TY - JOUR T1 - Effectiveness of the Baby Friendly Community Initiative in Italy: a non-randomised controlled study JF - BMJ Open JO - BMJ Open DO - 10.1136/bmjopen-2015-010232 VL - 6 IS - 5 SP - e010232 AU - Adriano Cattaneo AU - Maria Enrica Bettinelli AU - Elise Chapin AU - Anna Macaluso AU - Lílian Córdova do Espírito Santo AU - Anna Maria Murante AU - Marcella Montico Y1 - 2016/05/01 UR - http://bmjopen.bmj.com/content/6/5/e010232.abstract N2 - Objective To assess the effectiveness of the Baby Friendly Community Initiative (BFCI) on exclusive breast feeding at 6 months.Design Controlled, non-randomised trial.Setting 18 Local Health Authorities in 9 regions of Italy.Participants 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.Intervention Implementation of the 7 steps of the BFCI.Main outcome measures The rate of exclusive breast feeding at 6 months was the primary outcome; breast feeding at discharge, 3 and 12 months was also measured.Results 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.Conclusions 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. ER -