A Breastfeeding Education Initiative for Registered Nurses Outside the Obstetric Unit: Emergency Department and Medical-Surgical Nurses Learn to be Baby-Friendly

The most recent statistics available from the Centers for Disease Control and Prevention indicate that 77% of mothers initiated breastfeeding in the year 2009 in the United States. In 2012, the American Academy of Pediatrics recommended breastfeeding for 1 year or longer as mutually desired by mother and infant. Consequently, we have increased the length of time when a breastfeeding woman may experience a hospitalization related or unrelated to her childbirth or lactation status. During hospital care, mothers may be needlessly instructed to pump and dump their breast milk due to lack of evidence-based practice. The purpose of the program was to close the education gap for registered nurses (RNs) who may care for a breastfeeding patient on a nonmaternity unit. The results of a needs assessment indicated that the most common medical needs of breastfeeding mothers receiving care in the emergency department and medical/surgical units of four Midwestern Mercy Health Hospitals included conditions unrelated to childbirth, such as injuries, gall bladder, asthma, and ear infections; conditions related to childbirth, such as postpartum hypertension, uterine infection, cesarean delivery incision complications, spinal headaches, deep vein thrombosis, pulmonary embolism, and postpartum hemorrhage; and conditions related to lactation, such as engorgement, plugged ducts, mastitis, abscess, and fungal infection. Our program had the added challenge of providing education in the midst of closing two hospitals to move to a new hospital, adding maternity services for the first time, and implementing Baby Friendly Hospital Initiative guidelines. To provide breastfeeding education to all RNs in the emergency department and medical/surgical units. Implementation included providing a 60-minute PowerPoint lecture during 13 inservices over a 1-month period. The lecture introduced breastfeeding-related policy, equipment, medication safety, and resources. Outcomes and evaluation included short- and long-term data. Short-term data include evaluation collected immediately postlecture. Long-term data include the number and type of consultations that RNs who were caring for breastfeeding patients requested from lactation or obstetric providers. Could your hospital benefit from a program targeted to meet these needs?