Experiences of the revised Baby Friendly Initiative standards v 0.1
Research type
Research Study
Full title
How the revised UNICEF UK Baby Friendly Initiative (BFI) standards influence the experiences of women from different socio-economic backgrounds.
IRAS ID
298819
Contact name
Nicola Crossland
Contact email
Sponsor organisation
University of Central Lancashire
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
The Baby Friendly Initiative (BFI) revised standards provide an opportunity to meet the emotional and practical needs of all mothers and to support optimal infant feeding practices irrespective of infant feeding method. However, there is no longitudinal research exploring how the standards influence the support received by women from different socio-economic backgrounds to ensure their individual needs are met.
This research aims to address the evidence gap by understanding the influence of the BFI standards on the infant feeding and early parenting experiences of women from both high and low socio-economic backgrounds. The research will be undertaken within East Lancashire where all organisations providing infant feeding support have BFI accreditation and are implementing the standards.
Women will reflect on their experiences in a password protected section in a OneNote notebook. They will be encouraged to complete at least four entries in their diary but will be able to complete as many entries as they wish. The women will also participate in four interviews either via video call on Teams or via telephone to further explore the experiences they have identified in their diaries. If women do not wish to record their experiences in the notebook they can just do the interviews. Women will be recruited during pregnancy and will remain in the study until they are introducing their baby to solid food. They will be asked to reflect on the care they have received, how they felt and whether the support they received had influenced the way they fed and cared for their baby. There will be a focus on the language used and the way in which infant feeding support is provided. Vignettes will be developed from the results of this study. These vignettes could then be used in practice to improve the way in which infant feeding messages are communicated.Lay summary of study results: The UNICEF UK Baby Friendly Initiative (BFI) is based on the Baby Friendly Hospital Initiative, a global accreditation programme between UNICEF and the World Health Organization. Following a major review of the standards and to incorporate new evidence, UNICEF UK BFI introduced revised standards in 2012. These revised standards emphasise the importance of supporting and valuing the mother-baby relationship and promoting safe and informed infant feeding behaviours irrespective of infant feeding method. However, there is no research relating to how women experience the revised BFI standards over time and whether the woman’s socioeconomic context influences the care she receives. Therefore, this qualitative longitudinal study using a narrative approach was undertaken to understand how women from different socio-economic backgrounds experience infant feeding care from UNICEF UK BFI Gold accredited maternity and community health services.
This study was undertaken in an area in Northwest England where all services (maternity, health visiting and Children’s Centres) providing infant feeding care have been awarded BFI Gold accreditation. First time mothers from both high and low socio-economic backgrounds were recruited via posters, social media and in-person. Diaries and interviews were used to collect stories from eight women (four from a low-income background and four from a high-income background) from 28 weeks gestation until around six months after birth. Women were prompted to complete an entry in their diary after an appointment with a health professional who had provided them with information about feeding and caring for their baby. Diary entries were completed using a OneNote notebook that provided various options for recording thoughts and feelings. Interviews were undertaken (n=5 offered for each woman) to further explore the stories recorded in the diary entries.
From the women’s stories, four meta-narratives were identified. These meta-narratives illustrate how interacting factors operating at different system levels influenced women’s infant feeding experiences and outcomes. The women’s stories were then considered in relation to the revised BFI standards. To communicate the results of this research to organisations currently embedding the BFI standards a visual metaphor was created.
This research marks a unique contribution to knowledge by providing evidence of how women from different socio-economic backgrounds experience infant feeding care from gold accredited BFI organisations. Whilst the standards have been updated in 2024, this research suggests that incorporating a strengths-based approach which identifies the resources women have available to them could facilitate more equitable baby friendly care in the future. Further research is needed to confirm the findings and to explore how health professionals can provide more equitable and woman-centred care.REC name
North East - Tyne & Wear South Research Ethics Committee
REC reference
21/NE/0160
Date of REC Opinion
13 Aug 2021
REC opinion
Further Information Favourable Opinion