Abstract

Exclusive breastfeeding can be challenging to maintain. At the project site there was an inconsistent process for breastfeeding support, so an evidence-based solution was sought. The purpose of this quantitative, quasi-experimental quality improvement project was to determine if or to what degree the implementation of the World Health Organization (WHO) Guideline’s Baby-Friendly Hospital Initiative (BFHI) Step Four would impact exclusive breastfeeding rates (EBFRs) when compared to current practice among adult postpartum patients in an acute care hospital in Southern California over four weeks. Nola Pender’s middle-range nursing theory utilizing the health promotion model (HPM), and Kurt Lewin’s change theory provided the project’s theoretical underpinnings. The total sample size was 318, with n = 150 in the comparative group and n = 168 in the implementation group. Data were extracted from the electronic health record. A chi-square test was used and showed X 2 (1, N = 318) = 4.18, p = .041, and was both statistically and clinically significant. Clinical significance was further noted with an 11.4% increase in exclusive breastfeeding rates. Based on these findings, the WHO Guideline’s BFHI Step Four may impact EBFRs in this population. Recommendations include maintaining the intervention at the project site, providing consistent nursing education and cultural competency training, and disseminating the results.

Notes

References:

Miller, C. J., Shawna, N., & Smith, M. P. (2020). Experimental and quasi-experimental designs in implementation research. Psychiatry Research, 283. https://doi.org/10.1016/j.psychres.2019.06.027

Office of the Surgeon General. (2011). The Surgeon General's Call to Action to Support Breastfeeding. Rockville, MD: Office of the Surgeon General. https://www.ncbi.nlm.nih.gov/books/NBK52684/

Schober, P., & Vetter, T. R. (2019). Chi-square tests in medical research. Anesthesia and Analgesia, 129(5), 1193. https://doi.org/10.1213/ANE.0000000000004410

World Health Organization. (2018). Implementation guideline: Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: The revised Baby-Friendly Hospital Initiative. https://apps.who.int/iris/bitstream/handle/10665/272943/9789241513807-eng.pdf?sequence=19&isAllowed=y

Description

The project site is an acute care hospital where exclusive breastfeeding rates are below the exclusive breastfeeding rate target goal. Therefore, it is imperative to facilitate early breastfeeding initiation within the first hour after delivery. The World Health Organization (WHO) and the United Nations International Children’s Emergency Fund (UNICEF) launched the Baby-Friendly Hospital Initiative (BFHI) to implement evidence-based practices that increase breastfeeding initiation (WHO, 2018).

Author Details

Camille Chua, DNP, MSN-Ed, RN, PHN

Sigma Membership

Chi Beta

Type

Poster

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Public/community Health, Breastfeeding

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the poster.

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Improve Exclusive Breastfeeding Rates Through Early Initiation

Seattle, Washington, USA

Exclusive breastfeeding can be challenging to maintain. At the project site there was an inconsistent process for breastfeeding support, so an evidence-based solution was sought. The purpose of this quantitative, quasi-experimental quality improvement project was to determine if or to what degree the implementation of the World Health Organization (WHO) Guideline’s Baby-Friendly Hospital Initiative (BFHI) Step Four would impact exclusive breastfeeding rates (EBFRs) when compared to current practice among adult postpartum patients in an acute care hospital in Southern California over four weeks. Nola Pender’s middle-range nursing theory utilizing the health promotion model (HPM), and Kurt Lewin’s change theory provided the project’s theoretical underpinnings. The total sample size was 318, with n = 150 in the comparative group and n = 168 in the implementation group. Data were extracted from the electronic health record. A chi-square test was used and showed X 2 (1, N = 318) = 4.18, p = .041, and was both statistically and clinically significant. Clinical significance was further noted with an 11.4% increase in exclusive breastfeeding rates. Based on these findings, the WHO Guideline’s BFHI Step Four may impact EBFRs in this population. Recommendations include maintaining the intervention at the project site, providing consistent nursing education and cultural competency training, and disseminating the results.