The Baby Friendly Journey: Does Breastfeeding Education Of Nurses Increase Exclusive Breastfeeding Rates In a Large Academic Medical Institution?

Purpose for the program: To determine if increased breastfeeding education among 500 perinatal nursing staff using the Baby Friendly Health Initiative (BFHI) requirements is effective for increasing exclusive breastfeeding rates.

Proposed change: A large academic Women’s medical center which delivers 12,500 infants per year entered into the Baby Friendly Health Initiative in January 2011 and initiated breastfeeding nursing education in April 2013. This hospital is the largest hospital to date to enter the Baby Friendly pathway. Prior to entering into the BFHI, there was very few nursing breastfeeding education opportunities offered.

Implementation, outcomes and evaluation: Twenty hours of nursing breastfeeding education as mandated by the Baby Friendly Health Initiative was initiated in April of 2013. A multidisciplinary team of nursing advanced practice nurses, managers, lactation consultants, and education coordinators from the Neonatal Intensive Care Unit, Labor and Delivery Unit, and Mother Baby Unit came together to plan for this initiative. The perinatal service line used a variety of methods to meet the twenty hour requirement of education needs. Fifteen of these hours involved a didactic portion of education. Programs chosen to meet the didactic requirements were one of the following programs: Certified Lactation Counselor course, Certified Breastfeeding Counselor course, The University of Virginia Breastfeeding Education course, or the Breastfeeding Advisor course.  Five of the hours of training were required for hands on skilled nursing breastfeeding education. The multidisciplinary team developed a breastfeeding educational skills workshop, electronic learning module, and a hands-on bedside learning opportunity to meet these requirements.

Following implementation of a comprehensive educational program, the rates of initiation of exclusive breastfeeding have trended upward. Prior to nursing breastfeeding education from December 2012-March 2013, the average exclusive breastfeeding rate was 38.55%. After completion of nursing breastfeeding education, from April 2013-July 2013, the average exclusive breastfeeding rate was 53.5%.

By providing a comprehensive breastfeeding education plan to perinatal nursing staff, we have demonstrated that the BFHI is a valid breastfeeding educational program and leads to an increased exclusive breastfeeding rates. 

Implications for nursing practice: A multidisciplinary team approach is an effective way to develop plan to support breastfeeding nursing education based on the principles of the BFHI and effectively change breastfeeding culture and increase exclusive breastfeeding rates in a large academic medical setting.

Keywords: Baby Friendly Health Initiative, Nursing Breastfeeding Education, Exclusive Breastfeeding