Methods: A before-and-after design with two independent groups of mother-infant couplets, one pre-intervention (N=43) and a one post-intervention (N=45) were longitudinally evaluated on breastfeeding rates at four time intervals. The four time intervals were the newborn visit, 1-month, 2-month and 4-month well child visits for exclusive, partial and any breastfeeding rates. Recruitment for the pre-implementation group included the first 43 healthy newborns presenting for the newborn visit from November 2013 through the 4-month visit of the final enrolled infant, which occurred in June 2014. Recruitment for the post-implementation group included the first 45 healthy newborns presenting for the initial newborn visit from July 2014 through the 4-month visit of the final enrolled infant, which occurred in February 2015. Relationships for the two groups were compared using two sample t-tests Chi square, and Fisher’s exact tests. Statistical analysis was done using SPSS 22.0 with the level of significance set at p = .05.
Results: Post-implementation rates for any breastfeeding progressively increased for each time point and achieved >10% increases at the 2-month (13.86%) and 4-month (47.25%) visits. Exclusive breastfeeding rates increased by 40.98% at the 1-month visit, 27.4% at the 2-month visit, and 139% at the 4-month visit.
Conclusions: Implementing an NP-led evidence-based breastfeeding-friendly office protocol in a rural pediatric primary care setting with low breastfeeding rates is associated with increased breastfeeding rates.
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