Where's the Lactation Consultant? Increasing Exclusive Breastfeeding Rates by Empowering L&D Nurses


Poster Presentation

Purpose for the Program

Breastfeeding is widely recognized as the ideal method of feeding infants. An objective of Healthy People 2010 was for 75% of infants to be exclusively breastfed upon hospital discharge. Currently, breastfeeding rates in the United States have not met this goal. Baylor University Medical Center (BUMC) implemented a program that focused on increasing exclusive breastfeeding rates (EBRs).

Proposed Change

There has been a significant increase in BUMC's EBR because of nurse and patient education, nurses’ hands-on assistance with breastfeeding initiation, and the labor and delivery (L&D) nurses role as bedside breastfeeding advocates.

Implementation, Outcomes, and Evaluation

An International, Board Certified, Lactation Consultant (IBCLC) at BUMC championed a project that filled the gap in lactation support, which is given to patients throughout the Women's and Children's service line, by creating the crew. The crew consists of nurses that underwent training and were committed to serving their individual unit's needs regarding breastfeeding. The L&D crew is addressing barriers to breastfeeding on our unit and is implementing changes to overcome these challenges. In particular, we re-purposed a patient breastfeeding education sheet used by the lactation department. By adding the breastfeeding education sheet to our electronic system, it prints with the chart and is readily accessible to staff. Also, crew members are assessing attitudes and comfort levels of L&D nurses regarding lactation support by using an online survey. Once survey results are analyzed, in-services and staff education will be implemented that focuses on topics such as hand expression of colostrum and spoon-feeding, skin-to-skin contact, breastfeeding in the operating room, use of breast pumps, and breast milk storage. Implementation of the crew in L&D has already made an impact on our EBR, increasing the rates from 41% to 72%. Follow-up from the online surveys will hopefully further increase the EBR rate.

Implications for Nursing Practice

Increasing the EBR is a Baylor Healthcare System goal, prompted by Medicaid reimbursement policies, The Joint Commission quality measurement tools, and the Baby Friendly designation that BUMC is working to achieve. This innovative project will increase the EBR at our institution by empowering BUMC nurses to be champions of excellent care of women and newborns. By exclusively breastfeeding, our patients will take part in one of the most highly effective preventative measures a mother can take to protect the health of her infant and herself.