Increasing Initiation and Exclusivity of Breastfeeding in the Hospitalized, Postpartum Dyad

Abstract

<h2>Poster Presentation</h2><h3>Objective</h3> To increase initiation and exclusivity of breastfeeding in the hospitalized, postpartum dyad via an educational module for staff registered nurses (RNs). This module consisted of interventions to increase bedside lactation support and build maternal confidence in breastfeeding success, defined as <i>breastfeeding self‐efficacy</i>. The specific program objectives with measurable outcomes were set based on the Joint Commission Perinatal Core Measures and Healthy People 2020. <h3>Design</h3> The increasing breastfeeding rates program was designed as an evidence‐based practice change of increased bedside registered nurse (RN) lactation support. It was based upon education and involvement of the institution's current Lactation Operations Group (LOG) aligned with education of the bedside RN. It was designed as a quality improvement project with RN education as the intervention. <h3>Sample</h3> The target population included hospitalized women in the immediate postpartum period in a coastal mid‐Atlantic inner city hospital who desired to breastfeed. A convenience sample of one month's breastfeeding rates was compared retrospectively (preintervention) with one month's rates postintervention. <h3>Methods</h3> With the breastfeeding rates identified as the problem, the evidence‐based practice change began with the assessment of a need for change in the current breastfeeding support and an increase in education for bedside RNs. <h3>Implementation Strategies</h3> A mandatory 2 1/2 hour educational intervention for all labor and delivery, postpartum and newborn nursery nurses (<i>N</i> = 70) was presented on bedside lactation support aligned with maternal breastfeeding self‐efficacy. The intervention included skin‐to‐skin techniques, rooming in discussions, and scripting for no supplementation. The concept of self‐efficacy was addressed, specifically increasing maternal confidence in successful breastfeeding. <h3>Results</h3> The outcome measures demonstrated an increase in scores for breastfeeding. The initiation of breastfeeding within the first hour of life score increased from 55.4 % to 62.3%, whereas the exclusivity of breast milk feeding while in the hospital increased from 63.1% to 70.78%. <h3>Conclusion/Implications for Nursing Practice</h3> The advantages of breastfeeding for mother and infant are substantial and include protecting infants from allergens to reducing rates of maternal breast and ovarian cancer. These evidence‐based practices for lactation support have the potential to improve health outcomes not only for the hospitalized maternal/infant dyad, but also for society.