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Access through your institution Buy or subscribe We appreciate the interest and the comments expressed in response to our article.1, 2 We are in agreement with the author’s viewpoint that
the lack of commitment to implement the 10 steps of the Baby-Friendly Hospital Initiative, and specifically those that require staff skills and time may be the key reason why early
complementary feeding is observed even in baby-friendly hospitals (BFH) and that these deserve special mention. Our study, which objectively assessed the compliance to exclusive
breastfeeding (EBF), drew the same conclusion, and objectively showed that even BFH may not necessarily have improved rates of EBF. We therefore emphasize the need to monitor and reassess
the functioning of BFH in India. In addition, the authors have emphasized the lack of commitment, inadequate counselling during antenatal, perinatal and postnatal period, as well as
inadequate training in terms of fewer health professional receiving training, as key drawbacks. These are the important factors to consider; nevertheless, there may be other crucial areas,
such as support from the family and community that may be equally important to address, if compliance to EBF needs to be improved. For example, all the mothers in our cohort reported having
received counselling during pregnancy and immediately after birth while at the hospital; however when they were back at home, these instructions were not followed. This raises two important
questions: first, if counselling was given, why was it ineffective, and second, what were the home barriers that prevented mothers from implementing the hospital-based training they had
received. This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through your institution Subscribe to this journal Receive 12 print issues and online
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are calculated during checkout ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support REFERENCES * Das RR, Naik SS .
Baby-friendly hospitals: only the better, but not the best. _Eur J Clin Nutr_ 2012; 66: 1077. Article CAS Google Scholar * Samuel TM, Thomas T, Bhat S, Kurpad AV . Are infants born in
baby-friendly hospitals being exclusively breastfed until 6 months of age? _Eur J Clin Nutr_ 2012; 66: 459–465. Article CAS Google Scholar * Mclnnes RJ, Chambers JA . Supporting
breastfeeding mothers: qualitative synthesis. _J Adv Nurs_ 2008; 62: 407–427. Article Google Scholar Download references ACKNOWLEDGEMENTS This research was supported by the Coordinated
Research Program (13319/RO) of International Atomic Energy Agency, Vienna. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Division of Nutrition, St John’s Research Institute, St John’s
National Academy of Health Sciences, Bangalore, India T M Samuel, T Thomas & A V Kurpad * Department of Pediatrics, St John’s Medical College, Bangalore, India S Bhat Authors * T M
Samuel View author publications You can also search for this author inPubMed Google Scholar * T Thomas View author publications You can also search for this author inPubMed Google Scholar *
S Bhat View author publications You can also search for this author inPubMed Google Scholar * A V Kurpad View author publications You can also search for this author inPubMed Google Scholar
CORRESPONDING AUTHOR Correspondence to A V Kurpad. ETHICS DECLARATIONS COMPETING INTERESTS Dr Anura V Kurpad is a member of the Kraft Health and Wellness Board. His honoraria go entirely to
charity. The remaining authors declare no conflict of interest. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Samuel, T., Thomas, T., Bhat, S. _et al._
Baby-friendly hospitals: only the better, but not the best. _Eur J Clin Nutr_ 66, 1078 (2012). https://doi.org/10.1038/ejcn.2012.65 Download citation * Published: 13 June 2012 * Issue Date:
September 2012 * DOI: https://doi.org/10.1038/ejcn.2012.65 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a
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