Supporting Breastfeeding Dyads and Families in Outpatient Pediatrics: A Pilot Breastfeeding Support Group.

다국어 초록 (Multilingual Abstract)

Background: Optimizing breastfeeding is a global health priority. Early breastfeeding cessation is costly to both health and national economies worldwide. In Kansas, 60% of mothers do not breastfeed as long as they intend (Kansas Breastfeeding Coalition, 2018). The United Nations Children’s Fund and the World Health Organization have identified eight areas of focus to improve breastfeeding practices including the use of breastfeeding support programs. Breastfeeding support groups increase breastfeeding rates; the most effective interventions are multi-modal breastfeeding education and breastfeeding support. There were currently no breastfeeding support groups offered within the Health System.Project Aims: The aims of this quality improvement project were to 1) improve breastfeeding support in an outpatient pediatric practice by establishing a support group and 2) trial a reporting method for infant nutrition data.Project Methods: The project, guided by the Plan-Do-Study-Act framework, included development, implementation, and evaluation of a pilot four-week professionally facilitated breastfeeding support group. Outcomes for evaluation included breastfeeding duration (any) and exclusivity rates of three groups: (the general pediatric practice rates–both historical (January, 2019) and current (February, 2020), along with the pilot test participants) compared at three time-points: newborn, one-month, and two-month well child visits. Pilot test participants’ maternal breastfeeding self-efficacy pre-post intervention, post-intervention support rating, and maternal satisfaction post-intervention were evaluated, and content analysis of the narrative data was completed.Results: Exclusive breastfeeding rate at two months for pilot support group participants was 100%; higher than historical or current rates. Pilot project participants’ mean self-efficacy scores increased from 2.67 (out of 5) to 3.33 post-implementation. After the support group, mothers reported feeling supported with a mean score of 4.5 (out of 5) and satisfied with the support group with a mean score of 4.83. Infant nutrition documentation in the electronic health record nutrition form improved from 10.8% to 77% in just over a year, with staff receiving one formal education intervention.Conclusion: The pilot support group was beneficial to our patients and for our practice. All pilot support group participants were exclusively breastfeeding at two months with an increased mean self-efficacy score. Mothers reported perceived support, satisfaction with the group, and offered their perceptions of benefit, recommendations going forward, and characteristics of the support group. Due to COVID19 Public Health Emergency, the in-person support group is on hold indefinitely. In the interim, an online breastfeeding support group, approved by the pediatrics department has been implemented.