| Description |
This quality improvement scholarly project used evidence to assist providers to deliver information to patients about the benefits of breastfeeding, assess risks for early breastfeeding attrition (EBA), and offer interventions to help achieve continued breastfeeding. Mothers and their healthcare providers both recognize that effective, multi-disciplinary breastfeeding support is beneficial and needed, but seldom achieved. The purpose of this project was to introduce and pilot a toolkit to help providers deliver integrative breastfeeding support to mothers at risk for EBA. The objectives for this project were to, 1) identify benefits for breastfeeding, 2) define social risk factors for EBA, 3) identify effective modes of support as a basis for the toolkit design, 4) pilot the toolkit with a group of women's healthcare providers, and 5) disseminate the toolkit to those who are interested in utilizing it. Breastfeeding has been shown to reduce rates of common childhood illnesses and chronic conditions, such as asthma, irritable bowel syndrome, food allergies, and even certain cancers. Improving breastfeeding rates and duration has the potential to make significant improvements in public health, but progress has been slow. This may be attributed to a lack of adequate support provided to breastfeeding mothers. Important aspects of breastfeeding support include continuity of care during the breastfeeding period and timely access to help when problems arise. Providers admit to a lack of resources for breastfeeding and realize that other professionals and breastfeeding peers are needed to optimize support. Research indicates that integrated, multidisciplinary support from clinicians, lactation experts, and peers is the best approach to help mothers meet their breastfeeding goals. This project piloted a toolkit to help providers deliver integrative breastfeeding support to mothers at risk for EBA, beginning in the prenatal setting. The toolkit was piloted by obstetricians (n=3) and certified nurse midwives (n=4) recruited from an Army outpatient facility. Each participant completed a pre-implementation questionnaire to evaluate current breastfeeding support practices, then implemented the toolkit with 5 women in their last trimester of pregnancy for a total of 35 encounters. The toolkit included breastfeeding education, risk assessment for EBA, and local resources. After using the toolkit, participants completed a post-implementation questionnaire and evaluated the toolkit for its relevance, timeliness, and usability. Results from the pre-implementation questionnaire indicate that only 25% of participants discussed benefits of breastfeeding with their patients, and less than half assessed for EBA. If assessment occurred, it was only completed in the postpartum setting, and less than half of the providers offered peer support. In the post-implementation survey, 100% of providers stated that the toolkit increased the likelihood of breastfeeding teaching, risk assessment for EBA, and recommendation of peer resources and lactation experts. The toolkit was adopted for widespread use at the pilot site with only minor edits in font and format. Multi-disciplinary support is necessary to improve breastfeeding rates and duration. This toolkit offers a timely and efficient means of giving patients information and support to make breastfeeding a success. The toolkit can be easily adjusted to meet the teaching needs in any prenatal setting. |
