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  • 1.
    Abraham, Klaus
    et al.
    BfR Fed Inst Risk Assessment, Natl Breastfeeding Comm, Berlin, Germany.
    Brennan, Christine
    Stillforderung Schweiz, Bern, Switzerland.
    Cattaneo, Adriano
    Univ La Laguna, Breastfeeding Comm Spanish Pediat Assoc, Tenerife, Spain.
    Gomez, Marta Diaz
    Univ La Laguna, Breastfeeding Comm Spanish Pediat Assoc, Tenerife, Spain.
    Grguric, Josip
    Univ Zagreb, UNICEF Off Croatia, Zagreb, Croatia.
    Solveig, Thorp Holmsen
    Oslo Univ Hosp, Norwegian Resource Ctr Breastfeeding, Oslo, Norway.
    Kylberg, Elisabeth
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    van Lonkhuijsen, Myrthe
    Nederlandse Vereniging van Lactatiekundigen, Amsterdam, Netherlands.
    Breastfeeding in Europe: Current Status and Perspectives2015In: Annals of Nutrition and Metabolism, ISSN 0250-6807, E-ISSN 1421-9697, Vol. 67, p. 15-Article in journal (Other academic)
  • 2.
    Agrasada, Grace V.
    et al.
    Univ Philippines, Philippine Gen Hosp, Dept Pediat, Coll Med, Manila 1000, Philippines / Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden .
    Ewald, Uwe
    Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden .
    Kylberg, Elisabeth
    University of Skövde, School of Life Sciences.
    Gustafsson, Jan
    Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden .
    Exclusive breastfeeding of low birth weight infants for the first six months: infant morbidity and maternal and infant anthropometry2011In: Asia Pacific Journal of Clinical Nutrition, ISSN 0964-7058, E-ISSN 1440-6047, Vol. 20, no 1, p. 62-68Article in journal (Refereed)
    Abstract [en]

    Background: to report anthropometry and morbidity among term low birth weight infants and anthropometry of their first time mothers during the first six months in relation to breastfeeding practice. Methods: we examined data from a randomized controlled trial in Manila, the Philippines. Of the 204 mothers randomized, 68 mothers received eight postpartum breastfeeding counseling sessions, the rest did not. Maternal and infant anthropometric data at birth, 2, 4 and 6 months were taken. During seven follow-up hospital visits, an independent interviewer recorded feeding data. Results: the 24 infants exclusively breastfed from birth to six months did not have diarrhea compared to 134 partially breastfed (mean 2.3 days) and 21 non-breastfed infants (mean 2.5 days). Partially breastfed and non-breastfed infants compared to exclusively breastfed infants had more frequent, as well as more severe episodes of respiratory infections. At six months, neither overall gain in infant weight, length and head circumferences nor mean maternal weight and body mass index differed significantly between the feeding groups. Conclusions: exclusive breastfeeding for 6 months can be recommended in term low birth weight infants, who were protected from diarrhea, had fewer respiratory infections, required no hospitalization and had catch up growth. Exclusively breastfeeding mothers did not differ from mothers who breastfed partially or those who did not breastfeed with regard to weight changes at six months.

  • 3.
    Agrasada, Grace V.
    et al.
    Department of Pediatrics, College of Medicine, University of the Philippines, Manila.
    Kylberg, Elisabeth
    University of Skövde, School of Life Sciences.
    When and why Filipino mothers of term low birth weight interrupted breastfeeding exclusively2010In: Breastfeeding Review, ISSN 0729-2759, Vol. 17, no 3, p. 5-10Article in journal (Refereed)
    Abstract [en]

    This paper makes use of data collected in a randomised controlled trial that was designed to test the efficacy of postpartum breastfeeding counselling to increase exclusive breastfeeding among term low birth weight infants in Manila during the first six months. Mothers were randomised to a control group or one of two home visit interventions: by trained breastfeeding counsellors or child care counsellors without breastfeeding support training. Sixty mothers received peer breastfeeding counselling while a further 119 mothers did not. The median duration of exclusive breastfeeding among mothers who received counselling was five weeks versus two weeks among those who received no counselling (p<0.001). Exclusive breastfeeding was interrupted to offer infants water, traditional herbal extracts or artificial baby milk. Mothers who interrupted exclusive breastfeeding claimed they had insufficient milk or that their infants had slow weight gain. Early and sustained breastfeeding support will enable mothers to exclusively breastfeed low birth weight infants for the first six months.

  • 4.
    Ekström, Anette
    et al.
    University of Skövde, School of Life Sciences.
    Kylberg, Elisabeth
    University of Skövde, School of Life Sciences.
    Nissen, Eva
    University of Skövde, School of Life Sciences. Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Sweden.
    A Process-Oriented Breastfeeding Training Program for Healthcare Professionals to Promote Breastfeeding2010In: Proceedings of the Second Biannual Uppsala Symposium on lactation research in mammals and humans: The mammary gland in health and disease with particular focus on the mammary gland close post partum including indicators of inflammation and pathogens of the mammary gland / [ed] Sigrid Agenäs, Gunilla Hallberg, Elisabeth Kylberg, Karin Perss on Waller & Bodil Ström Holst, Uppsala: CRU , 2010, p. 9-Conference paper (Refereed)
    Abstract [en]

    Introduction: The impact of giving an infant food other than breast milk depends on several factors. Evidence to date supports the recommendation for exclusive breastfeeding for six months.

    The aim of the this study was to evaluate the effect of a process-oriented training in support during childbirth and breastfeeding for midwives and postnatal nurses in relation to  the time of initial breastfeeding session, introduction of breast milk substitute and solids effects on  the duration of breastfeeding.

    Materials and methods: Ten municipalities in Sweden were randomized to either intervention (IG) or control groups (CGA and CGB). The intervention included a process-oriented training program* for midwives and postnatal nurses in the intervention municipalities. Primiparas (n=540) who were living at either site were asked to respond to questionnaires at three days, three and nine months postpartum. Data collection for mothers in CGA (n=162) started before effects of the intervention could be studied, CGB (n=172) was collected simultaneously with the IG (n=206).

    Results: Preliminary results showed that fewer infants in the IG received breast milk substitute (the first week of life) without medical reasons (p=0.01) and were older (3.8 months) when breast milk substitute was introduced after discharge compared with the infants in the control groups (CGA 2.3 months p= 0.01 and CGB 2.5 months p= 0.03).

    Discussion and Conclusion: A process-oriented training program for midwives and postnatal nurses (by changed attitudes among health staff and changing mothers self imaging) reduced the number of infants who got breastmilk substitute during the first week without medical reasons and delayed the introduction of breast milk substitute after the first week.

     

  • 5.
    Ekström, Anette
    et al.
    University of Skövde, School of Life Sciences.
    Kylberg, Elisabeth
    University of Skövde, School of Life Sciences.
    Nissen, Eva
    University of Skövde, School of Life Sciences.
    A process-oriented breastfeeding training program for healthcare professionals to promote breastfeeding: an intervention study2012In: Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine, ISSN 1556-8342, Vol. 7, no 2, p. 85-92Article in journal (Refereed)
    Abstract [en]

    Abstract Aim: The aim of the study was to evaluate the effects of process-oriented training in supportive breastfeeding counseling for midwives and postnatal nurses on the time lapse between the initial breastfeeding session, introduction of breastmilk substitutes and solids, and the duration of breastfeeding. Materials and Methods: Ten municipalities in Sweden were randomized to either the intervention or control groups. The intervention included a process-oriented training program for midwives and postnatal nurses in the intervention municipalities. Primiparas (n=540) living in either an intervention or control municipality were asked to participate in a longitudinal study to evaluate the care given. Data collection for control group A (CGA) (n=162) started before the intervention was initiated. Data for control group B (CGB) (n=172) were collected simultaneously with the intervention group (IG) (n=206). The mothers responded to questionnaires at 3 days, 3 months, and 9 months postpartum. Results: As a result of the process-oriented training program for midwives and postnatal nurses, the IG mothers had a significantly longer duration of exclusive breastfeeding, even if the initial breastfeeding session did not occur within 2 hours after birth, than the corresponding group of CGA mothers (p=0.01). Fewer infants in the IG received breastmilk substitutes (in the first week of life) without medical reasons compared with the control groups (p=0.01). The IG infants were significantly older (3.8 months) when breastmilk substitutes were introduced (after discharge from the hospital) compared with the infants in the control groups (CGA, 2.3 months, p=0.01; CGB, 2.5 months, p=0.03). Conclusion: A process-oriented training program for midwives and postnatal nurses was associated with a reduced number of infants being given breastmilk substitutes during the 1st week without medical reasons and delayed the introduction of breastmilk substitutes after discharge from the hospital.

  • 6.
    Ekström, Anette
    et al.
    University of Skövde, School of Life Sciences.
    Kylberg, Elisabeth
    University of Skövde, School of Life Sciences.
    Svensson, Kristin
    Karolinska institutet.
    Föräldrar vill ha amningsstöd baserat på fakta2012In: Jordemodern - Tema Amning, ISSN 0021-7468, no 3, p. 27-29Article in journal (Other (popular science, discussion, etc.))
  • 7. Forss, Kim
    et al.
    Kylberg, Elisabeth
    University of Skövde, School of Life Sciences.
    Maclean, Gaynor
    Sida supported infant and young child feeding networks: An evaluation of activities, achievements and aspirations2007Report (Other academic)
  • 8.
    Grguric, Josip
    et al.
    Department of Pediatrics, University Medical School, Zagreb / UNICEF Croatia.
    Wen, Ruth-Ann
    Centre of Excellence for Nutrition, Health Promotion Board, Singapore / Association for Breastfeeding Advocacy (Singapore), Singapore.
    Kylberg, Elisabeth
    University of Skövde, School of Life Sciences.
    Ashmore, Sue
    UNICEF UK Baby Friendly Initiative.
    MacEnroe, Trish
    Baby-Friendly USA, Inc..
    International Perspectives on the Baby-Friendly Initiative2012In: Journal of Human Lactation, ISSN 0890-3344, E-ISSN 1552-5732, Vol. 28, no 3, p. 281-284Article in journal (Other academic)
  • 9.
    Gånedahl, Hanna
    et al.
    University of Skövde, School of Health and Education.
    Zsaludek Viklund, Pernilla
    University of Skövde, School of Health and Education.
    Carlén, Kristina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kylberg, Elisabeth
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ekberg, Joakim
    Unit for Health Analysis, Centre for Healthcare Development, County Council of Östergötland, Linköping, Sweden / Unit of Community Medicine, Department of Medicine and Health, Linköping University, Sweden.
    Work-site wellness programmes in Sweden: a cross-sectional study of physical activity, self-efficacy, and health2015In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 129, no 5, p. 525-530Article in journal (Refereed)
    Abstract [en]

    In Sweden, a work-site wellness programme implies reimbursing some of the expenses for health-promoting activities. Although work-site wellness programmes are readily available in Sweden, a large number of employees elect not to participate.

    OBJECTIVES: The aim of this study was to investigate the association of physical activity, self-reported general health assessment and self-efficacy with participation in a work-site wellness programme.

    STUDY DESIGN: A cross-sectional study design was used.

    METHODS: An online questionnaire was distributed to employees of a manufacturing company with 2500 employees in southwest Sweden.

    RESULTS: Those who took advantage of the work-site wellness programme assessed their general health as better and had higher assessment of physical activity. The study showed that being enlisted also implies a higher level of physical activity and general health; however, the effect sizes of these correlations were small. Self-efficacy, i.e. perceived behavioural control, was not associated with participation in the work-site wellness programme. However, self-efficacy was correlated with both general health assessment and physical activity. A regression analysis to determine explanatory contributions to the general health assessment score showed no significant contribution from participation in a work-site wellness programme, but was instead explained by perceived behavioural control and physical activity.

    CONCLUSIONS: Given the small effect size of the difference in physical activity between participators and non-participators in the work-site wellness programme, it is probable that only a small proportion of participators changed their health-promoting activities as a result of the work-site wellness programme.

  • 10.
    Hedberg Nyqvist, Kerstin
    et al.
    Uppsala University.
    Häggkvist, Anna-Pia
    Oslo University Hospital.
    Ness Hansen, Mette
    Oslo University Hospital.
    Kylberg, Elisabeth
    University of Skövde, School of Life Sciences.
    Lyng Frandsen, Annemi
    Holbaek Hospital.
    Maastrup, Ranghild
    Lund University.
    Ezeonodo, Aino
    Children's Hospital, Helsinkin University.
    Hannula, Leena
    Metropolia University of Applied Sciences.
    Koskinen, Katja
    Helsinki University Central Hospital.
    Haiek, Laura N.
    McGill University.
    Expansion of the Ten Steps to Successful Breastfeeding into Neonatal Intensive Care: Expert Group Recommendations for Three Guiding Principles2012In: Journal of Human Lactation, ISSN 0890-3344, E-ISSN 1552-5732, Vol. 28, no 3, p. 289-296Article in journal (Refereed)
    Abstract [en]

    The World Health Organization/United Nations Children’s Fund Baby-Friendly Hospital Initiative: Revised, Updated, and Expanded for Integrated Care (2009) identifies the need for expanding the guidelines originally developed for maternity units to include neonatal intensive care. For this purpose, an expert group from the Nordic countries and Quebec, Canada, prepared a draft proposal, which was discussed at an international workshop in Uppsala, Sweden, in September 2011. The expert group suggests the addition of 3 “Guiding Principles” to the Ten Steps to support this vulnerable population of mothers and infants:

    1. The staff attitude to the mother must focus on the individual mother and her situation.

    2. The facility must provide family-centered care, supported by the environment.

    3. The health care system must ensure continuity of care, that is, continuity of pre-, peri-, and postnatal care and postdischarge care.

    The goal of the expert group is to create a final document, the Baby Friendly Hospital Initiative for Neonatal Units, including standards and criteria for each of the 3 Guiding Principles, Ten Steps, and the Code; to develop tools for self-appraisal and monitoring compliance with the guidelines; and for external assessment to decide whether neonatal intensive/intermediate care units meet the conditions required to be designated as Baby-Friendly. The documents will be finalized after consultation with the World Health Organization/United Nations Children’s Fund, and the goal is to offer these documents to international health care, professional, and other nongovernmental organizations involved in lactation and breastfeeding support for mothers of infants who require special neonatal care.

  • 11.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kylberg, Elisabeth
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Pilotstudie om psykisk ohälsa och utanförskap bland unga vuxna: Personliga berättelser och reflektioner kring vägar som bär till förändring2014Report (Other academic)
  • 12.
    Kazemi, Ali
    et al.
    University of Skövde, Health and Education. University of Skövde, School of Health and Education.
    Stark Ekman, Diana
    University of Skövde, Health and Education. University of Skövde, School of Health and Education.
    Kylberg, Elisabeth
    University of Skövde, Health and Education. University of Skövde, School of Health and Education.
    Differing attitudes toward health and sickness2014In: Encyclopedia of human services and diversity / [ed] Linwood H. Cousins, Sage Publications, 2014, p. 616-618Chapter in book (Refereed)
  • 13.
    Kylberg, Elisabeth
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Stark Ekman, Diana
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kazemi, Ali
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nutritional services and assessment2014In: Encyclopedia of Human Services and Diversity / [ed] Linwood H. Cousins, Thousand Oaks, California: Sage Publications, 2014, p. 975-977Chapter in book (Refereed)
  • 14.
    Kylberg, Elisabeth
    et al.
    University of Skövde, School of Life Sciences.
    Strindlund, Åsa
    Grön barnmat: Näringslära och vegomat för barn 0-5 år, gravida och ammande kvinnor2012 (ed. 3)Book (Other (popular science, discussion, etc.))
  • 15.
    Kylberg, Elisabeth
    et al.
    University of Skövde, School of Life Sciences.
    Westlund, Anna Maria
    Zwedberg, Sofia
    Amning i dag2009 (ed. 1)Book (Other academic)
  • 16.
    Nyqvist, Kerstin H.
    et al.
    Department of Women’s and Children’s Health, University Children’s Hospital, Uppsala, Sweden.
    Häggkvist, Anna-Pia
    Norwegian Resource Centre for Breastfeeding, Women and Children’s Division, Oslo University Hospital, Oslo, Norway.
    Hansen, Mette N.
    Norwegian Resource Centre for Breastfeeding, Women and Children’s Division, Oslo University Hospital, Oslo, Norway.
    Kylberg, Elisabeth
    University of Skövde, School of Life Sciences.
    Frandsen, Annemi L.
    Pediatric Department, Holbaek Hospital, Holbaek, Denmark.
    Maastrup, Ragnhild
    Neonatal Intensive Care Unit, Rigshospitalet, Copenhagen, Denmark, and Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Ezeonodo, Aino
    Helsinki University Central Hospital, Children’s Hospital, Department of Neonatology, Neonatal Intensive Care Unit, K7, Helsinki, Finland / Faculty of Health Care and Nursing, Helsinki Metropolia University of Applied Sciences, Helsinki, Finland.
    Hannula, Leena
    Faculty of Health Care and Nursing, Helsinki Metropolia University of Applied Sciences, Helsinki, Finland.
    Haiek, Laura N.
    Ministère de la Santé et des Services sociaux, Direction générale de santé publique, Quebec, Canada, and Department of Family Medicine, McGill University, Montréal, Québec, Canada.
    Expansion of the baby-friendly hospital initiative ten steps to successful breastfeeding into neonatal intensive care: Expert group recommendations2013In: Journal of Human Lactation, ISSN 0890-3344, E-ISSN 1552-5732, Vol. 29, no 3, p. 300-309Article in journal (Refereed)
    Abstract [en]

    In the World Health Organization/United Nations Children’s Fund document Baby-Friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care, neonatal care is mentioned as 1 area that would benefit from expansion of the original Ten Steps to Successful Breastfeeding. The different situations faced by preterm and sick infants and their mothers, compared to healthy infants and their mothers, necessitate a specific breastfeeding policy for neonatal intensive care and require that health care professionals have knowledge and skills in lactation and breastfeeding support, including provision of antenatal information, that are specific to neonatal care. Facilitation of early, continuous, and prolonged skin-to-skin contact (kangaroo mother care), early initiation of breastfeeding, and mothers’ access to breastfeeding support during the infants’ whole hospital stay are important. Mother’s own milk or donor milk (when available) is the optimal nutrition. Efforts should be made to minimize parent–infant separation and facilitate parents’ unrestricted presence with their infants. The initiation and continuation of breastfeeding should be guided only by infant competence and stability, using a semi-demand feeding regimen during the transition to exclusive breastfeeding. Pacifiers are appropriate during tube-feeding, for pain relief, and for calming infants. Nipple shields can be used for facilitating establishment of breastfeeding, but only after qualified support and attempts at the breast. Alternatives to bottles should be used until breastfeeding is well established. The discharge program should include adequate preparation of parents, information about access to lactation and breastfeeding support, both professional and peer support, and a plan for continued follow-up.

  • 17.
    Stark Ekman, Diana
    et al.
    University of Skövde, Health and Education. University of Skövde, School of Health and Education.
    Kazemi, Ali
    University of Skövde, Health and Education. University of Skövde, School of Health and Education.
    Kylberg, Elisabeth
    University of Skövde, Health and Education. University of Skövde, School of Health and Education.
    Health promotion services2014In: Encyclopedia of human services and diversity / [ed] Linwood H. Cousins, Sage Publications, 2014, p. 632-634Chapter in book (Refereed)
  • 18.
    Stark Ekman, Diana
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kazemi, Ali
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kylberg, Elisabeth
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Home and community services2014In: Encyclopedia of Human Services and Diversity / [ed] Linwood H. Cousins, Thousand Oaks: Sage Publications, 2014, p. 651-653Chapter in book (Refereed)
  • 19.
    Thernström Blomqvist, Ylva
    et al.
    Uppsala University.
    Rubertsson, Christine
    Uppsala University.
    Kylberg, Elisabeth
    University of Skövde, School of Life Sciences.
    Jöreskog, Karin
    Uppsala University.
    Hedberg, Kerstin
    Uppsala University.
    Kangaroo Mother Care helps fathers of preterm infants gain confidence in the paternal role2012In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 68, no 9, p. 1988-1996Article in journal (Refereed)
    Abstract [en]

    Aim.  This article is a report on a descriptive study of fathers’ experiences of providing their preterm infants with Kangaroo Mother Care.

    Background.  During neonatal intensive care, fathers describe the incubator as a barrier and the separation from their infant as stressful. Fathers consider it important to be close to the infant, and performing Kangaroo Mother Care makes them feel an important participant in their infants’ care.

    Method.  Individual interviews conducted in 2009 with seven fathers who performed Kangaroo Mother Care were analysed using qualitative content analysis.

    Results.  The fathers’ opportunity for being close to their infants facilitated attainment of their paternal role in the neonatal intensive care unit. Kangaroo Mother Care allowed them to feel in control and that they were doing something good for their infant, although the infant’s care could be demanding and stressful. As active agents in their infant’s care, some fathers stayed with the infant during the whole hospital stay, others were at the neonatal intensive care unit all day long. Despite the un-wished-for situation, they adapted to their predicament and spent as much time as possible with their infants.

    Conclusion.  Fathers’ opportunities for Kangaroo Mother Care helped them to attain their paternal role and to cope with the unexpected situation. The physical environment and conflicting staff statements influenced their opportunity for, and experience of, caring for their preterm infants.

  • 20.
    Theurich, Melissa Ann
    et al.
    LMU - Ludwig-Maximilians-Universität Munich, Div. Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Munich, Germany.
    Davanzo, Riccardo
    Department of Mother and Child Health, ASM-Matera and Task Force on Breastfeeding, MOH, Rome, Italy.
    Busck-Rasmussen, Marianne
    Danish Committee for Health Education, Copenhagen, Denmark.
    Díaz-Gómez, N. Marta
    Instituto de Tecnologías Biomédicas (ITB) and Centro de Investigaciones Biomédicas de Canarias (CIBICAN), Universidad de La Laguna, Spain.
    Brennan, Christine
    Breastfeeding Promotion Foundation, Bern, Switzerland.
    Kylberg, Elisabeth
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Bærug, Anne
    Norwegian National Advisory Unit on Breastfeeding, Oslo, Norway.
    McHugh, Laura
    Health Service Executive, Ennis, Ireland.
    Weikert, Cornelia
    German Federal Institute for Risk Assessment, Department of Food Safety, Berlin, Germany.
    Abraham, Klaus
    German Federal Institute for Risk Assessment, Department of Food Safety, Berlin, Germany.
    Koletzko, Berthold
    LMU - Ludwig-Maximilians-Universität Munich, Div. Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Munich, Germany.
    Breastfeeding Rates and Programs in Europe: A Survey of 11 National Breastfeeding Committees and Representatives2019In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 68, no 3, p. 400-407Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Among the world's regions, the WHO European Region has the lowest rates of exclusive breastfeeding at age 6 months with around 25%. Low rates and early cessation of breastfeeding have important adverse health consequences for women, infants and young children. Protecting, promoting and supporting breastfeeding are a public health priority.

    OBJECTIVES: National breastfeeding data and monitoring systems among selected European countries and the WHO European Region are compared. Mechanisms for the support, protection and promotion of breastfeeding are reviewed and successes and challenges in implementation of national programs are presented.

    METHODS: National representatives of national breastfeeding committees and initiatives in eleven European countries, including Belgium, Croatia, Denmark, Germany, Ireland, Italy, The Netherlands, Norway, Spain, Sweden and Switzerland, participated in a standardized survey. Results are evaluated and compared in a narrative review.

    RESULTS: Variation exists in Europe on breastfeeding rates, methodology for data collection and mechanisms for support, protection and promotion of breastfeeding. Directly after birth, between 56 and 98 % of infants in all countries were reported to receive any human milk, and at 6 months 38-71% and 13-39 % of infants to be breastfed or exclusively breastfed, respectively. National plans addressing breastfeeding promotion, protection and support exist in 6 of the 11 countries.

    CONCLUSIONS: National governments should commit to evidence-based breastfeeding monitoring and promotion activities, including financial and political support, to improve breastfeeding rates in the Europe. Renewed efforts for collaboration between countries in Europe, including a sustainable platform for information exchange, are needed.

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