A study in the International Journal of Nursing Studies concludes when NICU nurses have better work environments and higher education levels (at least a BSN) and the units are adequately staffed, more babies are discharged on breast milk, according to a news release. NICUs with better work environments allow nurses time and resources and have more supportive nurse managers and collaborative working relationships between nurses and physicians. These factors enhance nurses’ ability to provide breastfeeding support, which significantly increases the percentage of infants who receive breast milk.
Breast milk is widely recognized as the best form of nutrition for infants, particularly premature babies and those with low birth weights. Despite that, 52% of very low birth weight infants are discharged from neonatal NICUs on formula only and 42% are discharged on breast milk with a fortifier or formula, according to the release.
This study was based on data generated by an earlier study funded by the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative. The new study was led by Sunny Hallowell, PhD, PPCNP-BC, IBCLC, assistant professor at Villanova University School of Nursing.
The research team conducted secondary analysis of INQRI-funded nurse survey data from 5,614 nurses and breast milk discharge rates in 97 NICUs. These units cared for 6,997 very low birth weight infants (between 501 and 1500 grams at birth). The NICUs were part of the Vermont Oxford Network, a NICU quality improvement collaborative.
Several other factors, including the presence of lactation consultants, did not have a significant impact on the proportion of infants discharged on breast milk, according to the release. “Breastfeeding support by registered nurses had the largest impact on whether infants were receiving breast milk at discharge,” Eileen T. Lake, PhD, RN, FAAN, an INQRI research team leader, said in the release. “However, nursing unit factors — notably education levels and good work environment — also produced higher rates of breastmilk at discharge. Our findings speak to the importance of hospitals investing in better work environments and better educated nurses to increase the rate of infants discharged on breast milk, which provides them with the best nutritional care and the healthiest start in life.”
Other members of the research team were: Jeannette Rogowski, PhD, university professor in health economics in the Department of Health Systems and Policy at the Rutgers School of Public Health; Diane Spatz, PhD, RN-BC, FAAN, professor of perinatal nursing and Helen M. Shearer Term Professor of Nutrition at the University of Pennsylvania School of Nursing; Alexandra Hanlon, PhD, research professor of Nursing at the University of Pennsylvania School of Nursing; and Michael Kenny, MS, public health analyst, Vermont Department of Health.
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