Purpose for the Program
Exclusive breastfeeding is best for the infant and mother. Evidence-based practice describes this choice, but who can say their hospital truly promotes exclusive breastfeeding? We are a 600-bed hospital with more than 7,000 births/year. It takes our village to educate the mother, family, and staff within women's services. It is the responsibility of us all to help mothers be successful and promote the recommendations of the Association of Women's Health, Obstetric and Neonatal Nurses, World Health Organization, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, and the Joint Commission for exclusive breastfeeding.
We want to provide best patient care. In May 2010, our exclusive breastfeeding rate was 37%. We realized our shortfall and discussed ways to improve our rate. Within our shared governance structure, we have a unit research council. The topic of change regarding exclusive breastfeeding, hospital supplementation, and education for staff was our new project. Our council consists of staff nurses from the departments of mother–baby and gynecology. The nurse educator and lactation consultant are also committee members. We began with a literature search. How do you treat a baby with low blood sugar but still exclusively breastfeed? What do you do when a mother is medically unable to breastfeed after birth? What about mothers who want to sleep all night and request that staff bottle feed their infants? What about the obstetrician or pediatrician who tells the mother, “You need your sleep at night. A little formula never hurt.” What about labor and delivery nurses who say, “Breastfeeding is not our job, it's the lactation consultant's job.” Extensive education was needed for women's services staff, physicians, parents, and families.
Implementation, Outcomes and Evaluation
The nurse educator and lactation consultant developed an education program for all women's services staff. The major health care organizations that recommended exclusive breastfeeding were cited. Articles from the literature search were presented. Benefits of breastfeeding for the mother, infant, and community were discussed. Many examples of hospital practices that decrease success of exclusive breastfeeding were recalled. Skin-to-skin care and rooming in were discussed. In North Carolina, we have the Perinatal Quality Collaborative of North Carolina for exclusive breastfeeding. The Perinatal Quality Collaborative of North Carolina's well-baby track focuses on supporting mothers’ choice to provide exclusive breastfeeding for their term infants. We became an active member of the Perinatal Quality Collaborative of North Carolina project for exclusive breastfeeding.
Implications for Nursing Practice
We want to provide the best practice and the literature supports exclusive breastfeeding. As obstetric nurses, we have power to educate and support mothers and families to make informed decisions about their individual infant's care.