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Title: Exploring the Relationship between Health Care Practices and Breastfeeding Outcomes

Citation Type: Dissertation/Thesis

Publication Year: 2018

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Abstract: BACKGROUND: Suboptimal exclusive breastfeeding (EBF) is a serious public health issue as it is associated with infant and maternal morbidity and mortality. Health care practices mothers experience in hospitals and primary care settings are highly influential during the critical window when breastfeeding is being established and maintained. Research on health care practices in these settings is essential to positively impact breastfeeding rates. OBJECTIVE: Our goal was to examine the role of health care practices and breastfeeding outcomes during the early postpartum period by exploring maternity care practices such as the Baby-friendly Hospital Initiative (BFHI) in the hospital and the Outpatient Breastfeeding Champion (OBC) program in the primary care setting. Methods: Data obtained from hospitals nationwide was analyzed along with one health care systems implementation of a breastfeeding support program. Relationships between EBF rates in hospitals and BFHI status, maternity care practices, and demographic characteristics were explored using linear regression. In a primary care setting, nurses, medical providers and mothers were evaluated pre- and post-implementation of the OBC program. Non-parametric tests and generalized linear models were used to test statistical differences and relationships. RESULTS: In the hospital setting, BFHI was associated with higher EBF rates (p < 0.01) across all population demographics studied. Using multiple linear regression, a model was built that included a collection of maternity care practices and demographic characteristics that explained almost half the variability in EBF rates (Adjusted R2 = 47.3%). In the primary care setting, we found nurses’ attitudes towards breastfeeding (p < 0.05), nurses’ self-confidence in managing breastfeeding position and attachment (p = 0.09), and mothers attainment of breastfeeding goals was higher (p = 0.06) after the OBC program was implemented compared to data collected before the OBC program was implemented. CONCLUSION: A systematic approach to providing breastfeeding support in hospitals is important as no single health care practice was able to explain the variability in EBF rates as well as a collection of maternity care practices. In the primary care setting, a model of breastfeeding support, such as the OBC program, has the potential to positively influence mothers’ achievement of breastfeeding goals, nurses’ breastfeeding attitudes, and nurses’ self-confidence in providing breastfeeding support.

Url: https://search.proquest.com/docview/2195556719/abstract/9DE9F2540A6042C1PQ/1?accountid=14586

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Authors: Patterson, Julie Ann

Institution: The University of Wisconsin - Madison

Department: Nutritional Sciences

Advisor: Beth H. Olson

Degree: Doctor of Philosophy

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Pages: 154

Data Collections: IPUMS USA

Topics: Health, Population Health and Health Systems

Countries: United States