Rapid Responses to:

EDUCATION AND DEBATE: Adriano Cattaneo and Roberto Buzzetti Quality improvement report: Effect on rates of breast feeding of training for the Baby Friendly Hospital Initiative BMJ 2001; 323: 1358-1362 [Abstract] [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

Promoting breastfeeding as a pivotal practice for caring the disadvantaged families.

Maria A. Grimaldi   (3 July 2003)

Promoting breastfeeding as a pivotal practice for caring the disadvantaged families. 3 July 2003
Maria A. Grimaldi, Community Paediatrician Consultorio Familiare AUSL n. 5 Oristano 09170 Oristano, Italy Send response to journal: Re: Promoting breastfeeding as a pivotal practice for caring the disadvantaged families.	The implementation of preventive interventions for the community must entail an active offer of our health services, otherwise the population we serve will be mainly composed by healthy persons, the ones least in need of medical help. In order to reach the disadvantaged, from 1998 to the present time our home visiting nurses use to contact every mother after delivery, in the obstetrical department of our hospital. A home visit is proposed, which primarily aims at promoting breastfeeding, timely vaccinations, and at instructing the family about global child care, the prevention of home accidents and sudden infant death syndrome. In fact, through this visit, we are able to detect cases with special needs, the ones we never had the chance to encounter in our ambulatory, before we started with the home visits. These are the cases we take in charge with particular care. After detecting a new case, in our regular team sessions we prepare a personalized plan of intervention, stating explicitly the means we intend to use and the objectives we want to reach for every single case.The visiting nurse is the principal responsible of that particular project, and the first referent of that particular family. Around the case, she puts in motion a web of professionals, pertaining to every agency, internal or external to the local department of health, whose cooperation is deemed useful for the accomplishment of the project. The nurse enacts a regular surveillance, in order to ensure that the members of the family follow the guidelines we established with them. Contrary to the expectations of some of our staff, the home visit was accepted by a fair percentage (70%) of the families contacted. Through this project, we were able to encounter citizens in the disadvantaged sector of our society, individuals often neglected by, because unknown even to, social services. We were able to practice new strategies of intervention, more attuned to our mandate of community pediatricians and nurses. Although time- consuming, the home visits might be a long-term cost-effective practice and certainly one which unifies procedures and human and material resources. As such, it could be the logical complement to the training described by Buzzetti e Cattaneo [1]. In fact, we are now coupling the described practice with the administration of the OMS-Unicef 40 hours’ training course on breastfeeding counseling to all the professionals of our local department of health involved in the promotion of lactation. Maria Antonietta Grimaldi, MD, Oristano, Italia Competing interests: none declared References [1] Cattaneo A., Buzzetti, R Effect on rates of breast feeding of training for the Baby Friendly Hospital Initiative, BMJ 2001;323:1358–62 Competing interests:   None declared