<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Cattaneo, Adriano</style></author><author><style face="normal" font="default" size="100%">Bettinelli, Maria Enrica</style></author><author><style face="normal" font="default" size="100%">Chapin, Elise</style></author><author><style face="normal" font="default" size="100%">Macaluso, Anna</style></author><author><style face="normal" font="default" size="100%">Córdova do Espírito Santo, Lílian</style></author><author><style face="normal" font="default" size="100%">Murante, Anna Maria</style></author><author><style face="normal" font="default" size="100%">Montico, Marcella</style></author></authors><translated-authors><author><style face="normal" font="default" size="100%">BFCI Study Group</style></author></translated-authors></contributors><titles><title><style face="normal" font="default" size="100%">Effectiveness of the Baby Friendly Community Initiative in Italy: a non-randomised controlled study.</style></title><secondary-title><style face="normal" font="default" size="100%">BMJ Open</style></secondary-title><alt-title><style face="normal" font="default" size="100%">BMJ Open</style></alt-title></titles><dates><year><style  face="normal" font="default" size="100%">2016</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2016</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">6</style></volume><pages><style face="normal" font="default" size="100%">e010232</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;&lt;b&gt;OBJECTIVE: &lt;/b&gt;To assess the effectiveness of the Baby Friendly Community Initiative (BFCI) on exclusive breast feeding at 6 months.&lt;/p&gt;&lt;p&gt;&lt;b&gt;DESIGN: &lt;/b&gt;Controlled, non-randomised trial.&lt;/p&gt;&lt;p&gt;&lt;b&gt;SETTING: &lt;/b&gt;18 Local Health Authorities in 9 regions of Italy.&lt;/p&gt;&lt;p&gt;&lt;b&gt;PARTICIPANTS: &lt;/b&gt;5094 mother/infant dyads in 3 cohorts were followed up to 12 months after birth in 3 rounds of data collection: at baseline, after implementation of the intervention in the early intervention group and after implementation in the late intervention group. 689 (14%) dyads did not complete the study.&lt;/p&gt;&lt;p&gt;&lt;b&gt;INTERVENTION: &lt;/b&gt;Implementation of the 7 steps of the BFCI.&lt;/p&gt;&lt;p&gt;&lt;b&gt;MAIN OUTCOME MEASURES: &lt;/b&gt;The rate of exclusive breast feeding at 6 months was the primary outcome; breast feeding at discharge, 3 and 12 months was also measured.&lt;/p&gt;&lt;p&gt;&lt;b&gt;RESULTS: &lt;/b&gt;The crude rates of exclusive breast feeding at discharge, 3 and 6 months, and of any breast feeding at 6 and 12 months increased at each round of data collection after baseline in the early and late intervention groups. At the end of the project, 10% of infants were exclusively breast fed at 6 months and 38% were continuing to breast feed at 12 months. However, the comparison by adjusted rates and logistic regression failed to show statistically significant differences between groups and rounds of data collection in the intention-to-treat analysis, as well as when compliance with the intervention and training coverage was taken into account.&lt;/p&gt;&lt;p&gt;&lt;b&gt;CONCLUSIONS: &lt;/b&gt;The study failed to demonstrate an effect of the BFCI on the rates of breast feeding. This may be due, among other factors, to the time needed to observe an effect on breast feeding following this complex intervention.&lt;/p&gt;</style></abstract><issue><style face="normal" font="default" size="100%">5</style></issue><custom1><style face="normal" font="default" size="100%">http://www.ncbi.nlm.nih.gov/pubmed/27154476?dopt=Abstract</style></custom1></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Bettinelli, Maria Enrica</style></author><author><style face="normal" font="default" size="100%">Chapin, Elise M</style></author><author><style face="normal" font="default" size="100%">Cattaneo, Adriano</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Establishing the Baby-Friendly Community Initiative in Italy: development, strategy, and implementation.</style></title><secondary-title><style face="normal" font="default" size="100%">J Hum Lact</style></secondary-title><alt-title><style face="normal" font="default" size="100%">J Hum Lact</style></alt-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Breast Feeding</style></keyword><keyword><style  face="normal" font="default" size="100%">Continuity of Patient Care</style></keyword><keyword><style  face="normal" font="default" size="100%">Delivery Rooms</style></keyword><keyword><style  face="normal" font="default" size="100%">Female</style></keyword><keyword><style  face="normal" font="default" size="100%">Health Policy</style></keyword><keyword><style  face="normal" font="default" size="100%">Humans</style></keyword><keyword><style  face="normal" font="default" size="100%">Infant</style></keyword><keyword><style  face="normal" font="default" size="100%">Infant Care</style></keyword><keyword><style  face="normal" font="default" size="100%">Infant Welfare</style></keyword><keyword><style  face="normal" font="default" size="100%">Infant, Newborn</style></keyword><keyword><style  face="normal" font="default" size="100%">Italy</style></keyword><keyword><style  face="normal" font="default" size="100%">Maternal Health Services</style></keyword><keyword><style  face="normal" font="default" size="100%">Organizational Policy</style></keyword><keyword><style  face="normal" font="default" size="100%">Outcome and Process Assessment (Health Care)</style></keyword><keyword><style  face="normal" font="default" size="100%">Practice Guidelines as Topic</style></keyword><keyword><style  face="normal" font="default" size="100%">Pregnancy</style></keyword><keyword><style  face="normal" font="default" size="100%">Program Development</style></keyword><keyword><style  face="normal" font="default" size="100%">Program Evaluation</style></keyword><keyword><style  face="normal" font="default" size="100%">United Nations</style></keyword><keyword><style  face="normal" font="default" size="100%">World Health Organization</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2012</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2012 Aug</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">28</style></volume><pages><style face="normal" font="default" size="100%">297-303</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;&lt;b&gt;BACKGROUND: &lt;/b&gt;The Baby-Friendly Hospital Initiative (BFHI), developed by the World Health Organization and the United Nations Children's Fund (UNICEF) to promote breastfeeding in maternity facilities worldwide, has had a global impact on breastfeeding outcomes, but other interventions are needed both before and after hospital discharge to meet the recommended targets at 6 months. The Baby-Friendly Community Initiative (BFCI), a multifaceted program for community-based breastfeeding promotion that is complementary to the BFHI, addresses this challenge.&lt;/p&gt;&lt;p&gt;&lt;b&gt;OBJECTIVE: &lt;/b&gt;To describe the development, strategy, and implementation of the BFCI in Italy.&lt;/p&gt;&lt;p&gt;&lt;b&gt;METHODS: &lt;/b&gt;In 2006, UNICEF Italy created a working group to develop the BFCI for the Italian health system. A review of the different BFCI models worldwide was conducted. A preliminary adaptation of tools to Italian community health care settings was developed in 2007, when the Italian BFCI Seven Steps were published. Two years later, UNICEF Italy launched the Standards for Best Practice for both hospitals and communities, based on 2009 BFHI and UNICEF UK BFCI materials.&lt;/p&gt;&lt;p&gt;&lt;b&gt;OUTCOMES: &lt;/b&gt;The main outcome was to promote this process in Italian regional health systems and develop tools to assess compliance with the BFCI criteria. There is now one fully accredited Baby-Friendly Community in Italy, and 17 other communities are working on the various stages.&lt;/p&gt;&lt;p&gt;&lt;b&gt;CONCLUSIONS: &lt;/b&gt;The BFCI, a complex program that involves participation, training, audits, a continuous flow of feedback, and provision of resources for health workers and families, is now a reality in Italy.&lt;/p&gt;</style></abstract><issue><style face="normal" font="default" size="100%">3</style></issue><custom1><style face="normal" font="default" size="100%">http://www.ncbi.nlm.nih.gov/pubmed/22674964?dopt=Abstract</style></custom1></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Cattaneo, Adriano</style></author><author><style face="normal" font="default" size="100%">Williams, Carol</style></author><author><style face="normal" font="default" size="100%">Pallás-Alonso, Carmen Rosa</style></author><author><style face="normal" font="default" size="100%">Hernández-Aguilar, Maria Teresa</style></author><author><style face="normal" font="default" size="100%">Lasarte-Velillas, Juan José</style></author><author><style face="normal" font="default" size="100%">Landa-Rivera, Leonardo</style></author><author><style face="normal" font="default" size="100%">Rouw, Elien</style></author><author><style face="normal" font="default" size="100%">Pina, Mónica</style></author><author><style face="normal" font="default" size="100%">Volta, Alessandro</style></author><author><style face="normal" font="default" size="100%">Oudesluys-Murphy, Anne Marie</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">ESPGHAN's 2008 recommendation for early introduction of complementary foods: how good is the evidence?</style></title><secondary-title><style face="normal" font="default" size="100%">Matern Child Nutr</style></secondary-title><alt-title><style face="normal" font="default" size="100%">Matern Child Nutr</style></alt-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Breast Feeding</style></keyword><keyword><style  face="normal" font="default" size="100%">Evidence-Based Practice</style></keyword><keyword><style  face="normal" font="default" size="100%">Humans</style></keyword><keyword><style  face="normal" font="default" size="100%">Infant</style></keyword><keyword><style  face="normal" font="default" size="100%">Infant Food</style></keyword><keyword><style  face="normal" font="default" size="100%">Infant Nutritional Physiological Phenomena</style></keyword><keyword><style  face="normal" font="default" size="100%">Milk, Human</style></keyword><keyword><style  face="normal" font="default" size="100%">Nutritional Status</style></keyword><keyword><style  face="normal" font="default" size="100%">Public Health</style></keyword><keyword><style  face="normal" font="default" size="100%">Reproducibility of Results</style></keyword><keyword><style  face="normal" font="default" size="100%">World Health Organization</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2011</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2011 Oct</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">7</style></volume><pages><style face="normal" font="default" size="100%">335-43</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Since 2002, the World Health Organization and many governments and professional associations have recommended exclusive breastfeeding for 6 months followed by complementary feeding (giving solid foods alongside breast milk) as optimal infant feeding practice. Several articles have been published challenging this recommendation. Arguably, the most influential has been the 2008 commentary of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition, which recommended that complementary foods should be introduced to all infants between 17 and 26 weeks. We challenge the validity of ESPGHAN's position, questioning the adequacy of the literature search, the interpretation and evidence used to reach their conclusions and the balance of an approach that focuses on disease prevention, with scant consideration of growth and neuromotor development. We contend that ESPGHAN's position should be understood as an expert opinion that may be influenced by conflicts of interest. In our view, the ESPGHAN position paper is not evidence based and does not justify a change of the current public health recommendation for 6 months of exclusive breastfeeding. At an individual level, health professionals should understand that developmental readiness for starting solid foods has an age range like other developmental milestones; that fewer infants will probably be ready to start complementary feeding before, rather than after, 6 months; and that their role is to equip parents with the confidence and skills to recognise the signs of developmental readiness. This empowerment process for infants and parents should be preferred over the prescriptive ESPGHAN approach.&lt;/p&gt;</style></abstract><issue><style face="normal" font="default" size="100%">4</style></issue><custom1><style face="normal" font="default" size="100%">http://www.ncbi.nlm.nih.gov/pubmed/21902806?dopt=Abstract</style></custom1></record></records></xml>