Assessment of Breastfeeding Knowledge of Nurse Practitioners and Nurse-Midwives


  • Pam Hellings CPNP, PhD,

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    • Pam Hellings is Professor and Chairperson of the Department of Primary Care in the School of Nursing, Oregon Health Sciences University, Portland, Oregon. She received her BSN and NM and pediatric nurse practitioner certificate from UCLA and her PhD in Educational Psychology from the University of Oregon. She is also a lactation consultant and educator.

  • Carol Howe CNM, DNSc, FACNM

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    • Carol Howe is Professor and Director of the Nurse-Midwifery Education Program at the Oregon Health Sciences University, Portland, Oregon, and President of the ACNM Certification Council. She has a joint appointment as Associate Professor in the Department of Obstetrics and Gynecology, School of Medicine. She received her BSN from Texas Woman's University, her MSN and midwifery certificate from Yale University, and her DNSc from the University of California, San Francisco.

OHSU School of Nursing, 3181 S.W. Sam Jackson Park Rd., Portland, OR 97201.


The purpose of this study was to replicate a national study of physician knowledge, experience, and attitudes about breastfeeding. All family, pediatric, and women's health care nurse practitioners and nurse-midwives in a northwestern state were surveyed using a mail questionnaire; the response rate was 60.4%. Respondents were nearly unanimous in believing that “breast is best” and in recommending breastfeeding to expectant mothers as a part of their role. In general, 70% of respondents considered themselves effective or very effective in meeting the needs of breastfeeding patients. Although respondents were very supportive of breastfeeding, they were less knowledgeable about specific management strategies. There were differences in attitudes among nursing specialties and with years of experience. Overall, this statewide sample of nurse practitioners and nurse-midwives had a better understanding of the benefits of breastfeeding and an increased sense of effectiveness in managing breastfeeding problems than the physician participants in the national study. A national sample of nurse practitioners and nurse-midwives is needed to verify and expand on the results from this single jurisdiction, where 40% of the respondents were graduates of the home institution of the co-investigators.