EINC), a protocol that is part of the
Mother-Baby Friendly Hospital Initiative (MBFHI) as mandated by AO 2009-025
wherein all private and government hospitals offering maternity and newborn
care may be accredited as “Mother-Baby Friendly” if they implement the 10 Steps
to Successful Breastfeeding adopted from UNICEF and WHO. Breastmilk is the
preferred feeding for all infants while exclusive breastfeeding (EBF) for the first 6
months is considered one of the most effective preventive health measures to
reduce child morbidity and mortality. It promotes the general health of the
newborn and reduces the risk of acquiring acute and chronic illnesses. The WHO
recommends timely initiation of breastfeeding within the first hour of birth, EBF for
the first 6 months of life, followed by appropriate complementary feeding, while
continuing breastfeeding for 2 years and beyond. This study aims to determine the
impact of MBFHI implementation on success of breastfeeding practices among
patients who gave birth in a tertiary hospital. The participants attended at least
one prenatal check up and one breastfeeding module. Hospital staff educated
them about DOH mandates on EINC, Rooming-in and EBF upon admission,
delivery, and entire hospital stay. Results have shown that at first hour postpartum,
majority of the infants who did not initiate breastfeeding was due to respiratory
distress. Half of mothers exclusively breastfed up to 6 months, regardless of age,
parity and route of delivery. The main determinants of EBF cessation at 6-month
postpartum include inadequate milk production, resumption of work and inability
to collect milk.
III. Personal Insights
Through this journal, I have learned that aside from the EINC which we have
discussed in our nursing subjects, the hospitals are also accredited to be Mother-
Baby Friendly which aims to encourage optimal breastfeeding practices through
exclusive and early initiated breastfeeding. It was mentioned in the journal that
MBFHI is an effective strategy to reduce infant morbidity and mortality by
determining and removing the hindrances to breastfeeding within the health care
system, at the workplace, and in the community. As a student nurse, I agree with
this one since the steps followed in this policy is a collaborative work between the
hospital staff and the patients, and it is very helpful in utilizing the benefits of
breastfeeding to both the newborn and the mother. Since this requires the
healthcare staff to have sufficient knowledge and skills to support breastfeeding,
it means that they do not only educate mothers on the important information
TIGLAO, Kayla Marie D. DR/NR VD March 1-3, 2021
about breastfeeding, but also it enables them to have a better understanding

about it as well which can help them provide better care and health teachings to
their clients.
IV. Reflection on the Nursing Implications
Nursing Practice
In obstetrics, nurses have a significant role in providing care for their clients from
prenatal up to intrapartum and postpartum. During delivery, nurses are the ones
who do the time bound interventions for the newborn based on the EINC and this
include the facilitation of the immediate skin-to-skin contact and supporting
mothers to initiate breastfeeding as soon as possible after birth unless
contraindicated. Though it was mentioned in the study that breastfeeding
practices after delivery in that certain tertiary hospital was successful,
determinants of EBF cessation at 6-months was still identified. Since nurses and
other healthcare providers are responsible in providing health education to
mothers or parents about breastfeeding, knowing such determinants can help
them identify points that should be included in their care plan and health
teachings in order to manage the difficulties of breastfeeding that can lead to its
cessation and maintain breastfeeding up to the appropriate recommended
period.
Nursing Education
For nursing students like us, this journal is helpful for us to understand more the
importance of following the EINC protocol, which is one of our topics in our
maternal and child nursing subject, once we are already doing our duties in the
hospital. All the interventions are equally important and beneficial to both the
newborn and the mother but breastfeeding requires more support since it requires
longer monitoring and we are aware that breastmilk is essential for the growth,
development, and immunity of the newborn but there may also be a lot of
difficulties that can hinder the baby from getting optimum nutrition from the
breastmilk. By knowing how to identify these, us student nurses can prepare
ourselves on how to handle such situations and we can also learn how to give
proper health education and support to our clients especially that breastfeeding
provides a long-term benefit for the infant if it is properly maintained.
Nursing Research
As what is stated in the journal, the study contributes to national health

knowledge related to exclusive and proper breastfeeding within first hour after
delivery until the infants is 6 months of age. Further research can be conducted in
a larger population, including the private facilities. Aside from success of
breastfeeding, researchers can also look into the emotional aspect of
breastfeeding on the mothers and the emotional support given by the hospital
staff and family members. The results of this study determined resumption of work
and lack of lactation clinic in their workplace as a factor to cease breastfeeding,
TIGLAO, Kayla Marie D. DR/NR VD March 1-3, 2021
so it is also recommended to investigate on the effect of work on the mother’s

decision on breastfeeding as well as its nature. These future studies may help
strengthen the breastfeeding policy implementation to promote, protect, and
maintain breastfeeding.

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TIGLAO, Kayla Marie D.

DR/NR VD March 1-3, 2021

I. Title: Impact of mother-baby friendly hospital initiative in a tertiary hospital on

Early initiation of breastfeeding is one of the time-bound interventions of the

III. Personal Insights

about breastfeeding, but also it enables them to have a better understanding

IV. Reflection on the Nursing Implications

As what is stated in the journal, the study contributes to national health

so it is also recommended to investigate on the effect of work on the mother’s

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