1. Beal, Judy DNSc, PNP, RN

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Bernaix, L. W., Schmidt, C. A., Arrizola, M., Iovinelli, D., & Medina-Poelinez, C. (2008). Journal of Obstetric, Gynecologic and Neonatal Nursing, 37, 436-445.


The many benefits of breastfeeding for ill and premature infants are well documented, including improved immunologic and developmental outcomes and shorter durations of parenteral nutrition and NICU hospitalization. Despite efforts of professional organizations such as AAP and WHO and the well-documented evidence promoting breastfeeding in the group, the actual rate is low. Several barriers have been cited, such as the stressful NICU environment, parental concern for their infant's condition, maternal perceived lack of competence, a variety of physical problems that make breastfeeding difficulties exaggerated in this setting, and lack of knowledge of nurses. This quasi-experimental study examined the effects of a 4-hour educational program for nurses on nursing knowledge, attitudes, intention to provide lactation support, and mothers' perception of lactation support in a 42-bed NICU in Midwestern United States.


A convenience sample of 64 nurses and two separate samples of mothers (N=19 and N=13) was studied before and after the educational program, which included specific content on the anatomy and physiology of lactation and the technical aspects of introducing and supporting breastfeeding in the NICU. Although the study had many limitations, it did have some interesting and clinically relevant findings. The authors discovered that this very brief educational program did improve nurses' knowledge and attitude, intentions, and behaviors to initiate and support lactation in the NICU. Knowledge scores tapered off with time, which suggested that short and intermittent programs might be more effective. Regardless, the mothers reported an increase in support for breastfeeding following the intervention. These results are exciting, especially because such a program is simple to develop and implement. Future research should be conducted with larger, more diverse samples of nurses and mothers and a control group to build confidence in the results and greater generalizabilty.

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Judy Beal