Table 1 Newborn feeding practices in facility assessment
|  | District 1 – a government hospital | District 2 – mission hospital | District 3 – a government hospital |
|---|---|---|---|
The newborn baby is put on the abdomen or to the breast for skin contact immediately after birth if no need for resuscitation | 5 | 5 | 5 |
Initiation of breastfeeding is encouraged within the first hour, and mothers are given a quiet atmosphere to do so | 5 | 5 | 4 |
Staff are trained to assist mothers and babies in initiating breastfeeding correctly | 5 | 4 | 4 |
Expressed breastmilk is given by cup or nasogastric tube when the child is unable to feed or if the mother cannot stay with the child all the time | 5 | 5 | 3 |
There is no promotion of infant formula on the ward and samples are not distributed to mothers or staff | 5 | 5 | 5 |
Infant formula, glucose supplementation, water supplementation are not used unless upon written medical instruction | 5 | 5 | 5 |
Exceptions to exclusive breastfeeding are based on current evidence | 5 | 5 | 5 |
There are no restrictions on the frequency or length of breastfeeding | 5 | 5 | 5 |
At discharge, exclusive breastfeeding is recommended until the age of 6 months and complementary breastfeeding until 24 months | 5 | 4 | 5 |
Documentation on breastfeeding and frequency is kept | 1 | 1 | 1 |
Early and exclusive breastfeeding summary score | 5 | 4.8 | 4.6 |
All preterm and low birthweight are admitted for monitoring (<  2000 g) | 3 | 5 | 3 |
Mothers are NOT routinely separated from babies, and can room-in together | 5 | 5 | 2 |
Specific feeding needs of low birthweight and other sick newborns are taken care of | 3 | 2 | 2 |
There are feeding protocols by day/weight, etc. | 5 | 1 | 5 |
Special feeding needs are included in the patient plan/record | 5 | 3 | 3 |
Mothers’ milk is given to low birthweight (LBW) babies as much as possible | 4 | 5 | 4 |
Frequent feedings (at least 8 per day) are provided to LBW babies and intake is monitored | 5 | 3 | 3 |
Babies unable to feed are given expressed breast milk by cup, spoon, or fed by nasogastric tube in adequate amounts according to age. Intake is monitored | 4 | 4 | 4 |
Guidelines for recognition and treatment of hypoglycemia are available, known, and used by staff | 4 | 4 | 4 |
Feeding needs for sick neonates summary score | 3.8 | 3.3 | 3.5 |