Abstract
Breastfeeding has documented benefits for mothers and babies. A Healthy People 2010 goal is to increase breastfeeding rates to 75% initiation, 50% at 6 months, and 25% at 1 year. Nurses play a key role in meeting the goals by influencing policy and practices. Purpose: 1) examine breastfeeding-related policies/practices on perinatal units of Florida hospitals, 2) describe nurse attitudes toward breastfeeding, 3) examine the extent to which policies and practices are supportive of breastfeeding, and 4) compare findings with those of Churchill from 1992. Methodology: Non-experimental cross-sectional survey using modified Houston & Field Hospital Practices Questionnaire and Cusson's Attitudes Toward Breastfeeding Scale. Subjects: Perinatal unit managers and 4 nurses from each Florida hospital providing obstetric services.
Results: 75 of 119 unit managers and 268 of 476 staff nurses responded. Twenty-six managers (34.7%) reported that greater than 75% of mothers initiated breastfeeding; 24 (32.4%) reported that greater than 75% were discharged breastfeeding. Policies mostly supported breastfeeding: no routine supplements (98.7%), unrestricted suckling time (94.6%), demand feeding (92%), and no complements (87.7%); however, 53.3% of facilities restricted distribution of formula discharge packs. Nearly all managers reported one-on-one teaching is done, yet only 58.1% of units had a teaching protocol. Staff nurses reported the following practices: demand feeding (73.3%), unrestricted suckling time (80.1%), no routine supplements (22.3%), and no routine complements (29.6%); 32.3% reported restricted distribution of formula discharge packs. Most nurses had positive attitude scores (89.5%); none had negative attitude scores. There was insufficient evidence to conclude that perinatal unit level had an effect on policy compliance. There was a substantial discrepancy between policy and practice. Small improvements in policy and practice occurred since 1992. Conclusions: Most policies are up to date; however, pracctices at many facilities are not in line with those recommended by research.
|
