Online Program

Influence of nurses' knowledge, attitudes, and counseling practices on breastfeeding outcomes: A Philadelphia case study

Sunday, November 3, 2013

Pam Phojanakong, MPH, CARE Project, University of Pennsylvania, Philadelphia, PA
Claudia Valeggia, PhD, Department of Anthropology, University of Pennsylvania, Philadelphia, PA
Gail Herrine, MD, FACOG, IBCLC, Obstetrics/Gynecology, Temple Univeristy Hospital, Philadelphia, PA
Background: Nurses and midwives are in a prime position to provide mothers with valuable information and support; however, they can vary considerably in their knowledge of breastfeeding practices and their displays of support and encouragement of breastfeeding. Objective: A cross-sectional study was conducted to evaluate the effect of nurses' knowledge, attitudes, and counseling practices on breastfeeding outcomes in Philadelphia hospitals. Methods: Data was collected from 105 nurses and midwives from obstetric units of two Philadelphia teaching hospitals using a self-administered questionnaire assessing infant feeding practices in the unit, knowledge of effective breastfeeding practices and physiology, attitudes towards breastfeeding, and beliefs towards unit practices. Multivariate logistic regression was used to obtain adjusted odds ratios. Results: The majority of participants promoted exclusive breastfeeding (70.5%; n=74) however, many also reported the use of supplements (51.4%; n=54) and distribution of formula discharge packs (47.6%; n=50). Nurses with low attitude scores were six times more likely to send mothers home with a formula pack than nurses with higher scores (OR=6.08, 95% CI: 1.46-25.29). Additionally, nurses with positive perceptions of formula were twice as likely to not promote exclusive breastfeeding, compared to nurses with neutral or negative perceptions (OR=2.00, 95% CI: 1.17-3.42). Conclusion: Nurses' attitudes have implications for the maintenance of exclusive breastfeeding. Also, a more effective approach to increasing the prevalence of exclusive breastfeeding should focus on emphasizing the pitfalls of using formula as well as the benefits of breast milk.

Learning Areas:

Planning of health education strategies, interventions, and programs
Public health or related nursing

Learning Objectives:
Identify infant feeding and patient counseling practices that are prevalent in teaching hospitals that serve Philadelphia. Identify beliefs and attitudes held by nurses and midwives in teaching hospitals that serve Philadelphia. Identify knowledge gaps and potential areas for improvement in promoting exclusive breastfeeding in hospitals. Describe how nurses' and midwives' attitudes and beliefs affect the initiation of exclusive breastfeeding in the hospital.

Keyword(s): Breastfeeding, Nurses

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: This study was MPH thesis. I developed the majority of the data collection tools and protocol and collected a majority of the data myself. Additionally, I was responsible for the data analysis and synthesis of the study findings.
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.