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Hospital Education in Lactation Practices (Project HELP): Does Clinician Education Affect Breastfeeding Initiation and Exclusivity in the Hospital?

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Background: A woman’s decision to breastfeed may be influenced by her health care practitioners, but breastfeeding knowledge among clinicians is often lacking. Project HELP (Hospital Education in Lactation Practices) was an intensive education program designed to increase breastfeeding knowledge among health care practitioners. The purpose of this study was to determine whether educating practitioners affected breastfeeding initiation and exclusivity rates at hospitals with low breastfeeding rates.Methods: Between March 31, 2005, and April 24, 2006, we taught courses at four Massachusetts hospitals with low breastfeeding rates. Each course consisted of three, 4-hour teaching sessions and was offered nine times. The training, taught by public health professionals, perinatal clinicians, and peer counselors, covered a broad range of breastfeeding-related topics, from managing hyperbilirubinemia to providing culturally competent care. Medical records of infants born before and after the intervention were reviewed to determine demographics and infant feeding patterns.Results: Combining data from all hospitals, breastfeeding initiation increased postintervention from 58.5 to 64.7 percent (p = 0.02). An overall increase in exclusive breastfeeding rates was not statistically significant. In multivariate logistic regression for all hospitals combined, infants born postintervention were significantly more likely to initiate breastfeeding than infants born preintervention (adjusted OR 1.32, 95% CI 1.03–1.69).Conclusions: Intensive breastfeeding education for health care practitioners can increase breastfeeding initiation rates. (BIRTH 36:1 March 2009)

Keywords: breastfeeding initiation; breastfeeding knowledge; exclusive breastfeeding; practitioner education

Document Type: Research Article


Affiliations: 1: Xena Grossman is an Instructor, Jana Chaudhuri is a Fellow, and Anne Merewood is an Assistant Professor in the Division of General Pediatrics at the Boston University School of Medicine, Boston, Massachusetts 2: Lori Feldman-Winter is an Associate Professor in the Department of Pediatrics, Children’s Regional Hospital at Cooper-UMDNJ-Robert Wood Johnson Medical School, Camden, New Jersey 3: Jessica Abrams and Kimberly Niles Newton are Research Assistants in the Breastfeeding Center at Boston Medical Center, Boston, Massachusetts 4: Barbara L. Philipp is an Associate Professor in the Department of Pediatrics at the Boston Medical Center, Boston, Massachusetts, USA.

Publication date: 2009-03-01

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