Purpose for the program: Exclusive breastfeeding is best for baby and mom. Evidence based practice describes this choice, but who can say their hospital truly promotes exclusive breastfeeding? We are a 600 bed hospital with over 7,000 births per year. It takes our village to educate Mom, family and staff within Women's Services. It is all our responsibility to help moms be successful and promote AWHONN, WHO, AAP, ACOG, DHHS, CDC and Joint Commission for exclusive breastfeeding. 

Proposed change: We want to provide "best patient care." In May 2010, our exclusive breastfeeding rate was 37%. We realized our shortfall and discussed ways to improve. Within our shared governance structure, we have a unit Research Council. The topic of exclusive breast feeding, hospital supplementation and education for staff was our new project for change. Our council consists of staff nurses from Mother/Baby and Gyn. The Nurse Educator and Lactation Consultant are also committee members. We began with a literature search.  How do you treat a baby with low blood sugar but still exclusively breastfeed? What do you do when Mom is medically unable to breastfeed after birth? What about Moms who want to sleep all night and request staff give a bottle? What about the Obstetrician or Pediatrician who tells Mom, "you need your sleep at night. A little formula never hurt." What about L&D nurses who say, "breastfeeding is not our job, it is the Lactation Consultants' job", or Mother/Baby staff who say, "I fed my babies formula and they turned out just fine?  Extensive education was needed for Women's Services staff, physicians, parents and families.

Implementation, outcomes and evaluation: The Nurse Educator and Lactation Consultant developed a education for all Women's Services staff. The major healthcare organizations recommending exclusive breast feeding were cited. Articles from the literature search were presented. Benefits of breastfeeding for Mom, baby and community were discussed. Many examples of hospital practices that decrease success of exclusive breast feeding were recalled.  Skin to skin care and rooming in were discussed.  In NC we have The PQCNC (Perinatal Quality Collaborative of North Carolina) for exclusive breast feeding. "The Well Baby track focuses on supporting mother’s choice to provide exclusive breastfeeding for their term infants." We became an active member of the PQCNC project for exclusive breast feeding.

Implications for nursing practice: We want to provide best practice. Literature proves that exclusive breast feeding is a specific action that can provide this for Mom and baby. We, as Obstetric nurses, have power to educate and support Moms and families, to make informed decisions about their care.

Keywords: exclusive breastfeeding