Abstract: The Impact of the Implementation of a Formal Breastfeeding Program on the Knowledge, Comfort and Attitude of Neonatal Care Providers (Association of Women's Health, Obstetric and Neonatal Nurses (June 27

Sunday, June 28, 2009

Hall A (San Diego Convention Center)

Pamela S. Mellin, RN, MSN, APNC , Labor & Delivery, Morristown Memorial Hospital - Atlantic Health, Bernardsville, NJ

Donna T. Poplawski, RNC, MSN, NP , Labor & Delivery, Atlantic Health - Morristown Memorial Hospital, Morristown, NJ

Amy Gole, RNC, EdM, IBCLC , Parent Education Department, Morristown Memorial Hospital - Atlantic Health, Morristown, NJ

Sharon B. Mass, MD, FAACOG , Obstetrics and Gynecology, Morristown Memorial Hospital, Morristown, NJ

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          In the United States, the Healthy People 2010 goal is for 75% of newborns to be breastfed and for at least 50% to continue breastfeeding for six months (Healthy People 2010). At Morristown Memorial Hospital, 79% of mothers initiate breastfeeding. However, only 48% are breastfeeding at the time of hospital discharge. This may be related to patient concerns that mothers received conflicting information on breastfeeding from their healthcare providers including Obstetricians, Pediatricians, Lactation Consultants, and Maternity Nursing Staff. Despite the belief that the decision to breastfeed lies with the mother, physician and nurse counselling plays an important role in patient decision making regarding breastfeeding. Studies of clinician practices and breastfeeding rates have found that encouragement from healthcare providers is associated with increased breastfeeding initiation (Lu, 2003) and continuation. This study is aimed at investigating whether implementation of a formal breastfeeding program including protocols and educational presentations would have a positive impact on knowledge, comfort and attitudes toward breastfeeding among healthcare providers.
Hypothesis: The introduction of a formal breastfeeding program will increase the knowledge and comfort and positively influence the attitude of healthcare providers in regard to breastfeeding.
          The study included survey tools to assess the implementation of an intervention program reflected by a formal breastfeeding program that included protocols and educational presentations. A total of 53 healthcare providers (Obstetricians, Pediatricians, Labor & Delivery and Mother –Baby Nurses) completed surveys reflecting knowledge, comfort and attitude toward breastfeeding. The surveys used a combination of multiple choice and fill-in-the-blank questions to determine knowledge about breastfeeding as well as Likert scale type questions to determine levels of comfort and attitude toward dealing with breastfeeding management (higher scores indicated increased levels of comfort and improved attitude toward breastfeeding). Information was collected before implementation of the breastfeeding program and approximately 6 months after the implementation. The non-parametric Wilcoxon Signed-Ranks test was used to examine differences in knowledge, comfort and attitude levels regarding breastfeeding in the pre-and post-implementation periods. Pre- and post-implementation knowledge was assessed based on the total number of correct answers.

          Healthcare providers showed a statistically significant increased level of knowledge about breastfeeding after the implementation of the formal breastfeeding program (median number of correct answers for pre vs. post implementation was 5 vs. 6, respectively, p = 0.022). Overall, healthcare providers had a statistically significant increase in comfort with breastfeeding issues after the intervention (median score for pre vs. post implementation was 17.5 vs. 18.0, respectively, p = 0.040). There were trends toward a positive change in the area of counselling and breastfeeding advocacy (median score for pre vs. post implementation was 44.0 vs. 44.5, respectively, p = 0.075).

            A formal breastfeeding program that included protocols and educational presentations had a positive impact on provider knowledge, comfort, and attitudes regarding breastfeeding management. Results were limited by sample size which may not have been enough to detect significance in more items. Repeating this study in other settings should be considered. Future analysis will look at the impact of the intervention on patient breastfeeding practices.

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