Objective: Nation-wide breastfeeding rates remain low despite a decade of programming on state and local levels. Beliefs and attitudes of nursing Obstetrical staff may enhance or hinder the success of breastfeeding initiatives due to subtle messaging. The purpose of this work is to describe the impact of an educational intervention on attitudes and beliefs regarding breastfeeding in order to foster a Baby Friendly Hospital.

Design: An intervention study on staff attitudes and beliefs with the use of a reliable and valid tool was conducted with nursing staff. L&D and post-partum nurses from a large Midwestern urban hospital responded to the Breastfeeding Beliefs, Bottle Feeding Beliefs and Breastfeeding Attitudes Attitude Survey at baseline and following intervention.  Following the initial survey, staff were provided with a 5 hour educational intervention “Bridges to Breastfeeding” provided by  members of the Illinois Department of Health, Women, Infants and Children’s (WIC) program and breastfeeding advocates.

Patients/Participants: 139 staff nurses

Methods: Pre and post intervention survey of nurses beliefs and attitudes 

Implementation Strategies: Test

Results: Descriptive and inferential statistics were used in the analysis with significance determined with a p-value of <.05. A total of 139 surveys were analyzed. Eighteen stem questions were grouped into 4 categories:  beliefs and attitudes regarding infant health, medical concerns, effect on activities of daily living and privacy and intimacy. There were increases in scores in three of the four categories. Statistically significant findings were identified in the medical and maternal convenience sections. Results also demonstrated a difference between breastfeeding beliefs and attitudes among the Obstetrical staff. Post Partum nurses had three- times the overall positive change in scores when compared with the L&D respondents.

Conclusion/Implications for nursing practice: Breastfeeding beliefs and attitudes of the surveyed nurses were impacted positively following an educational intervention. Key areas impacted were those related to infant health and nutrition, maternal convenience and the medical effects of alcohol, tobacco and junk food. There was no measurable impact on questions related to intimacy or privacy indicating that these beliefs and attitudes were not ideally addressed by the educational offering and may be better addressed through sensitivity training. Understanding what nurses were thinking challenged our assumptions, redirected our training efforts, and identified a commonly cited finding: that some barriers to raising breastfeeding rates may be grounded in nurses own beliefs and attitudes. 

Keywords: Baby Friendly Hospital Initiative, beliefs and attitudes of nurses