55: Measuring the Neo-BFHI: Compliance with Baby-Friendly Practices in Neonatal Units in Quebec
Bibliographic record
Abstract
Since 2009, a Nordic and Quebec Working Group has been working on an adaptation of the Baby-Friendly Hospital Initiative for neonatal units (Neo-BFHI). The program will be disseminated globally as a package that will include a core document with adapted standards and criteria for each of the BFHI Ten Steps to Successful Breastfeeding, as well as self-appraisal, monitoring and external assessment tools to be used by units/institutions considering or seeking Neo-BFHI certification. In order to evaluate the newly-adapted tools, a pilot study was conducted to measure compliance with Baby-Friendly practices in three neonatal units with intensive or intermediate care beds in the province of Quebec that were not seeking certification at the time of the assessment. Compliance with each Neo-BFHI criterion was measured following the same process used for Baby-Friendly certification in regular maternity units (ie, based on three sources of information – mothers; managers/staff; an external observer). A total of 32 managers/staff members (10 to 11 per hospital) have participated in the assessment interviews and to date, 71 mothers of premature or ill infants requiring neonatal care (22 to 25 per hospital) have completed the interviews. Compliance with each of the Neo-BHFI criteria was measured by the percentage of respondents giving ‘correct’ answers. For example, the assessments showed that only 6% of clinical staff confirm that transport of a stable infant from the birthing ward to the neonatal ward is performed in skin-to-skin contact/kangaroo position on a parent's chest (Step 4), and 31% described infant stability as the only criterion for early initiation of breastfeeding (Step 5). Data collected from mothers and observations will also be presented and compared to those provided by staff. The pilot-test revealed the many challenges of measuring Baby-Friendly practices in neonatal settings, given the complexity and variability of care needs among this vulnerable pediatric population. Study findings will be used to fine-tune the adaptation and to finalize assessment tools that can be used to support the implementation and evaluation of Baby-Friendly practices in neonatal units.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".