[Breastfeeding Practices in Neonatal Wards in Spain. Neo-BFHI International Survey].

Introduction: In 2017, a worldwide survey was conducted on compliance with the practices promoted by Neo-BFHI (Baby-friendly Hospital Initiative expansion to neonatal wards). Objective: Present the results of the Spanish wards that participated in the global survey and compare them with those obtained internationally. Material and methods: Cross-sectional study through a survey on compliance with the Neo-BFHI (???Three basic principles???, ???Ten steps adapted to neonatal wards??? and ???the compliance with the International Code of Marketing of Breast-milk Substitutes??? and subsequent relevant World Health Assembly resolutions). Compliance was calculated as the mean in each indicator and a final mean score for each neonatal unit. For the partial and final scores for each country and at the international level, the median was used. All score ranged between 0 and 100. Results: The response rate in Spain was 90%. The range of the national mean for neonatal wards were from 37 to 99, with no differences in the final score according to the level of care. The global score for Spain (72) is below the international median (77) and this also occurs in 8 of 14 items. The neonatal wards from BFHI designated hospitals, obtained a significantly higher mean global score, and in 9 of 14 items than the non-accredited ones. Conclusions: Both international and national results indicate an improvement in breastfeeding practices in neonatal units. The benefits of the BFHI accreditation of maternity reach neonatal wards. Spain has several key points below the international score. ?? 2021 Published by Elsevier Espa??a, S.L.U. on behalf of Asociaci??n Espa??ola de Pediatr??a. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).