Breastfeeding Promotion in a Primary Care Setting

Breastfeeding (BF) promotion is critical for improving infant and child health outcomes. Many providers lack knowledge and confidence in BF promotion, and clinics often lack the structured education and tools to support providers in BF promotion. The purpose of this project was to increase the knowledge and confidence of providers in promoting BF to their patients in the perinatal period by creating a clinic-based educational program and toolkit for providers. Many women never initiate breastfeeding, while many others struggle to continue breastfeeding for the recommended period of time. As a major determinant in the health of infants and children, BF promotion must become a priority in primary care settings. The objectives of the project were: (1) to increase BF promotion rates among providers at a community health center in Western Idaho, (2) to increase provider BF knowledge and confidence through an educational intervention, and (3) to increase the number of prenatal and postpartum patients receiving appropriate BF information and encouragement from their providers. The final objective was to disseminate findings to the clinic staff and administration, as well as submit an abstract to a professional forum. A literature search revealed multiple sources for practice guidelines. In addition, the benefits of BF for mothers and infants, common barriers to BF, and resources to support BF mothers were found. Perhaps most importantly, current evidence focused on the importance of the provider's role in the promotion of breastfeeding with parents throughout the perinatal period. An interventional pilot program using current evidence and AAP recommendations for BF promotion was conducted with providers at a community health center in western Idaho between October 2014 and March 2015. A 30-minute education session was evaluated using preand post -assessments. A toolkit comprised of BF talking points, a factsheet, and a list of community BF resources for providers was created to facilitate BF promotion during patient encounters. Providers' behavioral changes were assessed using pre- and post-questionnaire responses before and after the interventions. Outcomes of the project were described in a brief newsletter distributed to community health center staff and submitted to a professional forum for presentation. Results of the project included an increase in provider confidence and knowledge related to BF promotion and resources following the 30-minute education session. The results and analysis of the patient questionnaires showed some improvement, but were inconclusive due to many limitations.