To assist each participating mother to breastfeed successfully for the duration of time she sets as her personal goal; reduce the relative risk of early weaning for first-time breastfeeding mothers; and investigate the efficacy of providing structured telephone support after discharge from the hospital, in a low-risk population of first-time breastfeeding mothers in Kent County Delaware.
Evidence-based quality improvement project.
Low-risk, first-time, breastfeeding mothers of term infants. First-time breastfeeding mothers are particularly vulnerable to the risk of early weaning, and lack of support plays a major role from birth to 6 months.
The project had two phases. In phase 1, a retrospective chart audit was conducted to determine baseline breastfeeding rates at the time of hospital discharge among low-risk, first-time, nonmilitary women who were not eligible for the Special Supplemental Nutrition Program for Women, Infants, and Children and who gave birth in the previous 6 months before introducing the translational intervention. A brief telephone survey was conducted with the mothers to inquire about their duration of breastfeeding and obtain their perspective regarding breastfeeding support. In phase 2, first-time breastfeeding mothers meeting the eligibility criteria, self-selected by completing the enrollment form; a telephone support intervention including weekly calls for 3 months, followed by monthly calls for three additional months, or until the mother weaned, which ever occurred first was implemented. Data obtained from the mothers were analyzed utilizing Ethno-nursing methodology and descriptive statistics. First-time breastfeeding mothers meeting eligibility criteria, self-selected (N = 27); telephone support provided by a lactation consultant included anticipatory guidance, education, and empowerment through weekly phone calls for 3 months, then monthly until the mother weaned or reached 6 months.
At the conclusion of the program 100% of the participants met their goals, 73% were still breastfeeding at 6 months as compared to 38% in the base-line group.
Conclusion/Implications for Nursing Practice
The provision of structured telephone support decreased the risk of early weaning and empowered participants to overcome challenges and meet their stated goals. Nurses have an ethical responsibility to advocate for breastfeeding support programs that extend beyond the immediate postpartum period. Support should include provisions that enhance and sustain the woman's breastfeeding efforts. Additional research and evidence-based projects are needed to actualize the Healthy People 2012 breastfeeding objectives.