Results
Most primary-care staff working with mother and infants in the PCHCs (58/63 pediatricians, 43/63 pediatric nurses and 37/47 midwives) attended the 20-h training course. A total of 200 hours of short-stay practice were offered to several neonatologists, pediatricians, midwives and pediatric nurses. Four annual conferences and six workshops welcomed nearly 900 professionals from all over the AC.
Over a four year period, 3,512 families visited the clinic 11,801 times. The number of first visits grew steadily from 503 in 2014 to 1456 in 2017. Most (79.5%, n: 2792) were referred by primary-care midwives and pediatricians. A large proportion of visits (39.7%, n: 1394) came from other HDs. Leading consultations were for breast pain and infants’ thriving problems (diagnosis at discharge in Table 2). The mean number of follow-up visits at the clinic was three (range 0-14) and EBF was significantly more prevalent “at discharge” than “at entry” (Table 3). Financial constrains disallowed a second population survey, thus hindering adequate assessment of the clinic’s impact on breastfeeding rates. As a proxy, for two weeks in 2016, clients of the clinic with infants younger than six months were invited to complete a self-administered on-line survey: Out of a total N: 298 respondents, EBF was reported by 236 families (79.1% ). Satisfaction with services was high, 67% of mothers reported to have achieved their breastfeeding goals and a very high mean level of satisfaction (4.8/5) reported by the 2013 families who responded the satisfaction questionnaire (Table 4). The costs per visit at the BFU-clinic were low (Table 5).
The group-support weekly-meetings welcomed around 2400 families. Three WhatsApp-based mobile-version breastfeeding support groups (reaching more than 700 families) and one formal BMSG emerged from these meetings (WhatsApp. 2018). The BFU collaborated with BMSG’ training programs for assessors, and jointly celebrated the World Breastfeeding Week every year.
During the second year, we started collaborating with the Foundation for Research: FISABIO (FISABIO, 2018). At present, the BFU participates in 2 different breastfeeding research projects. In 2015, we received an award of excellence from the Spanish Ministry of Health (MOH) and the project was published on the Ministry’s website for reproducibility (MSCBS, 2015) .