An Educational Strategy from a Dentistry Approach to Increase Breastfeeding Knowledge, Attitudes, and Skills

A strategy from a dentistry perspective, involving educational strategies among other measures, was developed to respond to the need to promote breastfeeding in Colombia considering its role in children’s oral and craniofacial development. The objective of this study was to design and implement a de...

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Autores:
Universidad Cooperativa de Colombia
Arias Ramírez, Johanna Carolina
Angarita Díaz, María del Pilar
Rodas Avellaneda, Claudia Patricia
Rojas Ramírez, Zhulma del Rocío
Tipo de recurso:
Article of journal
Fecha de publicación:
2019
Institución:
Universidad Cooperativa de Colombia
Repositorio:
Repositorio UCC
Idioma:
OAI Identifier:
oai:repository.ucc.edu.co:20.500.12494/16101
Acceso en línea:
https://doi.org/10.1080/13575279.2019.1612731
https://hdl.handle.net/20.500.12494/16101
Palabra clave:
Lactancia
Desarrollo del niño
Educación
Salud pública
Odontología preventiva
Breastfeeding
Development
Education
Public health
Preventive dentistry
Rights
openAccess
License
Atribución – No comercial – Sin Derivar
id COOPER2_baff984512b18f8ac7ba0452b031ff84
oai_identifier_str oai:repository.ucc.edu.co:20.500.12494/16101
network_acronym_str COOPER2
network_name_str Repositorio UCC
repository_id_str
dc.title.spa.fl_str_mv An Educational Strategy from a Dentistry Approach to Increase Breastfeeding Knowledge, Attitudes, and Skills
title An Educational Strategy from a Dentistry Approach to Increase Breastfeeding Knowledge, Attitudes, and Skills
spellingShingle An Educational Strategy from a Dentistry Approach to Increase Breastfeeding Knowledge, Attitudes, and Skills
Lactancia
Desarrollo del niño
Educación
Salud pública
Odontología preventiva
Breastfeeding
Development
Education
Public health
Preventive dentistry
title_short An Educational Strategy from a Dentistry Approach to Increase Breastfeeding Knowledge, Attitudes, and Skills
title_full An Educational Strategy from a Dentistry Approach to Increase Breastfeeding Knowledge, Attitudes, and Skills
title_fullStr An Educational Strategy from a Dentistry Approach to Increase Breastfeeding Knowledge, Attitudes, and Skills
title_full_unstemmed An Educational Strategy from a Dentistry Approach to Increase Breastfeeding Knowledge, Attitudes, and Skills
title_sort An Educational Strategy from a Dentistry Approach to Increase Breastfeeding Knowledge, Attitudes, and Skills
dc.creator.fl_str_mv Universidad Cooperativa de Colombia
Arias Ramírez, Johanna Carolina
Angarita Díaz, María del Pilar
Rodas Avellaneda, Claudia Patricia
Rojas Ramírez, Zhulma del Rocío
dc.contributor.advisor.none.fl_str_mv Morrison, Anne
Nicholl, Patricia
Monson, Tracey
Boyle, Clionagh
McCafferty, Paul
Nicholson, Frances
dc.contributor.author.none.fl_str_mv Universidad Cooperativa de Colombia
Arias Ramírez, Johanna Carolina
Angarita Díaz, María del Pilar
Rodas Avellaneda, Claudia Patricia
Rojas Ramírez, Zhulma del Rocío
dc.subject.spa.fl_str_mv Lactancia
Desarrollo del niño
Educación
Salud pública
Odontología preventiva
topic Lactancia
Desarrollo del niño
Educación
Salud pública
Odontología preventiva
Breastfeeding
Development
Education
Public health
Preventive dentistry
dc.subject.other.spa.fl_str_mv Breastfeeding
Development
Education
Public health
Preventive dentistry
description A strategy from a dentistry perspective, involving educational strategies among other measures, was developed to respond to the need to promote breastfeeding in Colombia considering its role in children’s oral and craniofacial development. The objective of this study was to design and implement a dentistry-based educational strategy to increase the knowledge, attitudes and skills (KAS) of pregnant women and nursing mothers. The study involved four phases: 1. Application of a validated questionnaire to measure breastfeeding KAS and babies’ craniofacial development. 2. Design of an educational strategy based on the information gathered. 3. Implementation of the strategy in the same population. 4. Second application of the survey six months later to determine the impact of the strategy. In Phase 1, it was detected that of 82.9% of the women had a high level of knowledge, 85.6% had a high level of attitudes, and 50.2% of skills. Phase 2 involved the design of an educational strategy based on the findings, which highlighted the importance of breastfeeding for the newborn’s craniofacial development. In Phase 4, following strategy implementation, it was found that the KAS of the 221 women who remained in the study, increased significantly (knowledge 99.5%, attitudes 99.1% and skills 86%, p = 0.00). An important increase was also detected in terms of the concept of breastfeeding children up to two years of age, which went up from 17.6% of the mothers surveyed to 51.1%. The educational strategy developed in this study increased the knowledge, attitudes, and, especially, the skills of pregnant women and nursing mothers. It also clarified concepts that contribute to the exercise of this activity.
publishDate 2019
dc.date.issued.none.fl_str_mv 2019-06-04
dc.date.accessioned.none.fl_str_mv 2020-01-20T16:10:29Z
dc.date.available.none.fl_str_mv 2020-01-20T16:10:29Z
dc.type.none.fl_str_mv Artículo
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dc.identifier.bibliographicCitation.spa.fl_str_mv Arias, J.C., Angarita-Díaz, M.P., Rodas, C.P., y Rojas, Z.R. (2019). An Educational Strategy from a Dentistry Approach to Increase Breastfeeding Knowledge, Attitudes, and Skills. Child Care in Practice. DOI: 10.1080/13575279.2019.1612731. Recuperado de: https://www.tandfonline.com/doi/abs/10.1080/13575279.2019.1612731?journalCode=cccp20
identifier_str_mv 13575279
Arias, J.C., Angarita-Díaz, M.P., Rodas, C.P., y Rojas, Z.R. (2019). An Educational Strategy from a Dentistry Approach to Increase Breastfeeding Knowledge, Attitudes, and Skills. Child Care in Practice. DOI: 10.1080/13575279.2019.1612731. Recuperado de: https://www.tandfonline.com/doi/abs/10.1080/13575279.2019.1612731?journalCode=cccp20
url https://doi.org/10.1080/13575279.2019.1612731
https://hdl.handle.net/20.500.12494/16101
dc.relation.isversionof.spa.fl_str_mv https://www.tandfonline.com/doi/abs/10.1080/13575279.2019.1612731?journalCode=cccp20
dc.relation.ispartofjournal.spa.fl_str_mv Child Care in Practice
dc.relation.references.spa.fl_str_mv Agarwal, M., Ghousia, S., Konde, S., Raj, S., & Price, W. (2012). Breastfeeding: Nature ‘s Safety Net. International Journal of Clinical Pediatric Dentistry, 5(1), 49–53. doi:10.5005/jp-journals-10005-1133
Anyanechi, C. E., Ekabua, K. J., Ekpenyong, A. B., & Ekabua, J. E. (2017). Parturients ‘awareness and perception of benefits of breast feeding in the prevention of infant and Childhood oral and dental diseases. Ghana Medical Journal, 51(2), 83–87. doi:http://doi.org/10.4314/gmj.v51i2.6
Benjumea, M. V., Falla, N. C., & Jurado, L. (2013). Knowledge and practices of pregnant women and caregivers about breasfeeding in five municipalities from Caldas, Colombia. Hacia Promoc Salud, 18(2), 66–78.
Dewey, K. G., Heinig, M. J., Nommsen, L. A., Peerson, J. M., & Lönnerdal, B. (1992). Growth of breast-fed and formula-fed infants from 0 to 18 months: The DARLING study. Pediatrics, 89 (6), 1035–1041.
Figueiras, A. C., Neves de Souza, I. C., Ríos, V. G., & Benguigui, Y. (2011). Manual para la vigilancia del desarrollo infantil (0-6 años) en el contexto de AIEPI. Washington, D.C: PAHO.
Gamboa, E. M., López, N., Prada, G. E., & Gallo, K. Y. (2008). Conocimientos, Actitudes y Prácticas relacionados con lactancia materna en mujeres en edad fértil en una population vulnerable. Revista Chilena de Nutrición, 35(1), 43–52.
Guerra, E., Martínez, M. E., Arias, Y., Fonseca, R. L., & Martínez, A. (2017). Impacto de estrategia educativa sobre lactancia materna a futuras madres. 2005-2016. Multimed, 21(2), 28–46.
Guise, J. M., Palda, V., Westhoff, C., Chan, B. K., Helfand, M., & Lier, T. A. (2003). The Effectiveness of Primary care- based interventions to promote breastfeeding: Systematic evidence review and meta-analysis for the US preventive services task force. The Annals of Family Medicine, 1 (2), 70–78.
Haroon, S., Das, J. K., Salam, R. A., Imdad, A., & Bhutta, Z. A. (2013). Breastfeeding promotion interventions and breastfeeding skills: A systematic review. BMC Public Health, 13(3), doi:10. 1186/1471-2458-13-S3-S20
Imdad, A., Yakoob, M. Y., & Bhutta, Z. A. (2011). Effect of breastfeeding promotion interventions on breastfeeding rates with special focus on developing countries. BMC Public Health, 11(3), doi:10.1186/1471-2458-11-S3-S24
Kim, S. K., Park, S., Oh, J., Kim, J., & Ahn, S. (2018). Interventions promoting exclusive breastfeeding up to six months after birth: A systematic review and meta-analysis of randomized controlled trials. International Journal of Nursing Studies, 80, 94–105. doi:10.1016/j.ijnurstu.2018.01.004
Lumbiganon, P., Martis, R., Laopaiboon, M., Festin, M. R., Ho, J. J., & Hakimi, M. (2011). Antenatal breastfeeding education for increasing breastfeeding duration. Cochrane Database of Systematic Reviews, 11, CD006425. doi:10.1002/14651858.CD006425.pub2
Mejia, C .R., Cárdenas, M. M., Cáceres, O. J., García-Moreno, K. M., Verastegui-Díaz, A., & Quiñones-Laveriano, D. M. (2016). Actitudes y prácticas sobre lactancia materna en puérperas de un hospital público de Lima, Perú. Revista Chilena de Obstreticia y Ginecología, 81(4), 281–287. doi:10.4067/S0717-75262016000400003
MINSALUD. (2012). Lactancia Materna, un compromiso de todos por el bienestar de la primera infancia. Bogotá: MINSALUD. Retrieved from https://www.minsalud.gov.co/Paginas/Lactancia %20Materna,%20un%20compromiso%20de%20todos%20por%20el%20bienestar%20de%20la% 20primera%20infancia.aspx
MinSalud, & Profamilia. (2011). Encuesta Nacional de Demografía y Salud 2010. Colombia: Ministerio de Salud y Protección Social-Profamilia.
Mohamed, M. J., Ochola, S., & Owino, V. O. (2018). Comparison of knowledge, attitudes and skills on exclusive breastfeeding between primiparous and multiparous mothers attending Wajir District hospital, Wajir County, Kenya: A cross-sectional analytical study. International Breastfeeding Journal, 13, 11. doi:10.1186/s13006-018-0151-3
Prell, C., & Koletzko, B. (2016). Breastfeeding and complementary feeding-recommendations on infant nutrition. Deutsches Arzteblatt international, 113, 435–444. doi:10.3238/arztebl.2016.0435
Radzyminski, S., & Callister, L. C. (2016). Mother’s beliefs, attitudes, and Decision making related to infant feeding choices. The Journal of Perinatal Education, 25(1), 18–28. doi:10.1891/1058-1243. 25.1.18
Rodríguez-García, J., & Acosta-Ramírez, N. (2008). Factores asociados a la lactancia materna exclusiva en población pobre de áreas urbanas de Colombia. Revista de Salud Pública, 10(1), 71–84.
Roscoe, M. G., da Silva-Bonifacio, S. V., da Silva, T. B., Pingueiro, J. M. S., Lemos, M. M., & Feres, M. F. N. (2018). Association of breastfeeding duration, nonnutritive sucking habits, and malocclusion. International Journal of Clinical Pediatric Dentistry, 11(1), 18–22. doi:10.5005/jpjournals- 10005-1477
Salone, L. R., Vann, W. F. Jr., & Dee D. L. (2013). Breastfeeding: An overview of oral and general health benefits. The Journal of the American Dental Association, 144(2), 143–151. doi:10.14219/ jada.archive.2013.0093
Santana, S. C., Cepero, M. T., & Expósito, O. (2014). Resultados de un programa educativo sobre lactancia materna a madres de niños menores de seis meses. Revista Médica Electrónica PortalesMedicos.com. Retrieved from https://www.revista-portalesmedicos.com/revista-medica/ programa-educativo-lactancia-materna/
Sinha, B., Chowdhury, R., Sankar, M. J., Martines, J., Taneja, S., Mazumder, S., & Bhandari, N. (2015). Interventions to improve breastfeeding outcomes: A systematic review and meta-analysis. Acta Paediatrica, 104(467), 114–134. doi:10.1111/apa.13127
Tedder, J. (2015). The Roadmap to breastfeeding success: Teaching child development to extend breastfeeding duration. The Journal of Perinatal Education, 24(4), 239–248. doi:10.1891/1058- 1243.24.4.239
UNICEF. (2005). Iniciativa Instituciones Amigas de la Mujer y la Infancia en el marco de los derechos- IAMI. Bogotá: UNICEF.
Veramendi-Espinoza, L. E., Zafra-Tanaka, J. H., Ugaz-Soto, L. M., Villa-Santiago, N. M., Torres- Bravo, L. A., Pinto-Arica, A. A., & Moras-Rosado, M. M. (2012). Conocimientos, actitudes y prácticas de lactancia materna en madres de niños de comunidad rural peruana y su asociación con la diarrea aguda infecciosa. CIMEL, 17(2), 82–88.
World Health Organization. (1981). International Code of Marketing of breast-milk Substitutes. Geneva: WHO.
World Health Organization. (2016). Breestfeeding. Retrieved from http://www.who.int/topics/ breastfeeding/en/
World Health Organization & UNICEF. (2003). Global strategy for infant and young child feeding. Geneva: WHO.
World Health Organization & UNICEF. (2009). Baby-friendly hospital initiative. Geneva: WHO.
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dc.publisher.spa.fl_str_mv Anne Morrison
Universidad Cooperativa de Colombia, Facultad de Ciencias de la Salud, Programa de Odontología, Villavicencio
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dc.publisher.place.spa.fl_str_mv Villavicencio
institution Universidad Cooperativa de Colombia
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spelling Morrison, AnneNicholl, PatriciaMonson, TraceyBoyle, ClionaghMcCafferty, PaulNicholson, FrancesUniversidad Cooperativa de ColombiaArias Ramírez, Johanna CarolinaAngarita Díaz, María del PilarRodas Avellaneda, Claudia PatriciaRojas Ramírez, Zhulma del Rocío2020-01-20T16:10:29Z2020-01-20T16:10:29Z2019-06-0413575279https://doi.org/10.1080/13575279.2019.1612731https://hdl.handle.net/20.500.12494/16101Arias, J.C., Angarita-Díaz, M.P., Rodas, C.P., y Rojas, Z.R. (2019). An Educational Strategy from a Dentistry Approach to Increase Breastfeeding Knowledge, Attitudes, and Skills. Child Care in Practice. DOI: 10.1080/13575279.2019.1612731. Recuperado de: https://www.tandfonline.com/doi/abs/10.1080/13575279.2019.1612731?journalCode=cccp20A strategy from a dentistry perspective, involving educational strategies among other measures, was developed to respond to the need to promote breastfeeding in Colombia considering its role in children’s oral and craniofacial development. The objective of this study was to design and implement a dentistry-based educational strategy to increase the knowledge, attitudes and skills (KAS) of pregnant women and nursing mothers. The study involved four phases: 1. Application of a validated questionnaire to measure breastfeeding KAS and babies’ craniofacial development. 2. Design of an educational strategy based on the information gathered. 3. Implementation of the strategy in the same population. 4. Second application of the survey six months later to determine the impact of the strategy. In Phase 1, it was detected that of 82.9% of the women had a high level of knowledge, 85.6% had a high level of attitudes, and 50.2% of skills. Phase 2 involved the design of an educational strategy based on the findings, which highlighted the importance of breastfeeding for the newborn’s craniofacial development. In Phase 4, following strategy implementation, it was found that the KAS of the 221 women who remained in the study, increased significantly (knowledge 99.5%, attitudes 99.1% and skills 86%, p = 0.00). An important increase was also detected in terms of the concept of breastfeeding children up to two years of age, which went up from 17.6% of the mothers surveyed to 51.1%. The educational strategy developed in this study increased the knowledge, attitudes, and, especially, the skills of pregnant women and nursing mothers. It also clarified concepts that contribute to the exercise of this activity.http://scienti.colciencias.gov.co:8081/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0001561382https://orcid.org/0000-0002-5435-3456GIOMETmaria.angaritad@campusucc.edu.cojohanna.ariasr@campusucc.edu.coclaudiap.rodas@campusucc.edu.coZhulma.Rojas@campusucc.edu.co12Anne MorrisonUniversidad Cooperativa de Colombia, Facultad de Ciencias de la Salud, Programa de Odontología, VillavicencioOdontologíaVillavicenciohttps://www.tandfonline.com/doi/abs/10.1080/13575279.2019.1612731?journalCode=cccp20Child Care in PracticeAgarwal, M., Ghousia, S., Konde, S., Raj, S., & Price, W. (2012). Breastfeeding: Nature ‘s Safety Net. International Journal of Clinical Pediatric Dentistry, 5(1), 49–53. doi:10.5005/jp-journals-10005-1133Anyanechi, C. E., Ekabua, K. J., Ekpenyong, A. B., & Ekabua, J. E. (2017). Parturients ‘awareness and perception of benefits of breast feeding in the prevention of infant and Childhood oral and dental diseases. Ghana Medical Journal, 51(2), 83–87. doi:http://doi.org/10.4314/gmj.v51i2.6Benjumea, M. V., Falla, N. C., & Jurado, L. (2013). Knowledge and practices of pregnant women and caregivers about breasfeeding in five municipalities from Caldas, Colombia. Hacia Promoc Salud, 18(2), 66–78.Dewey, K. G., Heinig, M. J., Nommsen, L. A., Peerson, J. M., & Lönnerdal, B. (1992). Growth of breast-fed and formula-fed infants from 0 to 18 months: The DARLING study. Pediatrics, 89 (6), 1035–1041.Figueiras, A. C., Neves de Souza, I. C., Ríos, V. G., & Benguigui, Y. (2011). Manual para la vigilancia del desarrollo infantil (0-6 años) en el contexto de AIEPI. Washington, D.C: PAHO.Gamboa, E. M., López, N., Prada, G. E., & Gallo, K. Y. (2008). Conocimientos, Actitudes y Prácticas relacionados con lactancia materna en mujeres en edad fértil en una population vulnerable. Revista Chilena de Nutrición, 35(1), 43–52.Guerra, E., Martínez, M. E., Arias, Y., Fonseca, R. L., & Martínez, A. (2017). Impacto de estrategia educativa sobre lactancia materna a futuras madres. 2005-2016. Multimed, 21(2), 28–46.Guise, J. M., Palda, V., Westhoff, C., Chan, B. K., Helfand, M., & Lier, T. A. (2003). The Effectiveness of Primary care- based interventions to promote breastfeeding: Systematic evidence review and meta-analysis for the US preventive services task force. The Annals of Family Medicine, 1 (2), 70–78.Haroon, S., Das, J. K., Salam, R. A., Imdad, A., & Bhutta, Z. A. (2013). Breastfeeding promotion interventions and breastfeeding skills: A systematic review. BMC Public Health, 13(3), doi:10. 1186/1471-2458-13-S3-S20Imdad, A., Yakoob, M. Y., & Bhutta, Z. A. (2011). Effect of breastfeeding promotion interventions on breastfeeding rates with special focus on developing countries. BMC Public Health, 11(3), doi:10.1186/1471-2458-11-S3-S24Kim, S. K., Park, S., Oh, J., Kim, J., & Ahn, S. (2018). Interventions promoting exclusive breastfeeding up to six months after birth: A systematic review and meta-analysis of randomized controlled trials. International Journal of Nursing Studies, 80, 94–105. doi:10.1016/j.ijnurstu.2018.01.004Lumbiganon, P., Martis, R., Laopaiboon, M., Festin, M. R., Ho, J. J., & Hakimi, M. (2011). Antenatal breastfeeding education for increasing breastfeeding duration. Cochrane Database of Systematic Reviews, 11, CD006425. doi:10.1002/14651858.CD006425.pub2Mejia, C .R., Cárdenas, M. M., Cáceres, O. J., García-Moreno, K. M., Verastegui-Díaz, A., & Quiñones-Laveriano, D. M. (2016). Actitudes y prácticas sobre lactancia materna en puérperas de un hospital público de Lima, Perú. Revista Chilena de Obstreticia y Ginecología, 81(4), 281–287. doi:10.4067/S0717-75262016000400003MINSALUD. (2012). Lactancia Materna, un compromiso de todos por el bienestar de la primera infancia. Bogotá: MINSALUD. Retrieved from https://www.minsalud.gov.co/Paginas/Lactancia %20Materna,%20un%20compromiso%20de%20todos%20por%20el%20bienestar%20de%20la% 20primera%20infancia.aspxMinSalud, & Profamilia. (2011). Encuesta Nacional de Demografía y Salud 2010. Colombia: Ministerio de Salud y Protección Social-Profamilia.Mohamed, M. J., Ochola, S., & Owino, V. O. (2018). Comparison of knowledge, attitudes and skills on exclusive breastfeeding between primiparous and multiparous mothers attending Wajir District hospital, Wajir County, Kenya: A cross-sectional analytical study. International Breastfeeding Journal, 13, 11. doi:10.1186/s13006-018-0151-3Prell, C., & Koletzko, B. (2016). Breastfeeding and complementary feeding-recommendations on infant nutrition. Deutsches Arzteblatt international, 113, 435–444. doi:10.3238/arztebl.2016.0435Radzyminski, S., & Callister, L. C. (2016). Mother’s beliefs, attitudes, and Decision making related to infant feeding choices. The Journal of Perinatal Education, 25(1), 18–28. doi:10.1891/1058-1243. 25.1.18Rodríguez-García, J., & Acosta-Ramírez, N. (2008). Factores asociados a la lactancia materna exclusiva en población pobre de áreas urbanas de Colombia. Revista de Salud Pública, 10(1), 71–84.Roscoe, M. G., da Silva-Bonifacio, S. V., da Silva, T. B., Pingueiro, J. M. S., Lemos, M. M., & Feres, M. F. N. (2018). Association of breastfeeding duration, nonnutritive sucking habits, and malocclusion. International Journal of Clinical Pediatric Dentistry, 11(1), 18–22. doi:10.5005/jpjournals- 10005-1477Salone, L. R., Vann, W. F. Jr., & Dee D. L. (2013). Breastfeeding: An overview of oral and general health benefits. The Journal of the American Dental Association, 144(2), 143–151. doi:10.14219/ jada.archive.2013.0093Santana, S. C., Cepero, M. T., & Expósito, O. (2014). Resultados de un programa educativo sobre lactancia materna a madres de niños menores de seis meses. Revista Médica Electrónica PortalesMedicos.com. Retrieved from https://www.revista-portalesmedicos.com/revista-medica/ programa-educativo-lactancia-materna/Sinha, B., Chowdhury, R., Sankar, M. J., Martines, J., Taneja, S., Mazumder, S., & Bhandari, N. (2015). Interventions to improve breastfeeding outcomes: A systematic review and meta-analysis. Acta Paediatrica, 104(467), 114–134. doi:10.1111/apa.13127Tedder, J. (2015). The Roadmap to breastfeeding success: Teaching child development to extend breastfeeding duration. The Journal of Perinatal Education, 24(4), 239–248. doi:10.1891/1058- 1243.24.4.239UNICEF. (2005). Iniciativa Instituciones Amigas de la Mujer y la Infancia en el marco de los derechos- IAMI. Bogotá: UNICEF.Veramendi-Espinoza, L. E., Zafra-Tanaka, J. H., Ugaz-Soto, L. M., Villa-Santiago, N. M., Torres- Bravo, L. A., Pinto-Arica, A. A., & Moras-Rosado, M. M. (2012). Conocimientos, actitudes y prácticas de lactancia materna en madres de niños de comunidad rural peruana y su asociación con la diarrea aguda infecciosa. CIMEL, 17(2), 82–88.World Health Organization. (1981). International Code of Marketing of breast-milk Substitutes. Geneva: WHO.World Health Organization. (2016). Breestfeeding. Retrieved from http://www.who.int/topics/ breastfeeding/en/World Health Organization & UNICEF. (2003). Global strategy for infant and young child feeding. Geneva: WHO.World Health Organization & UNICEF. (2009). Baby-friendly hospital initiative. 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