الفهرس 
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Abstract
This study is an intervention study aiming at promoting the quality of services delivered to the mothers at birth and babies by monitoring the implementation the ten steps of both Baby friendly and Mother friendly.
The study involved a design of educational material in Mother Friendly and introducing it together with a software program for monitoring Baby Friendly and mother friendly practices.
This study was carried out at Quisna hospital and Shibin ElKom teaching hospital by sampling 10 mother-infant pairs at three weeks intervals from each hospital over a period of six months with a total of 120 mother-infant Pairs over the entire period of study from July to December 2010.
In between the monitoring sessions, the gaps in practices identified were corrected by continued in-service training of the staff. This helped to improve the identified gaps in implementation of the Ten Steps of both Mother and Baby Friendly.
We analyzed our results, after feeding in the computerized program, on monthly basis by line charts and by comparing the first three months of both hospitals (60 mother -infant pairs) with the results of the second three months of the study (60 mother -infant pairs of both hospitals) and the findings between the two hospitals.
The results of this study revealed that there was improvement in Mother friendly practices include allowing a companion of her choice with her during delivery, allowing mothers to have light foods and drinks, encouraging her to move and explaining to the mother her choices at birth. The increase was more evident in Quisna Hospital as compared to Shibin Teaching Hospital.
There was also a statistically significant improvement in the mode of delivery that encouraged least medical interventions (Step 6 of Mother Friendly) as NVD with medication decreased from 26.7% to 11.7% and NVD without medication increased from 33.3% to 55%.
There was also significant improvement in Baby friendly practices, as skin to skin which was not implemented reached 95% by the end of the study and rooming-in increased to 91%. Any artificial nipples offered to newborns decreased significantly. Milk expression increased to 95% .
Most significant findings was the steep rise in exclusive breastfeeding rates in the post partum period reaching 75% from 40%. The increase was more in Quisna Hospital as compared to Shibin Teaching Hospital.
Breast and nipples problems in the postpartum period decreased significantly over time. Also mother presenting with any post partum medical complication mainly bleeding and sepsis decreased from 21% to 8.3% by the end of the study. Finally babies presenting with neonatal jaundice decreased from 18.3% to 10% by the end of the study.
The study showed that improving Mother friendly practices go hand in hand with improving Baby friendly practices and that more attention needs to be given to teaching (university) hospitals as these are key to disseminating the culture of Mother and Baby Friendly and ensuring sustainability of any program. Hence such practices need to be included in the current reform initiative of the Medical and Nursing Teaching systems. Moreover the specialty of lactation management is needed and should be encouraged and specialist in this field posted and assigned to their posts in hospitals and primary heath care and become integrated into the system. We have a long way to go before we can make all hospitals Baby and Mother friendly in Egypt, but when this happens we will have ensured all babies a safe and secure begin.