Adherence to Baby Friendly Hospital Initiative Global Standards During the COVID‐19 Pandemic: A Nationwide, Cross‐Sectional Study.

AIM: The COVID-19 pandemic caused considerable organisational changes in maternity facilities. We investigated adherence to the Baby Friendly Hospital Initiative (BFHI) standards in Croatian maternity hospitals. METHODS: A cross-sectional online survey targeted participants of the only Croatian antenatal course available during the pandemic. Women aged 18+ years, resident in Croatia, who had given birth in a Croatian maternity facility between February 2020 and December 2021 were eligible. A 75-item questionnaire was created including BFHI adherence statements and open-ended items. Quantitative data were analysed descriptively and content analysis was used for qualitative data. RESULTS: Out of 3288 responses from across Croatia, 2130 were valid. Two-thirds (1473; 69%) had skin-to-skin contact (SSC) within 5 min of birth. Only 45% (795) held their baby for an hour, and 49% (1047) of babies latched during SSC. Just 29% (558) received breastfeeding help within 6 h, and 27% (582) exclusively breastfed in the first 2 days. Only 42% (886) were with their baby 24/7. Four qualitative themes are reported. CONCLUSION: BFHI standards were not followed during the pandemic, leading to unnecessary separations and low exclusive breastfeeding rates. Prioritising breastfeeding is essential for the optimal health of mothers and newborns.