Effect of Maternal Exhaustion on Breastfeeding Exclusivity

Abstract

The current rate of exclusive breastfeeding at Bon Secours St. Francis Hospital is 68.3%, with 910 newborns out of 1,332 eligible newborns being exclusively breastfeed over a 6-month period. The general assumption by staff was that a lactation consultant nurse could improve, during the night shifts, breastfeeding exclusivity until the patient was discharged. Data were gathered over a 6-month period on 1,332 births. The mother–baby unit manager was a key stakeholder who used the eight-step plan–do–check–act (PDCA) methodology to solve this problem. The unit manager selected to investigate the subset of 44 mothers who attempted breastfeeding but failed and identified that exhaustion, pain, or unknown reasons were causes. The unit manager worked with front-line staff to develop a root cause analysis using the categories of man, method, material, machine. and environment and identified five important causes of the exhaustion that new mothers experienced:•Care providers were operating on their own schedules, which resulted in 31 planned encounters with the mother during the first 24-hr postbirth.•The hospital did not have mandatory quiet hours or a process to limit visitors.•The patient rooms are side by side with no sound protection.•Staff lacked the awareness of their noise level and how it related to the mother’s exhaustion and lower breastfeeding rates.•Badge swipes for supply, medical, and linen (any locked door) on the unit created loud beeps and mechanical sounds throughout the unit any time a locked door was accessed. Since March 2018, breastfeeding exclusivity rates have remained above 70% and patient satisfaction scores have improved. The hospital also was surveyed for Baby-Friendly hospital designation in August 2018 and is awaiting results. The staff was not familiar with the eight-step PCDA process, and, in the beginning, they believed that the solution was to add lactation support at night. There were additional opportunities that could have been taken advantage of with these improvements by working with internal marketing to promote the initiative and exploring the potential to partner with physician practices to focus on women’s care from prenatal planning to postpartum care.