Objective: To explore manager, educator, and clinical leader perceptions of barriers and facilitators to implementing Baby-Friendly practice in the neonatal intensive care unit (NICU).
Design: Qualitative, descriptive design.
Setting: Two university-affiliated level-III NICUs in Canada.
Participants: A purposive sample of 10 medical and nursing managers, nurse educators, lactation consultants, and neonatal nurse practitioners.
Methods: In-depth, semistructured interviews transcribed and analyzed using qualitative content analysis.
Results: Participants valued breastfeeding and family-centered care yet identified numerous contextual barriers to Baby-Friendly care including infant health status, parent/infant separation, staff workloads and work patterns, gaps in staff knowledge and skills, and lack of continuity of breastfeeding support. Facilitators included breastfeeding education, breastfeeding champions, and interprofessional collaboration.
Conclusion: Despite identifying numerous barriers, participants recognized the potential value of expanding the Baby-Friendly Hospital Initiative (BFHI) to the NICU setting. Recommendations include promoting BFHI as a facilitator of family-centered care, interdisciplinary staff education, increasing access to lactation consultants, and establishing a group of NICU champions dedicated to BFHI implementation.
Keywords: BFHI; Baby-Friendly Hospital Initiative; NICU; barriers; breastfeeding; facilitators; implementation; neonatal intensive care unit.
© 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.