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Lori B. Feldman-Winter, MD, School of Public Health, University of Medicine and Dentistry of New Jersey, 3 Cooper Plaza Suite 520, Camden, NJ 08103, 856-757-7729, winterlb@umdnj.edu
Objective. This was a multi-institutional study to determine health care providers’ ability to provide culturally competent and effective breastfeeding care in the delivery hospital environment. Methods. Eight hospitals, located in NJ, PR, and NY, with breastfeeding initiation rates below 50% were studied using randomly selected chart reviews. Each chart review included twenty-five mother-infant dyads per hospital during two time periods. The two time periods corresponded to periods before and after a training program was implemented. A total of 375-paired charts were reviewed. Eight quality assessment measures were described for breastfeeding care and analyzed for their relationship to exclusive breastfeeding. Results. Documentation of optimal provider practices predicted exclusive breastfeeding (EBF) for seven out of eight quality assessment measures. Translation for mothers with low English proficiency (LEP) did not predict EBF, whereas having LEP decreased the chance of EBF (OR .42; p=.039). Mothers were 5.94 times more likely to exclusively breastfeed in hospitals with higher overall breastfeeding rates (p<.001; 95% CI 3.40-10.38). Breastfeeding in the first hour, exclusivity of breastfeeding, reasons for supplements and documentation of breastfeeding care were all hospital-specific (p < .001), and positively related to rates of breastfeeding (p<.001). Conclusions. Quality assessments revealed gaps in hospital policies and practices necessary to support exclusive breastfeeding in the delivery hospital environment. Chart reviews using eight indicators of breastfeeding care were valuable in assessing the likelihood of EBF. Mothers with LEP represent a vulnerable population in the delivery hospital environment and warrant enhanced efforts to support exclusive breastfeeding.
Learning Objectives:
Keywords: Breast Feeding, Assessments
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.