Improving Breastfeeding Rates and Duration Through Education and Support in the Primary Care Setting

Abstract

Background: Breastfeeding is the most nutritious, safest, and most economical and environmentally sound way for a newborn to be fed. Almost 50% of women who wish to breastfeed give up before six months (CDC, 2014). The most common causes of this is a lack of support and knowledge (Bonuck, Stuebe, Barnett, Labbock, Fletcher, & Bernstein, 2014). Evidence has shown that increased support and in the primary care setting drastically improves breastfeeding (Bonuck et al., 2014). This is through prenatal education and postpartum support groups, all of which can be provided in a primary care setting. Objective: The purpose of this project was to develop a breastfeeding support intervention at a women’s health clinic to provide more extensive breastfeeding education and support during the prenatal period. Design: This project evaluated the effectiveness of an educational intervention through quantitative survey assessments. This project was also categorized as a quality improvement project and guided by the Plan-Do-Study-Act (PDSA) framework. Setting: Sinai Community Care is a small community clinic with affiliations with Sinai Hospital, a local, community hospital in Baltimore, Maryland. This clinic consists of two medical doctors and three certified nurse midwives who oversee the practice. This clinic sees a variety of patients, however a majority, almost 80%, are younger than 40 years old, African American, unmarried women. Participants: 10 women in their prenatal Centering Pregnancy Group that attend monthly meetings met the project’s inclusion criteria. Of these 10 women, nine of them were African American, eight were single while two are married, and five of the 10 had attempted to breastfeed before but had been unsuccessful for the full duration of six months as recommended. Measurements: Data collection for this project was done through surveys distributed during the educational intervention. A paired T-test was used to determine statistical significance of this difference in breastfeeding intention, breastfeeding knowledge, confidence in breastfeeding, and helpfulness of the program itself. Results: On the post- survey following the educational intervention, 60% of women planned to breastfeed exclusively, with 40% still planning on using some formula. 100% of the women answered they are now somewhat to very comfortable with breastfeeding and a further 100% indicated that they knew how to find resources for help in the postpartum period. Those findings that were considered statistically significant were the changes in comfort level with breastfeeding and the knowledge of postpartum support changes, supporting that this intervention achieved two of its aims to increase comfort level and knowledge concerning breastfeeding. Conclusions: This project answered the question; does providing increased access to support and resources for postpartum with group breastfeeding education and support during the prenatal period improve breastfeeding knowledge, intended initiation rates, and confidence at the Sinai Community Care clinic? Based on the evidence and the 300% increase in those planning to breastfeed, this question can be answered, yes, improving access to support, resources, and education during the prenatal period does improve breastfeeding knowledge, intended breastfeeding rates, and confidence at Sinai Community Care Clinic. Recommendations were also made.