台灣母嬰親善醫院與國際愛嬰醫院活動的歷史與展望

世界衛生組織（WHO）與聯合國兒童基金會（UNICEF）自1991年開始推展愛嬰醫院活動（Baby-Friendly Hospital Initiative, BFHI），鼓勵產科機構執行成功母乳哺育十措施，支持母乳哺育，維護母親與嬰兒的健康。台灣國民健康署自2001年以十措施為原則，下修其基準，開始推動全國性母嬰親善醫院認證計畫迄今，參與認證的家數以及全國母乳哺育率在最初十幾年逐年增加。然而因為醫療人員能力及人力的不足，及相關資源的缺乏，無法完全落實對母親及嬰兒餵食的支持及協助，造成醫療端以及民眾端的反彈，參加的家數以及哺乳率開始微幅下降。WHO及UNICEF於2018年更新BFHI執行指導，呼籲各國政府持續宣導相關政策之外，應提供足夠人力物力資源，以及整合BFHI與生產及週產期相關照護品質提升計畫，並加強醫療工作人員的養成教育以及能力驗證，以提供更有品質的母嬰照護，達成最適當的嬰兒餵食方式。台灣也在2021年進行第一次國際愛嬰醫院認證，期待能持續改善母嬰照護品質。

關鍵字

國際愛嬰醫院活動；母嬰親善醫院；母乳哺育；嬰兒餵食

並列摘要

Breastfeeding is crucial for maternal and infant health. The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) launched the Baby-Friendly Hospital Initiative (BFHI) in 1991, for encouraging maternal facilities to implement Ten Steps to Successful Breastfeeding and support mothers breastfeeding. Health Promotion Administration, Ministry of Health and Welfare, Taiwan established a national Mother-Baby Friendly Institute program in 2001, based on the Ten steps but implemented with standards that did not completely meet BFHI standards. The number of designated facilities and the national breastfeeding rate have increased in the first 12 years but declined after then, which might be due to the lack of sustained medical personnel capacity and manpower, and the lack of related resources. WHO and UNICEF updated the BFHI implementation guidance in 2018, calling on governments to publicize relevant policies, provide sufficient human and financial resources, integrate BFHI with mother-friendly childbirth and other quality improvement programs for perinatal care, enforce the education about infant feeding and breastfeeding in pre-service education for health professionals and ensure their competencies in implementing BFHI. With all these strategies, the facilities may improve their maternal and newborn care quality for achieving the optimal infant feeding method. The BFHI designation program based on WHO 2009 guidance was launched in 2021 to improve the quality of mother-infant care.

並列關鍵字

baby-friendly hospital initiative ； mother-baby friendly institute program ； breastfeeding ； infant feeding

參考文獻

陳昭惠、高美玲、盧玉贏、潘履嵐（2001）．台灣地區嬰兒親善醫院實施現況與未來展望．長庚護理，12（1），64-71。https://doi.org/10.6386/CGN.200103_12(1).0008

蔡碩心、楊美賞、王秀紅（2016）．親子同室之施行與婦女身心健康．護理雜誌，63（3），119-125。https://doi.org/10.6224/JN.63.3.119

Chen, C. H., Chen, R. C., Chen, M. S., Chen, L. C., & Wei, H. Y. (2020). Challenges and outcomes of using the ten steps to successful breastfeeding in the Mother-Baby Friendly Institute Program in Taiwan. Journal of Human Lactation, 36(1), 187-191. https://doi.org/10.1177/0890334419839366

Pérez-Escamilla R., Martinez J. L., & Segura-Pérez S. (2016). Impact of the Baby-Friendly Hospital Initiative on breastfeeding and child health out-comes: A systematic review. Maternal & Child Nutrition, 12(3), 402-17. https://doi.org/10.1111/mcn.12294

Victora, C. G., Bahl, R., Barros, A. J., França, G. V., Horton, S., Krasevec, J., Murch, S., Sankar, M. J., Walker, N., & Rollins, N. C. (2016). Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect. Lancet, 387(10017), 475-490. https://doi.org/10.1016/s0140-6736(15)01024-7

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台灣母嬰親善醫院與國際愛嬰醫院活動的歷史與展望

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