Hostname: page-component-745bb68f8f-b95js Total loading time: 0 Render date: 2025-01-11T02:58:07.012Z Has data issue: false hasContentIssue false
  • English
  • Français

Assessment of breast-feeding promotion in hospitals and follow-up survey of mother–infant pairs in Germany: the SuSe Study

Published online by Cambridge University Press:  02 January 2007

Mathilde Kersting  and
Madeleine Dulon
Mathilde Kersting*
Affiliation:
Research Institute for Child Nutrition, Heinstück 11, D-44225 Dortmund, Germany
Madeleine Dulon
Affiliation:
Department of Epidemiology and Medical Statistics, School of Public Health, University of Bielefeld, PO Box 100131, D-33501 Bielefeld, Germany
*
*Corresponding author: Email kersting@fke-do.de
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

To assess breast-feeding promotion in maternity hospitals and breast-feeding prevalences during the first year of life in mother–infant pairs in Germany.

Design:

Cross-sectional assessment of breast-feeding practices in a random sample of German maternity hospitals by use of a postal questionnaire. Follow-up of mother–infant pairs recruited in the participating hospitals to assess breast-feeding prevalences and infant feeding practices by use of a telephone interview 14 days after birth and food-frequency questionnaires mailed at the end of the 2nd, 4th, 6th, 9th and 12th month of life. Use of indicators for breast-feeding proposed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF).

Setting:

Nation-wide survey.

Subjects:

One hundred and seventy-seven maternity hospitals, 1717 mother–infant pairs.

Results:

There were wide variations in breast-feeding promotion in hospitals as evaluated by the practice of the '10 Steps to Successful Breastfeeding' given by WHO and UNICEF for certification as a ‘Babyfriendly Hospital’. Some steps (3, 4, 8) were practised in about 90% of the hospitals, others (steps 7, 9) in only 10%. Prevalences for exclusive (total) breast-feeding as defined by WHO were: 73% (86%) at discharge, 60% (85%) at 14 days, 42% (70%) at 2 months, 33% (59%) at 4 months, 10% (48%) at 6 months, <1% (26%) at 9 months and 0 (13%) at 12 months.

Conclusions:

By use of indicators proposed by WHO and UNICEF, a differentiated insight into the breast-feeding situation in Germany has become possible. Moderate levels of breast-feeding promotion in hospitals resulted in almost satisfactory early breast-feeding prevalences but were not effective for long-term breast-feeding success in most mothers.

Keywords

Breast-feeding surveyBreast-feeding promotionMaternity hospitalsBreast-feeding prevalencesExclusive breast-feeding
Type
Research Article
Information
Public Health Nutrition , Volume 5 , Issue 4 , August 2002 , pp. 547 - 552
Copyright
Copyright © CABI Publishing 2002

References

1 World Health Organization. Global breastfeeding data collection: sources, prevalence, trends and association with global programmes. Personal communication, 2001.Google Scholar
2Cattaneo, A, Davanzo, R, Ronfani, L. Are data on the prevalence and duration of breastfeeding reliable? The case of Italy. Acta Paediatr. 2000; 89: 88–93.CrossRefGoogle ScholarPubMed
3http://www.babyfriendly.org.uk/indust.htm.Google Scholar
4Kersting, M, Koester, H, Wennemann, T, Wember, T,Schöch, G. Studies on breastfeeding 1981–1983 in 1500 mothers in Dortmund and Haltern. Parts I, II, III [in German]. Monatsschr. Kinderheilkd. 1987; 135: 204–9, 247–52, 314–9.Google Scholar
5Bergmann, RL, Dudenhausen, J, Bergmann, E, Bergmann, KE, Schmidt, E, Bauer, CP, et al. Infant feeding practices in Germany. Results of the multicenter cohort study on atopic diseases [in German]. Monatsschr. Kinderheilkd. 1994; 142: 412–7.Google Scholar
6http://www.bgvv.de/kommission.nsk/index.htm.Google Scholar
7Dulon, M, Kersting, M. Breastfeeding and infant nutrition in Germany: the SuSe-Study [in German]. In: German Nutrition Society, ed. The Nutrition Report 2000. Frankfurt: German Nutrition Society, 2000; 81–95.Google Scholar
8. World Health Organization (WHO)/Wellstart International. Promoting Breastfeeding in Health Facilities. A Short Course for Administrators and Policy-makers. WHO/NUT/96.3. Geneva: WHO, 1996.Google Scholar
9. World Health Organization (WHO). Division of Diarrhoeal and Acute Respiratory Disease Control. Indicators for Assessing Breastfeeding Practices. Report of an informal meeting, 11–12 June 1991. WHO/CDD/SER 91.14. Geneva: WHO, 1991.Google Scholar
10Dulon, M, Kersting, M. Breastfeeding promotion in German hospitals: results of the SuSe-Study [in German]. Frauenarzt 2000; 41: 1248–55.Google Scholar
11Dulon, M, Kersting, M, Schach, S. Duration of breastfeeding and associated factors in Western and Eastern Germany. Acta Paediatr 2001; 90: 931–5.CrossRefGoogle ScholarPubMed
12Springer, S, Kersting, M, Nehlsen, E, Przyrembel, H. Definitions of infant nutrition. Proposals from the National Committee on Breastfeeding Promotion in Germany [in German]. Sozialpädiatrie 1998; 21: 39–42.Google Scholar
13Kersting, M. Normal nutrition of infants. Food and meal based dietary guidelines [in German]. Monatsssch. Kinderheilkd. 2001; 149: 4–10.CrossRefGoogle Scholar
14IVE Research International. IVE Babymonitor. Hamburg: IVE Research International, 1999.Google Scholar
15Heiberg Endresen, E, Helsing, E. Changes in breastfeeding practices in Norwegian maternity wards: national surveys 1973, 1982 and 1991. Acta Paediatr. 1995; 84: 719–24.CrossRefGoogle ScholarPubMed
16Kramer, MS, Chalmers, B, Hodnett, ED, Sevkovskaja, Z, Dzikovich, I, Shapiro, S, et al. Promotion of breastfeeding intervention trial (PROBIT): a randomized trial in the Republic of Belarus. J. Am. Med. Assoc. 2001; 285: 413–20.CrossRefGoogle ScholarPubMed
17 Fifty-fourth World Health Assembly: Infant and Young Child Nutrition. WHA54.2, 18 May 2001.Google Scholar
18American Academy of Pediatrics. Workgroup on breastfeeding. Breastfeeding and the use of human milk. Pediatrics 1997; 100: 1035–9.CrossRefGoogle Scholar
19Michaelsen, KF, Weaver, L, Branca, F, Robertson, A. Feeding and Nutrition of Infants and Young Children. Guidelines for the WHO European Region, With Emphasis on the Former Soviet Countries. WHO Regional Publication, European Series No. 87. Copenhagen: World Health Organization European Regional Office, 2000.Google Scholar
20Aarts, C, Kylberg, E, Hornell, A, Hofvander, Y, Gebre-Medhin, M, Greiner, T. How exclusive is exclusive breastfeeding? A comparison of data since birth with current status data. Int. J. Epidemiol. 2000; 29: 1041–6.CrossRefGoogle ScholarPubMed
21Ryan, AS. The resurgence of breastfeeding in the United States. Pediatrics Online 1997; 99. Available at www.pediatricsorg/cgi/content/full/99/4/e12.Google ScholarPubMed
22Freeman, V, van't Hof, M, Haschke, F, and the Euro-Growth Study Group. Patterns of milk and food intake in infants from birth to age 36 months: The Euro-Growth Study. J. Pediatr. Gastroenterol. Nutr. 2000; 31: (Suppl. 1) 76–85.Google Scholar
23Riva, E, Banderali, G, Agostoni, C, Silano, M, Radaelli, G, Giovannini, M. Factors associated with initiation and duration of breastfeeding in Italy. Acta Paediatr. 1999; 88: 411–5.CrossRefGoogle ScholarPubMed
24Giovannini, M, Banderali, G, Agostoni, C, Silano, M, Radaelli, G, Riva, E. Epidemiology of breastfeeding in Italy. Acta Paediatr. Suppl. 1999; 430: 19–22.CrossRefGoogle Scholar
25Zetterström, R. Foreword. Biol. Neonate 1998; 10: 80–3.CrossRefGoogle Scholar