Hospital Education in Lactation Practices (Project HELP): Does clinician education affect breastfeeding initiation and exclusivity in the hospital?

Background: A woman's decision to breastfeed is influenced by her health care providers, but clinician breastfeeding knowledge is often lacking. Project HELP (Hospital Education in Lactation Practices) was an intensive education program designed to increase breastfeeding knowledge among health care providers.

Objective: To determine whether provider education affected breastfeeding initiation and exclusivity at hospitals with low breastfeeding rates.

Methods: Between March 31, 2005, and April 24, 2006, we taught courses at 4 Massachusetts hospitals with low breastfeeding rates. Each course consisted of 3, 4-hour teaching sessions and was offered a total of 9 times. The training, taught by public health professionals, perinatal clinicians and peer counselors, covered a broad range of breastfeeding-related topics, from managing hyperbilirubinemia to providing culturally competent care. Medical records of infants born before and after the intervention were reviewed retrospectively to determine demographics and infant feeding patterns. A total of 1347 charts were reviewed: 668 pre-intervention and 679 post-intervention.

Results: Breastfeeding initiation and exclusivity increased post-intervention at 3 of the 4 hospitals. When data from all hospitals were combined, breastfeeding initiation overall increased post-intervention from 58.5% to 64.7% (p=0.02). The overall increase in exclusive breastfeeding rates was not statistically significant. In multivariate logistic regression for all hospitals combined, infants born post-intervention were significantly more likely to initiate breastfeeding than infants born pre-intervention (AOR 1.33; 95% CI 1.043-1.703).

Conclusion: Intensive breastfeeding education for providers can increase breastfeeding initiation rates.