Attitudes, Perceptions, and Knowledge of Breastfeeding Among Professional Caregivers in a Community Hospital.

OBJECTIVE: To explore the knowledge, attitudes, and perceptions of exclusive breastfeeding among professional caregivers in a suburban community hospital who typically provide, or influence, the care of parturient women. DESIGN: Cross-sectional quantitative study. SETTING: Acute care community hospital in suburban New Jersey with 3,500 births per year. PARTICIPANTS: Obstetricians, midwives, neonatologists, pediatricians, and registered nurses. INTERVENTIONS/MEASUREMENTS: We designed a survey using two instruments-the Iowa Infant Feeding Attitudes Scale and the Breastfeeding Attitudes Scale-to explore concepts of breastfeeding knowledge, attitudes, and perceptions. Data were analyzed by using descriptive and inferential statistics with SPSS (Version 19). Independent sample t tests, Pearson's correlation coefficient, and Pearson's chi-square test (×2) were used to assess differences between the groups. RESULTS: When the physician scores were separated out by specialty, statistically significant differences in mean scores were found (p = .002). Pediatricians had lower scores on attitude toward breastfeeding. In contrast, mean scores for perceptions and knowledge of breastfeeding were positive for physicians and nurses, regardless of area of specialization, with no statistically significant differences found. CONCLUSION: Although pediatricians' attitudes, perceptions, and knowledge of breastfeeding cannot be deemed the sole cause for our organization's low rates of sustained exclusive breastfeeding in the postpartum period, this study provided an avenue for exploration that we did not immediately consider as we dissected our performance metrics related to exclusive breastfeeding. We encourage teams at other organizations to replicate and build on this work to explore influences surrounding low rates of exclusive breastfeeding.

Breastfeeding Simulation With the Standardized Patient.

Despite an emphasis on lactation and the availability of resources to support and sustain lactation, our community hospital's rates of exclusive breastfeeding remained less than the 50% to 70% benchmark recommended by The Joint Commission and the World Health Organization. Concluding that we had exhausted the majority of evidence-based best practices described in the literature, we sought to find a new way to provide an engaging, useful medium for nursing education and improvement of clinical nurses' skills related to breastfeeding. Here, we describe the simulation program we developed using the standardized patient model. Although our rates of exclusive breastfeeding remained unchanged after introducing the simulation program, the experience enabled us to identify inconsistent practices and knowledge gaps.