• comprehensive breastfeeding program;
  • Christiana Care Health System (CCHS)

Poster Presentation

  1. Top of page
  2. Poster Presentation

Purpose for the Program

Despite evidence for breastfeeding benefits, hospitals fall short in breastfeeding rates and duration. Recent Centers for Disease Control and Prevention data suggest less than 4% of U.S. hospitals offer the full support necessary to meet enduring, committed breastfeeding, and nearly 75% do not provide maternal support after discharge. This challenges an institutional ability to meet the Healthy People 2020 goals to have 81.9% of mothers initiate breastfeeding, 60.6% breastfeed at 6 months, and 34.1% breastfeed at 1 year. The Surgeon General's Call to Action to Support Breastfeeding underscores this critical need, noting low priorities for breastfeeding, and use of nonevidence-based practices as barriers to enduring breastfeeding.

Proposed Change

To create a comprehensive breastfeeding program to meet the challenges stated above

Implementation, Outcomes, and Evaluation

Christiana Care Health System has built an enduring lactation program available across the continuum of perinatal care aimed to meet these action calls. Support is offered to mothers and other perinatal clinicians by experienced lactation consultants to overcome breastfeeding obstacles. This program promotes the development of knowledgeable mothers and health care providers. Our facility maintains a free, breastfeeding hotline that is staffed by lactation consultants. Mothers may initiate a call at any time during their breastfeeding experience when they encounter questions or concerns. As part of this program, logs document telephone conversations. To ensure that mothers are being offered relevant information, logs were subjected to qualitative analysis, which determined the nature of maternal concerns. Ten themes emerged and specific, predictable breastfeeding topics developed at key points during the first year of life.

Data from 1,025 mothers who breastfed and called during 2009 were examined. Findings were then compared to the nurses’ perceived breastfeeding barriers by care area, as defined in a separate performance improvement project. Results of both projects clearly indicated the need to initiate breastfeeding education activities during prenatal classes, maintain momentum during the inpatient phase, and provide anticipatory postdischarge guidance so that a successful support program would be in place to meet the aforementioned goals.

Implications for Nursing Practice

A team approach focused on breastfeeding to support maternal-child nurses and mothers is one way to improve hospital practices and meet goals. Inpatient nurses should address predictable areas of concern with new mothers, particularly concerning milk supply, baby behaviors, and pumping. Outpatient clinicians can offer anticipatory guidance based on consistent patterns of data across the postpartum period, such as drug and diet interaction with milk, stooling patterns, and weaning among other issues. Information and available resources that are appropriately timed and offered when the mother is ready to learn improve the chances that the mother will be able to process and retain the shared information.