241423 Assessing and Addressing Healthcare Providers' Attitudinal Barriers to Improving Breastfeeding Support in the Maternity Setting

Monday, October 31, 2011: 8:30 AM

Emily C. Taylor, MPH, CD(DONA), LCCE , Carolina Global Breastfeeding Institute, Department of Maternal and Child Health, School of Public Health, University of North Carolina, Chapel Hill, NC
Miriam Labbok, MD, MPH, FACPM, IBCLC, FABM , Carolina Global Breastfeeding Institute, Department of Maternal Child Health, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC
Nathan C. Nickel, MPH , Carolina Global Breastfeeding Institute, Department of Maternal and Child Health, Gillings School of Global Public Health at the University of North Carolina-Chapel Hill, Chapel Hill, NC
Brook Colgan, MPH, IBCLC , Carolina Global Breastfeeding Institute, Department of Maternal Child Health School of Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC
Background/Purpose: Breastfeeding support during the maternity stay is highly correlated with later breastfeeding success. However, the best practices based on the Ten Steps to Successful Breastfeeding, are not normative. This study, part of a larger study of maternity breastfeeding practices, assesses provider knowledge, attitude and practice of the Ten Steps to inform maternity nurses' training to improve the quality of breastfeeding support.

Data/Methods: The Carolina Global Breastfeeding Institute conducted an electronic survey, key informant interviews and semi-structured meetings with health care providers as part of baseline and mid-point assessment for the Breastfeeding-Friendly Healthcare Project. These tools assess providers' knowledge, attitudes and practices in relation to breastfeeding and the Ten Steps to Successful Breastfeeding before and following intervention activities. Quantitative findings are enriched by thematic content analysis of key informant interviews, which were organized around the same principles as the e-survey.

Results: In 2010, we reported that many professionals demonstrate a theoretical awareness of “best practices.” While some mal-adherence to evidence-based practice is due to lacking knowledge, most appears to be related to attitudes about breastfeeding, women and children, and patient care priorities. Specifically, the study found: 1) predominant belief that breastfeeding support is too time consuming, 2) mother's sleep is given priority over opportunities to support feeding, and 3) other anti-breastfeeding or pro-commercial formula attitudes that deleteriously effect implementation of evidence-based practice.

Recommendations: Nurse-level and other breastfeeding knowledge and skills training should include significant attention to attitudinal barriers to supporting breastfeeding.

Learning Areas:
Administration, management, leadership
Planning of health education strategies, interventions, and programs
Program planning
Provision of health care to the public
Public health or related nursing
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Identify five specific attitudinal barriers to practice change among maternity nurses. Name three evidence-based approaches for overcoming attitudinal barriers to practice change among maternity nurses.

Keywords: Breast Feeding, Maternal Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the program coordinator of the study being presented. I am also an experienced nurse trainer and quality improvement specialist.
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.