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Dell LG, Spatz DL. Managing tandem breastfeeding during acute hospitalization: A case study. J Pediatr Nurs 2023; 73:e134-e137. [PMID: 37544856 DOI: 10.1016/j.pedn.2023.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/31/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023]
Abstract
This case study presents a mother who continued tandem breastfeeding throughout the acute admission of her critically ill newborn. Her younger child, the subject of this case report was admitted to our hospital with septic shock and progressing bullous scalp lesions. The infant had streptococcal toxic shock syndrome and necrotizing fasciitis of the scalp due to streptococcus pyogenes. The infant required immediate life-sustaining interventions, followed by weekly surgical procedures which meant the infant had brief periods of intravenous nutrition surrounding the time of anesthesia administration. During instances when the infant was unable to orally feed, such as while intubated for procedures, she was fed her mother's milk via nasogastric tube. At times that the infant was stable to orally feed, the mother directly breastfed the infant. Even when the infant was on strict bedrest, bedside nurses assisted the mother with infant positioning to breastfeed. In addition, when the infant was able to be held out of bed, the mother was able to resume breastfeeding both of her children simultaneously. Despite the critical nature of this child's illness, the mother was able to provide 100% human milk diet to her child during the 68-day hospital stay. With assistance and support of nursing staff the mother was ultimately able to resume breastfeeding both children simultaneously.
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Affiliation(s)
- Lisa G Dell
- Staff Nurse & Chair of Unit Based Human Milk Committee, Newborn/Infant Intensive Care Unit, Children's Hospital of Philadelphia, USA
| | - Diane L Spatz
- Professor of Perinatal Nursing & the Helen M. Shearer Profession of Nutrition, The University of Pennsylvania School of Nursing, Nurse Scientist-Lactation, The Center for Pediatric Nursing Research & Evidence Based Practice, Children's Hospital of Philadelphia, USA.
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Kawan M, Gregory EF, Spatz DL. Improving breastfeeding care & support in a large, urban, pediatric primary care practice. J Pediatr Nurs 2022; 70:e3-e8. [PMID: 36424329 DOI: 10.1016/j.pedn.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 10/06/2022] [Accepted: 10/14/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND SPECIFIC AIMS Human milk/breastfeeding is the gold standard for infant nutrition. Interventions in pediatric primary care could improve breastfeeding exclusivity and duration. Our specific aims were two-fold: 1) Accurately measure breastfeeding indicators and 2) Implement AAP Breastfeeding-Friendly Pediatric Office Practice Recommendations. MATERIALS AND METHODS In 2018, a single, urban, large primary care pediatric practice initiated a Quality Improvement project to improve breastfeeding outcomes. Stakeholders met to discuss metrics of interest, develop documentation templates, review data capture, and plan interventions to support breastfeeding. Practice based interventions to improve measurement included: piloting documentation templates, incorporation of default templates office-wide, and developing tracking tools for both use of templates and breastfeeding outcomes. Interventions to support breastfeeding occurred simultaneously and included workflow redesign to increase nurse-provided breastfeeding education, partnering with community-based lactation consultants for outpatient support, staff education, and National Breastfeeding Month activities. RESULTS Since initiation of the data analytic tool, breastfeeding data has been analyzed from over 30,000 visits (86% Medicaid-insured, 82% Black race). Currently, 80% of providers use default templates that allow standardized data capture. At first newborn visit, 74% of infants were breastfed. At six months, 36% of infants were breastfed; 23% exclusively. Standardized documentation of infant feeding status improved and has remained consistent. Breastfeeding duration did not significantly improve despite practice interventions. CONCLUSIONS Pediatric primary care measurement tools are feasible and critical to understand breastfeeding continuation. Increased resources and interventions to support breastfeeding in Primary Care are necessary to improve outcomes.
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Affiliation(s)
- Meg Kawan
- Children's Hospital of Philadelphia, United States of America
| | - Emily F Gregory
- Children's Hospital of Philadelphia, United States of America
| | - Diane L Spatz
- Children's Hospital of Philadelphia, United States of America; University of Pennsylvania School of Nursing, United States of America.
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A Statewide Evaluation of the Breastfeeding Resource Nurse Model. Nurs Womens Health 2021; 25:337-345. [PMID: 34478735 DOI: 10.1016/j.nwh.2021.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 05/26/2021] [Accepted: 07/21/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate a statewide initiative to increase the provisioning of human milk in NICUs. DESIGN A survey of nurses before participation in an educational session, immediately after education, and again 9 months later. SETTING Nurses from 22 hospitals throughout Florida. PARTICIPANTS We surveyed 121 participants, including some nurses who had prior breastfeeding education or certification as well as those without specialized breastfeeding training. INTERVENTION An educational project called the Breastfeeding Resource Nurse Master program was intended to educate NICU nurses to implement the "Ten Steps to Promote and Protect Human Milk and Breastfeeding in Vulnerable Infants." MEASUREMENT A quantitative needs assessment survey was administered to participants to determine current hospital practices, policies, and perceived areas for improvement. Pre- and immediate posttraining surveys assessed NICU nurses' knowledge, attitudes, and beliefs about human milk feeding of critical care infants and their self-efficacy for implementing the program in their respective NICUs. A follow-up, open-ended survey was administered at 9 months to yield information on program implementation. RESULTS NICU breastfeeding practices varied widely at baseline. Nurses' scores for knowledge, beliefs, and behavioral intentions improved postsession, but the implementation of practice changes related to the Ten Steps for Vulnerable Infants proved difficult. Nurses identified insufficient time and resources as barriers to educating others and changing practice. CONCLUSIONS Policies and regulations that make hospitals accountable for increasing human milk provision to vulnerable infants may be necessary to ensure that hospitals devote adequate resources to implementing practice changes in this area.
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Development of an Interprofessional Policy on the Use of Human Milk and Breastfeeding for Pain Relief. Adv Neonatal Care 2021; 21:267-273. [PMID: 33009155 DOI: 10.1097/anc.0000000000000793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Infants are subjected to painful procedures as part of routine care. Evidence suggests human milk (HM) has pain-relieving qualities; however, nurses may not be aware of this evidence. PURPOSE This article presents the evidence for HM and breastfeeding for pain management, as well as describes using the evidence to create an interprofessional enterprise-wide policy on the topic. METHODS/SEARCH STRATEGY Cochrane, PubMed, CINAHL, and Medline were searched for full-length articles published in peer-reviewed journals between 2012 and 2020. Articles using HM as an independent variable during a painful procedure, or discussing benefits of HM for pain management, were analyzed. FINDINGS/RESULTS Ten articles were selected for evaluating use of HM for pain relief in term and preterm infants. There is statistically significant evidence that expressed HM has pain-relieving abilities, especially when combined with other soothing interventions such as rocking. HM reduces crying time, and lowers pain scores during painful procedures. Seven articles recommend breastfeeding for effective pain management. Breastfeeding reduces crying time, heart rate, and pain scores compared with oral sucrose, holding, nonnutritive sucking, swaddling, and topical anesthetics. IMPLICATIONS FOR PRACTICE Breastfeeding and HM should be offered as primary pain management options. Having an interprofessional enterprise-wide policy for the use of breastfeeding and HM for pain management during painful procedures, such as vaccination, will provide safe, effective pain management. IMPLICATIONS FOR RESEARCH Further understanding of effective HM dosing for pain management and use of pasteurized donor HM in place of expressed HM is required.
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Using World Breastfeeding Week to Transform Institutional Culture. MCN Am J Matern Child Nurs 2020; 45:126. [DOI: 10.1097/nmc.0000000000000608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tan DJA, Lew JP, Jumhasan MB, Pang C, Sultana R, Sng BL. Investigating factors associated with success of breastfeeding in first-time mothers undergoing epidural analgesia: a prospective cohort study. Int Breastfeed J 2018; 13:42. [PMID: 30202425 PMCID: PMC6125871 DOI: 10.1186/s13006-018-0184-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 08/27/2018] [Indexed: 12/04/2022] Open
Abstract
Background We investigated the possible risk factors that could influence the likelihood of breastfeeding at 5 to 9 weeks postpartum with our primary aim being to analyse the associations between psychological vulnerabilities, such as peripartum depression and anxiety, and continued breastfeeding. Our secondary aim was to investigate other non-psychological factors’ influence on continued breastfeeding. Methods A prospective cohort study was conducted in KK Women’s and Children’s Hospital in Singapore. Healthy nulliparous parturients at ≥36 weeks gestation with a singleton fetus who received epidural analgesia were recruited. Demographic and anaesthetic data were obtained. Self-reported psychological and pain determinants such as anxiety (State-Trait Anxiety Inventory), depression (Edinburgh Postnatal Depression Scale), stress (Perceived Stress Scale), pain susceptibility (Pain Catastrophizing Scale) and pain perception (McGill Pain Questionnaire) were also recorded at baseline. A phone interview was then performed at 5 to 9 weeks postpartum to obtain information on breastfeeding status. Results 329 participants were included into this study, of which 263 (79.9%) of them were still breastfeeding at 5 weeks postpartum. Multivariate logistic regression analysis showed that a higher State-Trait Anxiety Inventory score (Adjusted Odds Ratio [AOR] 0.97; 95% Confidence Interval [CI] 0.94, 1.00) at baseline, higher intrapartum blood loss (AOR 0.76; 95% CI 0.61, 0.93), and occurrence of fetal anomalies (AOR 0.15; 95% CI 0.03, 0.72) were associated with reduced likelihood of breastfeeding at 5 to 9 weeks postpartum. Indians (AOR 0.56; 95% CI 0.20, 1.53), Malays (AOR 0.30; 95% CI 0.14, 0.62) and other ethnicities (AOR 0.36; 95% CI 0.16, 0.83) were less likely to continue breastfeeding compared to Chinese participants. On the other hand, receiving any support services on breastfeeding during the participants’ hospital stay was 3.3 times more likely (AOR 3.30; 95% CI 1.21, 9.02) to increase the likelihood of breastfeeding at 5 to 9 weeks postpartum. Conclusion We identified 5 independent association factors that could have significant influences on breastfeeding at 5 to 9 weeks postpartum. Healthcare providers could utilize this risk stratification to identify parturients likely to have poorer breastfeeding outcomes and undertake interventions that may help safeguard optimization of breastfeeding outcomes and parturient care. Trial registration Clinicaltrials.gov NCT02278601. Registered 26 October 2014. Electronic supplementary material The online version of this article (10.1186/s13006-018-0184-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - John Paul Lew
- 2Department of Anaesthesiology, Singapore General Hospital, Singapore, Singapore
| | | | - Cynthia Pang
- 3Division of Nursing, KK Women's and Children's Hospital, Singapore, Singapore
| | - Rehena Sultana
- 4Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Ban Leong Sng
- 1Duke-NUS Medical School, Singapore, Singapore.,5Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore, Singapore
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Candelaria LM, Spatz DL, Giordano N. Experiences of Women Who Donated Human Milk. J Obstet Gynecol Neonatal Nurs 2018; 47:556-563. [PMID: 29477272 DOI: 10.1016/j.jogn.2017.12.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2017] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To examine the experiences of women who donated breast milk to a hospital-based milk bank regulated under the policies and procedures set forth by the Human Milk Banking Association of North America (HMBANA). DESIGN Qualitative, phenomenological design. SETTING The Mothers' Milk Bank in a children's hospital in the Northeastern region of the United States. PARTICIPANTS Twelve HMBANA-approved milk donors older than 21 years with infants hospitalized in the NICU. METHODS Edmund Husserl's design of interpretive phenomenology and Colaizzi's method of data analysis were used for this study. Participants were interviewed using a face-to-face, semistructured interview format. RESULTS Four themes represented the experience of donating breast milk: Ripple of Hope and Help, Dynamic Interplay of Nurturance, Standing on the Shoulders of Others, and Sharing Their Stories. Donors felt proud and accomplished to provide hope for other infants and families. Nurses were crucial in facilitating and motivating donors and making donation achievable in a supportive environment. Donors felt compelled to share their experiences to teach and motivate others to donate. CONCLUSION For our participants, donation of human milk was a positive, valuable, and nurturing experience. Donors reported feelings of increased self-esteem during donation that motivated them to "give back" and continue. The support of a well-trained nursing staff is essential for donors to meet their personal goals.
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Froh EB, Vanderpool J, Spatz DL. Best Practices to Limit Contamination of Donor Milk in a Milk Bank. J Obstet Gynecol Neonatal Nurs 2018; 47:547-555. [PMID: 29304316 DOI: 10.1016/j.jogn.2017.12.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2017] [Indexed: 11/30/2022] Open
Abstract
Human milk donated to a milk bank can become contaminated in a number of ways, but processes exist to eradicate pathogenic bacterial growth. Donor human milk may be cultured before or after pasteurization or both. The purpose of this article is to describe standard operations of the Mothers' Milk Bank of the Children's Hospital of Philadelphia, best practices to limit the bacterial contamination of donor human milk, and implications for future research.
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Abstract
All health professional organizations recommend exclusive breastfeeding for at least 6 months, with continued breastfeeding for 1 year or more after birth. Women cite lack of support from health professionals as a barrier to breastfeeding. Meanwhile, breastfeeding education is not considered essential to basic nursing education and students are not adequately prepared to support breastfeeding women. Therefore, a toolkit of comprehensive evidence-based breastfeeding educational materials was developed to provide essential breastfeeding knowledge. A study was performed to determine the effectiveness of the breastfeeding toolkit education in an associate degree nursing program. A pretest/posttest survey design with intervention and comparison groups was used. One hundred fourteen students completed pre- and posttests. Student knowledge was measured using a 12-item survey derived with minor modifications from Marzalik's 2004 instrument measuring breastfeeding knowledge. When pre- and posttests scores were compared within groups, both groups' knowledge scores increased. A change score was calculated with a significantly higher mean score for the intervention group. When regression analysis was used to control for the pretest score, belonging to the intervention group increased student scores but not significantly. The toolkit was developed to provide a curriculum that demonstrates enhanced learning to prepare nursing students for practice. The toolkit could be used in other settings, such as to educate staff nurses working with childbearing families.
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Beyond BFHI: The Spatz 10-Step and Breastfeeding Resource Nurse Model to Improve Human Milk and Breastfeeding Outcomes. J Perinat Neonatal Nurs 2018; 32:164-174. [PMID: 29689018 DOI: 10.1097/jpn.0000000000000339] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
A report released by the World Health Organization states that worldwide less than 10% of birth occur in hospitals certified through the Baby-Friendly Hospital Initiative. Furthermore, the Baby-Friendly Hospital Initiative's primary focus is on breastfeeding for healthy, mother-infant dyads. This article provides alternative models for implementing evidence-based care during maternal-infant separation so that mothers can achieve their personal breastfeeding goals. These include the Spatz 10-step model for human milk and breastfeeding in vulnerable infants and the Breastfeeding Resource Nurse model. Clinical outcome data are provided to demonstrate the effectiveness of the models as well as a road map of strategies to implement the models and measure outcomes.
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Creation of a Regional Human Milk Assembly: A Model to Influence Practice and Policy Change in the NICU. Adv Neonatal Care 2017; 17:417-423. [PMID: 28338485 DOI: 10.1097/anc.0000000000000393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The 2011 Surgeon General's Call to Action to Support Breastfeeding highlights a need for optimizing lactation-based education for all health professionals; however, few schools of nursing and medicine offer lactation-based curriculum. In an effort to address these gaps in education and care, the director of the lactation program at a large urban children's hospital developed and instituted the annual regional Human Milk Assembly (HMA), a half-day collaborative meeting of the hospital's regional and referral hospitals' neonatal intensive care unit (NICU) nursing staff, to address lactation-based educational and training needs of all participating institutions. PURPOSE The purpose of this study was to determine whether and how participating HMA hospitals implemented the best practices surrounding human milk and breastfeeding shared by the host institution during a 10-year span of the HMA. METHODS A prospective descriptive study was designed using an electronic web-based survey (SurveyMonkey.com) to elicit participant data. Quantitative data were analyzed using descriptive statistics whereas qualitative data were analyzed for themes via content analysis. RESULTS Thirty-one of the 50 hospitals surveyed responded to the electronic survey for a total of 34 individual participants. Seventeen of the 22 (77%) of best practices were implemented at rates of over 50%. IMPLICATIONS FOR PRACTICE By enabling a culture of transparency and sharing, hospital staff can be encouraged to implement best practices across a network of regional care centers. IMPLICATIONS FOR RESEARCH This annual regional HMA could be a model for other areas and research should be conducted to evaluate such programs nationwide.
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Froh EB, Deatrick JA, Curley MAQ, Spatz DL. Mothers of Infants With Congenital Diaphragmatic Hernia Describe "Breastfeeding" in the Neonatal Intensive Care Unit: "As Long as It's My Milk, I'm Happy". J Hum Lact 2017; 33:524-532. [PMID: 28609176 DOI: 10.1177/0890334417709469] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Very little is known about the breastfeeding experience of mothers of infants born with congenital anomalies and cared for in the neonatal intensive care unit (NICU). Often, studies related to breastfeeding and lactation in the NICU setting are focused on the mothers of late preterm, preterm, low-birth-weight, and very-low-birth-weight infants. Congenital diaphragmatic hernia (CDH) is an anatomic malformation of the diaphragm and affects 1 in every 2,000 to 4,000 live births. Currently, there are no studies examining the health outcomes of infants with CDH and the effect of human milk. Research aim: This study aimed to describe the breastfeeding experience of mothers of infants with CDH cared for in the NICU. METHODS A prospective, longitudinal qualitative descriptive design was used. Phased interviews were conducted with a purposive sample of 11 CDH infant-mother dyads from a level 3 NICU in a children's hospital. RESULTS Six themes emerged from the data: (a) hopeful for breastfeeding, (b) latching on . . . to the pump, (c) we've already worked so hard, (d) getting the hang of it-it's getting easier, (e) a good safety net, and (f) finding a way that works for us. CONCLUSION For this population of CDH infant-mother dyads, the term breastfeeding is not exclusive to direct feeding at the breast and the mothers emphasized the significance of providing their own mother's milk through a combination of feeding mechanisms to their infants with CDH.
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Affiliation(s)
- Elizabeth B Froh
- 1 The University of Pennsylvania School of Nursing, Philadelphia, PA, USA.,2 The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Janet A Deatrick
- 1 The University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Martha A Q Curley
- 1 The University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Diane L Spatz
- 1 The University of Pennsylvania School of Nursing, Philadelphia, PA, USA.,2 The Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Abstract
BACKGROUND The provision of human milk and breastfeeding is essential in the neonatal intensive care unit (NICU) population. However, recent national research has demonstrated very low percentages of NICU nurses providing lactation-based support and care to patients and families, and less than half of all NICUs have an International Board Certified Lactation Consultant (IBCLC) on staff. PURPOSE The purpose of this study was to describe how NICU bedside nurses are providing lactation-based support and care during their shifts and the frequency of that support. The secondary aim was to gain an understanding of the NICU nurses' attitudes toward human milk and breastfeeding. METHODS Through a prospective descriptive cohort design, the authors of this study created and disseminated a web-based survey (SurveyMonkey) of 21 questions including the Iowa Infant Feeding Attitude Scale (IIFAS) to a Northeastern urban hospital staff of bedside nurses. RESULTS A total of 140 of the 389 eligible NICU bedside nurses responded to the survey. Between 50.7% and 72.9% of nurses reported to providing lactation-based support and care during the previous shift worked and during the previous week worked, respectively. The participants' responses to the IIFAS resulted in an overall score of 69.1, indicating an attitude of "positive to breastfeeding." IMPLICATIONS FOR PRACTICE The study demonstrates that the majority provide lactation-based support and care on every shift and hold very positive attitudes toward the provision of human milk and breastfeeding. Hospitals should be encouraged to promote educational and training programs in their respective institutions. IMPLICATIONS FOR RESEARCH Researchers should examine NICU nurses' attitudes and beliefs about human milk and breastfeeding on a national scale.
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Application of the EBP Process: Maximizing Lactation Support with Minimal Education. J Pediatr Nurs 2017; 33:97-100. [PMID: 28132750 DOI: 10.1016/j.pedn.2017.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ziadi M, Héon M, Aita M. A Critical Review of Interventions Supporting Transition from Gavage to Direct Breastfeeding in Hospitalized Preterm Infants. ACTA ACUST UNITED AC 2016. [DOI: 10.1053/j.nainr.2016.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Spatz DL, Froh EB, Schwarz J, Houng K, Brewster I, Myers C, Prince J, Olkkola M. Pump Early, Pump Often: A Continuous Quality Improvement Project. J Perinat Educ 2016; 24:160-70. [PMID: 26834437 DOI: 10.1891/1058-1243.24.3.160] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Research demonstrates that although many mothers initiate pumping for their critically ill children, few women are successful at maintaining milk supply throughout their infants' entire hospital stay. At the Garbose Family Special Delivery Unit (SDU) at the Children's Hospital of Philadelphia, we care for mothers who have critically ill infants born with complex cardiac and congenital anomalies. Human milk is viewed as a medical intervention at our institution. Therefore, nurses on the SDU wanted to ensure best practice in terms of pumping initiation. This article describes a continuous quality improvement project that ensured mothers pumped early and often. Childbirth educators can play a key role in preparing mothers who are anticipating an infant who will require hospitalization immediately post-birth.
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Froh EB, Spatz DL. Increasing Access to Evidence Based Lactation Resources Through an Intranet Portal. J Pediatr Nurs 2016; 31:109-12. [PMID: 26702933 DOI: 10.1016/j.pedn.2015.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 10/13/2015] [Indexed: 11/29/2022]
Affiliation(s)
| | - Diane L Spatz
- The Children's Hospital of Philadelphia, Pennsylvania; The University of Pennsylvania School of Nursing, Pennsylvania
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Hallowell SG, Rogowski JA, Spatz DL, Hanlon AL, Kenny M, Lake ET. Factors associated with infant feeding of human milk at discharge from neonatal intensive care: Cross-sectional analysis of nurse survey and infant outcomes data. Int J Nurs Stud 2016; 53:190-203. [PMID: 26518107 PMCID: PMC4784116 DOI: 10.1016/j.ijnurstu.2015.09.016] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 09/26/2015] [Accepted: 09/29/2015] [Indexed: 02/01/2023]
Abstract
CONTEXT Nurses are principal caregivers in the neonatal intensive care unit and support mothers to establish and sustain a supply of human milk for their infants. Whether an infant receives essential nutrition and immunological protection provided in human milk at discharge is an issue of health care quality in this setting. OBJECTIVES To examine the association of the neonatal intensive care unit work environment, staffing levels, level of nurse education, lactation consultant availability, and nurse-reported breastfeeding support with very low birth weight infant receipt of human milk at discharge. DESIGN AND SETTING Cross sectional analysis combining nurse survey data with infant discharge data. PARTICIPANTS A national sample of neonatal intensive care units (N=97), nurses (N=5614) and very low birth weight infants (N=6997). METHODS Sequential multivariate linear regression models were estimated at the unit level between the dependent variable (rate of very low birth weight infants discharged on "any human milk") and the independent variables (nurse work environment, nurse staffing, nursing staff education and experience, lactation consultant availability, and nurse-reported breastfeeding support). RESULTS The majority of very low birth weight infants (52%) were discharged on formula only. Fewer infants (42%) received human milk mixed with fortifier or formula. Only 6% of infants were discharged on exclusive human milk. A 1 SD increase (0.25) in the Practice Environment Scale of the Nursing Work Index composite score was associated with a four percentage point increase in the fraction of infants discharged on human milk (p<0.05). A 1 SD increase (0.15) in the fraction of nurses with a bachelor's degree in nursing was associated with a three percentage point increase in the fraction infants discharged on human milk (p<0.05). The acuity-adjusted staffing ratio was marginally associated with the rate of human milk at discharge (p=.056). A 1 SD increase (7%) in the fraction of infants who received breastfeeding support was associated with an eight percentage point increase in the fraction of infants discharged on human milk (p<0.001). CONCLUSIONS Neonatal intensive care units with better work environments, better educated nurses, and more infants who receive breastfeeding support by nurses have higher rates of very low birth weight infants discharged home on human milk. Investments by nurse administrators to improve work environments and support educational preparation of nursing staff may ensure that the most vulnerable infants have the best nutrition at the point of discharge.
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Affiliation(s)
- Sunny G Hallowell
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Fagin Hall, 418 Curie Boulevard, Philadelphia, PA 19104-4217, United States; Leonard Davis Institute of Health Economics, University of Pennsylvania, Colonial Penn Center, 3641 Locust Walk, Philadelphia, PA 19104-6218, United States.
| | - Jeannette A Rogowski
- Rutgers School of Public Health, Rutgers, The State University of New Jersey, SPH-Center for Health Economics, 683 Hoes Lane West, Piscataway, NJ 08854-8021, United States; Leonard Davis Institute of Health Economics, University of Pennsylvania, Colonial Penn Center, 3641 Locust Walk, Philadelphia, PA 19104-6218, United States.
| | - Diane L Spatz
- University of Pennsylvania School of Nursing, Room 413, Fagin Hall, 418 Curie Boulevard, Philadelphia, PA 19104-4217, United States and The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104-5127, United States.
| | - Alexandra L Hanlon
- University of Pennsylvania School of Nursing, Room 479, Fagin Hall, 418 Curie Boulevard, Philadelphia, PA 19104-4217, United States.
| | - Michael Kenny
- Vermont Department of Health, Burlington District Office, 108 Cherry Street, Burlington, VT 05401-4295, United States.
| | - Eileen T Lake
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Room 302, Fagin Hall, 418 Curie Boulevard Room, Philadelphia, PA 10104-4217, United States; Leonard Davis Institute of Health Economics, University of Pennsylvania, Colonial Penn Center, 3641 Locust Walk, Philadelphia, PA 19104-6218, United States.
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Chrupcala KA, Edwards TM, Spatz DL. A Continuous Quality Improvement Project to Implement Infant-Driven Feeding as a Standard of Practice in the Newborn/Infant Intensive Care Unit. J Obstet Gynecol Neonatal Nurs 2015. [PMID: 26195150 DOI: 10.1111/1552-6909.12727] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To increase the number of neonates who were fed according to cues prior to discharge and potentially decrease length of stay. DESIGN Continuous quality improvement. SETTING Eighty-five bed level IV neonatal intensive care unit. PATIENTS Surgical and nonsurgical neonates of all gestational ages. Neonates younger than 32 weeks gestation, who required intubation, continuous positive airway pressure (CPAP), high flow nasal cannula (HFNC), or did not have suck or gag reflexes were excluded as potential candidates for infant-driven feeding. INTERVENTION/MEASUREMENTS The project was conducted over a 13-month period using the following methods: (a) baseline data collection, (b) designation of Infant Driven Feeding (IDF) Champions, (c) creation of a multidisciplinary team, (d) creation of electronic health record documentation, (e) initial staff education, (f) monthly team meetings, (g) reeducation throughout the duration of the project, and (h) patient-family education. RESULTS Baseline data were collected on 20 neonates with a mean gestational age of 36 0/7(th) weeks and a mean total length of stay (LOS) of 43 days. Postimplementation data were collected on 150 neonates with a mean gestational age of 36 1/7(th) weeks and a mean total LOS of 36.4 days. A potential decrease in the mean total LOS of stay by 6.63 days was achieved during this continuous quality improvement (CQI) project. CONCLUSIONS Neonates who are fed according to cues can become successful oral feeders and can be safely discharged home regardless of gestational age or diagnosis.
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Spatz DL, Froh EB, Flynn‐Roth R, Barton S. Improving Practice at the Point of Care Through the Optimization of the Breastfeeding Resource Nurse Model. J Obstet Gynecol Neonatal Nurs 2015; 44:412-8. [DOI: 10.1111/1552-6909.12570] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Martino K, Wagner M, Froh EB, Hanlon AL, Spatz DL. Postdischarge breastfeeding outcomes of infants with complex anomalies that require surgery. J Obstet Gynecol Neonatal Nurs 2015; 44:450-7. [PMID: 25857622 DOI: 10.1111/1552-6909.12568] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To examine the duration and exclusivity of breastfeeding and provision of human milk among infants with complex anomalies that require surgery postdischarge from a neonatal intensive care unit (NICU). DESIGN Prospective cohort study. SETTING A tertiary care children's hospital with a fetal diagnostic and treatment center, special delivery unit, and NICU. PARTICIPANTS Mothers who had delivered infants with complex anomalies that require surgery between 2009 and 2012 (N = 165). METHODS Phone interviews were used for data collection and were analyzed using descriptive statistics methods. RESULTS The average duration of breastfeeding/provision of human milk was 8 months. The percentage of infants who received human milk at 6 months was 60.1% (n = 98/163,; p = .0063) and at 12 months was 34.5% (n = 57/165, p = .023). Of infants in this cohort, the percentage of those infants exclusively receiving human milk was 54.3% (n = 89/164, p = .0004) at 3 months of age and 35.6% (n = 58/163, p < .0001) at age 6 months. Another clinically important finding is that 30.7% of the cohort required gavage feeds postdischarge from the NICU. CONCLUSION Even for the most surgically complex infant/mother dyads, breastfeeding outcomes can improve significantly with a strong prenatal lactation program, nursing staff with specific breastfeeding education, and a hospital culture that values and supports breastfeeding and the provision of human milk. These findings support the use of hospital-grade electric breast pumps postdischarge for families of infants with complex anomalies that require surgery, as approximately one third of the cohort went home on tube feeds and their mothers continued to pump their breast milk at home.
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Froh EB, Deatrick JA, Curley MAQ, Spatz DL. Making meaning of pumping for mothers of infants with congenital diaphragmatic hernia. J Obstet Gynecol Neonatal Nurs 2015; 44:439-49. [PMID: 25851118 DOI: 10.1111/1552-6909.12564] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To describe the process of initiation and maintenance of milk supply and potential transition to direct breastfeeding among mother/infant dyads with infants with congenital diaphragmatic hernia (CDH). SETTING A Level-III neonatal intensive care unit. PARTICIPANTS Eleven mother/infant dyads with infants with CDH. METHODS Prospective, longitudinal qualitative descriptive design. Semistructured interviews were conducted over the course of the NICU stay. Conventional content analysis was used. RESULTS Human milk oral care emerged from the interview data as a strong facilitating factor to encouraging mothers to continue pumping during hospitalization. Four main themes emerged regarding the importance and value of human milk oral care for the mothers in relation to pumping and maintenance of milk supply: (a) It motivates me; (b) I'm a part of my baby getting better; (c) We do it together, and (d) We're getting somewhere. CONCLUSIONS The findings of this study reflect the importance and value of human milk oral care as a driving factor to motivate mothers to maintain milk supply during the critical time when the infant with CDH is not able to take in enteral nutrition and throughout the hospital stay.
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Cianelli R, Villegas N, Azaiza K, Henderson S, Hooshmand M, Peragallo N. Developing and testing an online breastfeeding training among undergraduate nursing students. ACTA ACUST UNITED AC 2014; 3:82-88. [PMID: 27766266 DOI: 10.5430/cns.v3n1p82] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The benefits of breastfeeding for mothers and babies have been well documented in the scientific literature, with new evidence about the benefits continuing to emerge. The Surgeon General's call to action to support breastfeeding recommends mandatory breastfeeding education and training for all healthcare providers that deliver care to mothers and babies. The purpose of this study is to analyze the development of an online computer based breastfeeding training (BT) and the preliminary outcomes of this training. The development of this training included consultation with content and technology experts. The collection of preliminary outcomes related to breastfeeding knowledge data and evaluation of the online BT was pre and posttest study. Eighty six undergraduate nursing students completed the online BT using Blackboard Learn. The online component of the BT consisted of five modules with a combined length of approximately 16 hours. After the completion of the modules, the students increased their levels of knowledge related to breastfeeding and the majority believed that they were fully able to perform skills to support breastfeeding. The results of this study indicate that a successful BT for nursing students can be effectively designed, which can in the future be disseminated to other healthcare providers and students. In addition, this online BT was cost-efficient and effective in improving students' knowledge and skills to support breastfeeding.
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Affiliation(s)
- Rosina Cianelli
- School of Nursing and Health Studies, University of Miami, Coral Gables, USA
| | - Natalia Villegas
- School of Nursing and Health Studies, University of Miami, Coral Gables, USA
| | - Khitam Azaiza
- School of Nursing and Health Studies, University of Miami, Coral Gables, USA
| | - Shakira Henderson
- School of Nursing and Health Studies, University of Miami, Coral Gables, USA; South Miami Hospital, Miami, Florida, USA
| | - Mary Hooshmand
- School of Nursing and Health Studies, University of Miami, Coral Gables, USA
| | - Nilda Peragallo
- School of Nursing and Health Studies, University of Miami, Coral Gables, USA
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Congenital hyperinsulinism: exclusive human milk and breastfeeding. Adv Neonatal Care 2014; 14:262-6; quiz 267-8. [PMID: 25000103 DOI: 10.1097/anc.0000000000000085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Congenital hyperinsulinism is a genetic condition causing dysregulation of insulin and results in persistent hypoglycemia. The most common types are sulfonylurea receptor (SUR1), potassium inward rectifying channel (Kir6.2), glutamate dehydrogenase (GDH), and glucokinase (GK), with SUR1 and Kir6.2 being the most prevalent. It is imperative that these infants undergo diagnostic testing, which includes genetic, neonatal fasting study to induce hypoglycemia, glucagon stimulation, and imaging. Once a diagnosis has been made, surgical intervention may be needed to help regulate blood glucose levels. During this diagnostic process and as the infant is undergoing treatment, there may be little concern for the mother's feeding plan. Because human milk is the preferred form of nutrition for all infants, these mothers should receive prenatal counseling regarding the initiation and maintenance of milk supply. Parenteral nutrition may be necessary to maintain blood glucose to support human milk administration and breastfeeding.
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The birth of the GEMs group: implementation of breastfeeding peer support in a children's hospital. Adv Neonatal Care 2014; 14:274-80. [PMID: 25000105 DOI: 10.1097/anc.0000000000000065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The need to support and promote breastfeeding is unquestionable. The World Breastfeeding Week 2013 theme, "Breastfeeding Support: Close to Mothers," focuses on "breastfeeding peer counseling." Mother support groups are traditionally community-based and little is published about peer-to-peer support for mothers who have critically ill newborns. This study describes the development of a support group established in a children's hospital. The Group of Empowered Mothers focuses on a unique population of mothers (those with critically ill hospitalized infants) and involves 3 basic tenets: healthcare provider support; mother-to-mother support; and Certified Breastfeeding Consultant Support.
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Invitation to develop targeted interventions to support continued direct breast-feeding in the NICU. J Perinat Neonatal Nurs 2012; 26:286-8. [PMID: 23111714 DOI: 10.1097/jpn.0b013e318272caea] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Budin WC. Breastfeeding Program at Children's Hospital is Worthy of Emulation. J Perinat Educ 2012; 14:39-41. [PMID: 17273420 PMCID: PMC1595227 DOI: 10.1624/105812405x23658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In this column, a group of nurses working in a special-care nursery at a small community hospital comment on a comprehensive, hospital-wide program that supports and promotes breastfeeding for vulnerable infants at the Children's Hospital of Philadelphia. The program is described by Diane Spatz in her article featured elsewhere in this issue of The Journal of Perinatal Education. The nurses who reviewed the article agreed that the program described by Spatz is truly an exemplary service worthy of being emulated.
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Affiliation(s)
- Wendy C Budin
- WENDY BUDIN is the associate dean for the Graduate Nursing Program and Research at Seton Hall University and the program director of the Lamaze International Childbirth Educator Program at Seton Hall. She is a fellow in the American College of Childbirth Educators and is currently chair of the Lamaze International Certification Council
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Rossman B, Engstrom JL, Meier PP. Healthcare providers' perceptions of breastfeeding peer counselors in the neonatal intensive care unit. Res Nurs Health 2012; 35:460-74. [PMID: 22753129 DOI: 10.1002/nur.21496] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2012] [Indexed: 11/08/2022]
Abstract
In this qualitative descriptive study we examined the perceptions of 17 neonatal intensive care unit (NICU) healthcare providers (nurses, neonatologists, lactation consultants, and dietitians) about the role of breastfeeding peer counselors who were mothers of former NICU infants and who provided primary lactation care in the NICU. Findings revealed that the healthcare providers respected the peer counselors' lactation expertise and identified three critical elements that contributed to the effectiveness of the peer counseling program: having a champion for the program, counselors being mothers of former NICU infants, and a NICU culture supportive of using human milk. Healthcare providers thought the peer counselors enhanced care of the infant by empowering mothers to provide milk and by facilitating and modeling positive patterns of maternal-infant interactions.
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Affiliation(s)
- Beverly Rossman
- Department of Women, Children, and Family Nursing, College of Nursing, Armour Academic Center, Rush University, Chicago, IL 60612-3832, USA
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Abstract
Research indicates that feeding preterm infants at the breast is physiologically less stressful than bottle-feeding. Poor sucking reflexes make it difficult to initiate breastfeeding for these high-risk infants. Mothers need to understand the difficulties of breastfeeding, as well as the advantages for herself and her baby. It is important for nurses to be well educated on how preterm infants are breastfed and how to best support the mother through her experience. The nurse must focus on caring for the infant as well as fostering the mother-infant connection to promote breastfeeding. A mother will need continual support, encouragement, and advice from the nurse, while teaching her baby how to breastfeed.
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Taylor C, Gribble K, Sheehan A, Schmied V, Dykes F. Staff Perceptions and Experiences of Implementing the Baby Friendly Initiative in Neonatal Intensive Care Units in Australia. J Obstet Gynecol Neonatal Nurs 2011; 40:25-34. [DOI: 10.1111/j.1552-6909.2010.01204.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Abstract
In the United States of America, approximately 40,000 infants are born annually with congenitally malformed hearts. Children with defects that require complex surgical palliation, or definitive repair, face many challenges in achieving optimal short-term and long-term growth. The presence of associated chromosomal abnormalities, cyanosis, and cardiac failure adds to the complexity and challenge. In this review, we address three themes related to feeding, growth, and nutrition of infants after neonatal cardiac surgery: nutritional challenges after chylothorax; breastfeeding after surgery; and the challenges of feeding after discharge. Chylothorax is a rare complication following cardiothoracic surgery in children. Children with chylothorax have nutritional depletion secondary to protein losses in chylous fluid, hypovolaemia, and electrolyte losses. In spite of the evidence supporting the use of human milk and breastfeeding in preterm infants, barriers to its use appear to persist in infants with critical cardiac disease. Yet, human milk is the preferred form of nutrition for well, preterm, or ill infants. It is well documented that after complex neonatal cardiac surgery medical teams and families struggle with infant feeding problems. Parents have described feeding their children as difficult, time consuming, and anxiety producing. Medical complications such as chylothorax, limited access to human milk, and parental concerns and stress about feeding are but three of the myriad of factors that may contribute to poor outcomes regarding nutrition and growth. Compelling evidence exists that this multi-factorial problem must be addressed with both physiological and behavioural strategies.
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Bernaix LW, Beaman ML, Schmidt CA, Harris JK, Miller LM. Success of an Educational Intervention on Maternal/Newborn Nurses' Breastfeeding Knowledge and Attitudes. J Obstet Gynecol Neonatal Nurs 2010; 39:658-66. [DOI: 10.1111/j.1552-6909.2010.01184.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Affiliation(s)
- Diane L Spatz
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania 19104, USA.
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An innovative model for achieving breast-feeding success in infants with complex surgical anomalies. J Perinat Neonatal Nurs 2010; 24:246-53; quiz 254-5. [PMID: 20697242 DOI: 10.1097/jpn.0b013e3181e8d517] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This manuscript describes an innovative nurse-driven continuous quality improvement project. Infants born with congenital surgical anomalies face significant challenges within the newborn period and human milk/breast-feeding may not be viewed as a priority. In many hospitals, nurses refer families to lactation consultants for all breast-feeding assistance and support. The Transition to Breast Pathway was developed on the basis of the evidence-based standards and protocols at The Children's Hospital of Philadelphia. The pathway consists of (1) initiation of pumping and maintenance of milk supply, (2) mouth care with human milk, (3) skin-to-skin care, (4) nonnutritive sucking at the breast, (5) transitioning to at breast feeds. A sample of 80 infants were enrolled in this project. Major results of the project are as follows: (1) mother's average milk supply was approximately 603 mL/d, (2) 71% (57/80) of the infants received mouth care with human milk, (3) 48% (38/80) mother/infant dyads performed skin-to-skin care, (4) 60% (35/58) of mother/infant dyads performed nonnutritive sucking at the breast, (5) 100% (58/58) of mother-infant dyads transitioned to breast prior to discharge. This continuous quality improvement project demonstrates that nurses can and should lead the process of transitioning infants to at breast feeds.
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Bernaix LW, Schmidt CA, Arrizola M, Iovinelli D, Medina-Poelinez C. Success of a Lactation Education Program on NICU Nurses' Knowledge and Attitudes. J Obstet Gynecol Neonatal Nurs 2008; 37:436-45. [DOI: 10.1111/j.1552-6909.2008.00261.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Myers LM, McDowell BM. Breastfeeding EMS for pediatric nurses. J SPEC PEDIATR NURS 2007; 12:132-4. [PMID: 17371559 DOI: 10.1111/j.1744-6155.2007.00104.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Leslie M Myers
- Lander University, Department of Nursing, Greenwood, SC, USA.
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Abstract
Human milk is the preferred form of nutrition for all infants including those born preterm or otherwise ill. However, without the commitment of knowledgeable healthcare providers to ensure success during mother-infant separation, many infants fail to receive their mother's own milk. Care of the mother-infant dyad during infant illness requires vigilant monitoring of the lactation experience and the commitment of healthcare providers to take a family through the step-by-step process needed to ensure positive outcomes related to the use of human milk and breast-feeding for vulnerable infants. The science tells us that human milk is the best form of nutrition for all infants. As practitioners we must be doing everything in our power to make sure the infants we care for are able to receive their mother's own milk.
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Affiliation(s)
- Diane L Spatz
- University of Pennsylvania School of Nursing and The Children's Hospital of Philadelphia, Philadelphia, USA.
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