Associations Between Hospital Nursing Resources and Breastfeeding Outcomes: A Narrative Review.

ABSTRACT

PURPOSE: To summarize how nursing resources and missed nursing care are associated with hospital breastfeeding outcomes, including human milk provision. BACKGROUND: Nurses are the primary providers of breastfeeding support in the hospital. Nursing resources, eg, staffing and the work environment, enable nurses to carry out their work successfully. If resources are constrained, nurses may miss providing breastfeeding support. There is a gap in the literature about the relationships among nursing resources, missed nursing care, and breastfeeding outcomes. METHODS: The Cumulative Index to Nursing and Allied Health Literature and PubMed were searched with keywords such as "nurse staffing," "nurse work environment," "missed nursing care," "breastfeeding," "human milk," and "lactation." We included peer-reviewed studies of US samples in English published between 2014 and 2022. RESULTS: Of 312 references, 8 met inclusion criteria 5 quantitative and 3 qualitative. Better nurse staffing and breastfeeding support were associated with improved breastfeeding outcomes in the qualitative and quantitative literature. Missed care partially mediated the relationship between staffing and exclusive breast milk feeding rates. Better nurse work environments were associated with increased breastfeeding support and provision of human milk. CONCLUSIONS: Empirical evidence supports an association between the nurse work environment, nurse staffing, breastfeeding support, and outcomes. Implications for practice and research Poor staffing may be associated with decreased breastfeeding support and outcomes. Hospital administrators and nurse managers may consider improving nurse staffing and the work environment to improve breastfeeding outcomes. Future research should simultaneously examine staffing and the work environment and address breastfeeding outcome disparities.