Increasing Exclusive Breastfeeding Rates in the Well-Baby Population: An Evidence-Based Change Project

Wednesday, July 13, 2011: 3:45 PM

Susan K. Davis, RN, MSN, CLE, CCE
Administration, Sharp Mary Birch Hospital for Women & Newborns, San Diego, CA
Jaynelle F. Stichler, DNS, RN, FACHE, FAAN
School of Nursing, San Diego State University, San Diego, CA
Debra Poeltler, PhD, MPH, RN
Clinical Research, Sharp Mary Birch Hospital for Women & Newborns, San Diego, CA

Learning Objective 1: 1. Identify two reasons why breastfeeding is a global healthcare issue.

Learning Objective 2: 2. Discuss the correlation between the nurse's knowledge of breastfeeding and the success of the breastfeeding mother.


Numerous studies indicate that exclusive breastfeeding during the postpartum hospital stay is one of the most important influences on the duration of exclusive breastfeeding after discharge. Support for exclusive breastfeeding during this critical time is essential for the long term outcomes for mother, baby and society and to meet regulatory requirements. An Evidenced-Based Practice change project was developed to meet this challenge and the goal was established of 61.8% exclusive breastfeeding for well-babies. This was to be achieved through enhancing provider knowledge, attitude and skill of teaching new mothers about the benefits of breastfeeding.


Among nurses on Maternal Infant Services (MIS) units (Population), what is the effect (as measured by a post-test) of an educational intervention to enhance their knowledge, attitude and skill of supporting new mothers in breastfeeding (Intervention) as compared to a pre-test (Comparison) and on improving the exclusive breastfeeding rates of well-babies at 24 hours of age (Outcome)?


Mandatory education classes were provided for all RN’s on MIS units. The instruments utilized were a demographic survey, a pre-test (Pre), a post-test (P1) immediately after class and a post-test (P2) three months later. Only aggregated data were reported. Participation in the project was voluntary with the goal to have 30 RN’s out of a pool of 130.


The goal of 61.8% was achieved and continues to be exceeded. It appears this outcome was influenced by the educational intervention as evidenced by statistically significant differences between scores in the Pre as compared to the P1 and P2 and between two items on the P1 and P2. Future recommendations include Baby Friendly certification and to continue mandatory education to enhance the knowledge, attitudes and skills of providers regarding breastfeeding and the effect on exclusive breastfeeding rates in the well-baby population.