Background: 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. 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 to healthcare providers would have a positive impact on patient satisfaction with the breastfeeding experience.
Hypothesis: The introduction of a formal breastfeeding program will increase maternity patient satisfaction with the breastfeeding experience.

Methods: The study included survey tools for breastfeeding patients to report items such as assistance received from maternity nursing staff, use of formula supplementation, and night feeding. The survey also included a Lickert scale type items to determine patient satisfaction with the breastfeeding experience. A total of 207 breastfeeding mothers agreed to participate in the study [130 (63%) in the pre-intervention group and 77 (37%) in the post-intervention group]. Information was collected before implementation of the breastfeeding program and approximately 6 months after the implementation. Statistical comparisons between pre and post-intervention in terms of responses to survey items were made using the Chi-square/Fisher’s exact test.
Results:  The pre-intervention group were highly satisfied with their breastfeeding experience. In spite of a formal breastfeeding program that included protocols and educational presentations to healthcare providers, there was no statistically significant difference in maternity patient satisfaction with the breastfeeding experience after the intervention.  The intervention did, however, indicate that a trend of change had occurred. Mothers reported an increase in night time feedings on postpartum day one after the intervention (55% pre-intervention vs. 71% post-intervention). At the same time, fewer breastfeeding mothers reported having the baby fed in the nursery at night (28% pre-intervention versus 21% post-intervention). These differences were marginally significant (p = 0.054). Also, patients reported an increase in nurses’ actively observing breastfeeding: 92% post intervention vs. 84% pre-intervention (p=0.095).

Conclusion: A formal breastfeeding program that included protocols and educational presentations did not have statistically significant impact on maternal satisfaction with the breastfeeding experience but did indicate positive trends toward changing patient and hospital behaviours related to breastfeeding. 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 duration and exclusivity.