A Controlled Study on Baby-Friendly Communities in Italy: Methods and Baseline Data

Aim. To report the research methods and baseline data of a project aimed at assessing the effect of an intervention based on the 7 Steps of the Baby Friendly Community Initiative on the rate of exclusive breastfeeding at 6 months in Italy. Methods. In this controlled, non-randomized study, 9 Local Health Authorities are assigned to an early and 9 to a late intervention group. Data on breastfeeding in infants followed from birth to 12 months are gathered at baseline and in two subsequent rounds, after the 7 Steps are implemented in the early and late intervention groups, respectively. Step-down logistic regression analysis, corrected for the cluster effect, is used to compare breastfeeding rates between groups. Results. At baseline, there were no significant differences in breastfeeding rates at birth (n=1781), 3 (n=1854), 6 (n=1601) and 12 (n=1510; loss to follow up 15.2%) months between groups. At birth, 96% of mothers initiated breastfeeding, 72% exclusively (recall from birth). At 3 months, 77% of infants were breastfed, 54% exclusively with 24-hour, 46% with 7-day recall. At 6 months, the rate of any breastfeeding was 62%; 10% and 7% exclusive with 24-hour and 7- day recall, respectively. At 12 months, 31% of children continued to breastfeed. Conclusions. The project is ongoing and will allow to estimate the effect of the BFCI.