Start/Search | Browse by Day | Author Index

Exclusive breastfeeding during the postpartum hospital stay is one of the most important influences on the duration of exclusive breastfeeding after discharge (Californian Women’s, Infant’s and Children’s Association & University of California Davis Human Lactation Center, 2008). Therefore, support for exclusive breastfeeding during this critical time is essential for the long term outcomes for mother, baby and society and for achievement of Healthy People 2010 goals. Additionally, the State of CA reports this score annually and it will also be part of the Perinatal Care Core Measure Set by Joint Commission in May 2010.

According to Miller, Cook, Brooks, Heine & Curtis, (2007), a women’s decision of whether or not to breastfeed is influenced by her family’s recommendations and by the information she receives from her health care provider. However, many health care providers lack sufficient knowledge surrounding breastfeeding.  The health care provider has an important role in the mother’s choice of infant feeding, and their lack of encouragement for breastfeeding represents an opportunity to improve the health of the mother and infant.  It is therefore imperative for nurses to identify barriers to breastfeeding for themselves and their patients in order to encourage and support breastfeeding adequately.  A large component of these barriers is lack of consistent and up-to-date, evidenced based education. According to a study by Bernaix (2000), the nurses’ knowledge of breastfeeding is the best predictor of supportive behavior as perceived by the patient. Additionally, Martens (2000) found that nurses’ knowledge base regarding breastfeeding was an important influence on the success of breastfeeding.

In the summer of 2008, Sharp Mary Birch Hospital for Women & Newborns (SMBHW&N) formed an Evidenced-Based Change Project Team to enhance provider knowledge, attitudes and skills of teaching new mothers about the benefits of breastfeeding, to provide consistent evidenced-based information to new mothers in the early days of breastfeeding to ensure their success, and to facilitate family support of the new mother’s choice. The target of 61.8% exclusive breastfeeding rate at 24 hours of age in the well-baby population by September 2009 was established with the baseline of 45.8% in September 2008. 

PICO Question: Among nurses on Maternal Infant Services (MIS) units (Population), what is the effect of an educational intervention to enhance their knowledge, attitude, skill and commitment to breastfeeding (Intervention) as compared to pre and post-tests conditions (Comparison) on improving the breastfeeding rates of new mothers upon discharge from the hospital (Outcome)?   

In May 2009, all Registered Nurses on MIS attended a mandatory two-hour breastfeeding education class that reviewed evidenced-based findings on breastfeeding basics. Project participants were given a 12 question pre-test prior to the start of the class and the same test as the post-test at the end of the class.  The same 12 question post-test was given three months after the class. In the fall of 2009 a comparison analysis will be made between the pre and post-tests to determine if there was a significant improvement in the knowledge, attitude and practices regarding breastfeeding.