Perspectives of Nurses in Mississippi on Implementation of the Baby-Friendly Hospital Initiative

Objective: To describe the experiences and perceptions of Mississippi maternity nurses in hospitals that gained Baby-Friendly designation, including perceived barriers and facilitators to implementation of the Baby-Friendly Hospital Initiative. Design: Descriptive qualitative study using thematic analysis of focus group data. Setting: Maternity care services of five Baby-Friendly-designated hospitals in Mississippi. Participants: Twenty-two maternity nurses. Methods: We conducted 90-minute in-person focus groups in which participants described their hospitals' Baby-Friendly experiences. We analyzed focus group transcripts thematically to describe the facilitators and barriers to implementation of the Baby-Friendly initiative. Results: We identified five main themes: The Change Required for BFHI Was Hard, Nurses Felt Empowered by Taking Leadership Roles, Patient Education Was Pivotal to Practice Implementation, Nurses Felt Challenged by Unintended Consequences, and Attitudes Changed From Negative to Positive Over the Course of Adoption. Conclusion: Participants from hospitals throughout Mississippi shared similar experiences and cited common facilitators and barriers to achieving Baby-Friendly designation. Participants described the overall process of Baby-Friendly designation as challenging but worthwhile because of the resulting improvements in maternity care, nurses' knowledge, and health outcomes for women and their newborns. Nurses at other hospitals that seek to obtain designation can learn from these experiences to make their own transitions easier.