173146 Hospital Education in Lactation Practices (Project HELP): Does clinician education affect breastfeeding initiation and exclusivity in the hospital?

Monday, October 27, 2008: 4:30 PM

Xena Grossman, MS, RD , Division of General Pediatrics, Boston Medical Center, Boston, MA
Jana Chaudhuri, PhD , Division of General Pediatrics, Boston Medical Center, Boston, MA
Jessica Abrams, MPH , Division of General Pediatrics, Boston Medical Center, Boston, MA
Kimberly Niles Newton, MPH , Division of General Pediatrics, Boston Medical Center, Boston, MA
Patricia Francisco , Division of General Pediatrics, Boston Medical Center, Boston, MA
Lori B. Feldman-Winter, MD, MPH , Department of Pediatrics, The Children's Regional Hospital at Cooper-UMDNJ-RWJMS, Camden, NJ
Barbara Philipp, MD , General Pediatrics, Boston University School of Medicine, Boston, MA
Anne Merewood, PhD, MPH, IBCLC , Division of General Pediatrics, Boston Medical Center, Boston, MA
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.

Learning Objectives:
Describe a lactation course used to educate health care providers Evaluate the effect of an intensive education course on breastfeeding rates Discuss factors which influence the success of a breastfeeding education intervention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I directed the research program described.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.