Attitudes, Practices, and Knowledge About Human Lactation Among Nursing Students

An Educational Intervention to Explore and Overcome Nursing Students' Breastfeeding Barriers: A Mixed-Methods Quasi-experimental Study

BACKGROUND

Nursing and midwifery students do not feel adequately prepared during their clinical training to support women who breastfeed, demanding more effective communication skills and knowledge.

AIM

The aim was to evaluate changes in students' breastfeeding knowledge.

METHODS

This was a mixed-methods quasi-experimental design. Forty students voluntarily participated. Using a 1:1 ratio, 2 groups were randomly created and completed the validated questionnaire ECoLaE (pre-post). The educational program consisted of focus groups, a clinical simulation, and a visit to the local breastfeeding association.

FINDINGS

The control group's posttest scores ranged from 6 to 20 (mean = 13.1, standard deviation [SD] = 3.0). The intervention group ranged from 12 to 20 (mean = 17.3, SD = 2.3). A Student's t test for independence samples was calculated ( P < .005, t = 4.5, median = 4.2). The intervention group had a mean difference of 10 points in improvement (mean =10.53, SD = 2.20, min = 7, max = 14), whereas the control group had a mean of 6 points (mean = 6.80, SD = 3.03, min = 3, max = 13). The multiple linear regression explained the intervention's effect. The regression model had statistical significance ( F = 4.87, P = 0.004), with an adjusted R2 = 0.31. The linear regression between the posttest scores and group variables after adjusting by age showed an increment of 4.1 points in the intervention posttest scores ( P < .005, 95% confidence interval [CI] = 2.1-6.1).

CONCLUSIONS

The educational program "Engage in breaking the barriers to breastfeeding" improved nursing students' knowledge.

Integrative Review of the Experiences of Registered Nurses Who Support Breastfeeding Women

OBJECTIVE

To describe the experiences of registered nurses (RNs) who support breastfeeding women and to understand the factors that they believe affect practices that support breastfeeding.

DATA SOURCES

We conducted an online search using five databases: Scopus, MEDLINE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), the Cochrane Database of Systematic Reviews, and Joanna Briggs Institute of Systematic Reviews.

STUDY SELECTION

We included original research articles on the experiences of RNs who support breastfeeding women that were published in 2009 or after and were available in English. After title and abstract review of 785 articles, we included 22 articles for full text review. Nine articles met the eligibility criteria and were included in the review.

DATA EXTRACTION

We used Whittemore and Knafl's five-step framework and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines to guide this integrative review. Three authors reviewed and appraised the articles independently.

DATA SYNTHESIS

We categorized the findings into three themes: Workplace Issues, Personal Experiences, and Breastfeeding Knowledge and Education. Workplace Issues included the subthemes Lack of Time and Workload and Infant Health Stability. Personal Experiences included the subthemes Attitudes, Individual Experiences With Breastfeeding, and The Experiences of Family and Friends. Breastfeeding Knowledge and Education included the subthemes Prelicensure Education and Workplace Education and Training. Most researchers identified deficits in knowledge and education among RNs. The concept of confidence was influenced by all the other themes. Participants in the included studies reported that they developed confidence after learning from lactation consultants and having role models who supported the development of their knowledge and skills.

CONCLUSION

Despite the heterogeneity among the studies, findings highlighted the need for an increased focus on the preparation of RNs to support women to effectively breastfeed within health care organizations. Multitargeted efforts, such as orientation programs and in-depth breastfeeding education using role modeling, mentorship, and role playing with practical scenarios, may improve RNs' abilities and confidence to support breastfeeding women.

Enabling Nursing Students to Achieve Their Breastfeeding Goals

Introduction

US workplace law requires employers to provide reasonable break time and space other than a bathroom for breastfeeding women to express their milk. However, this law does not include students in higher education institutions who choose to breastfeed, as students are typically not employed by their schools. The purpose of this report is to describe the joint efforts of faculty members and students to successfully operationalize a lactation room and develop college-specific lactation guidelines in a university in central Kentucky.

Method

Students from a college of nursing (CON) participated in a survey (N=135), of which 30% were parenting at that time (n=41).

Results

Responses from this subset were used to make the case to CON leadership and faculty to develop college-specific guidelines entitled, "Guidelines for Lactation Support," which was included in students' handbooks, and to the designated space for a lactation room in the CON building.

Discussion

The combined effort of faculty, administrators, and students was crucial to promote a breastfeeding-friendly environment in the CON.