Assess and Improve Intent to Exclusively Breastfeed Among Prenatal Women in a Rural Primary Care Setting

Abstract

Abstract Problem: The exclusive breastfeeding rate in the U.S. is low with only 24.9% of infants being exclusively breastfed for six months. The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for a minimum of six months because breastmilk contains the prefect mix of fat, protein and carbohydrates. It contains protective substances that assist in the infant’s immune system to fight diseases. Breastfeeding education and support could help initiate and maintain breastfeeding; however, there is limited breastfeeding support provided at a primary care setting. Project Aims: The purpose of this project was to provide maternal breastfeeding education and support information for rural prenatal women to improve intent to breastfeed exclusively for six months postpartum. This quality improvement project consisted of three aims: (1) assess prenatal women’s baseline intent to exclusively breastfeed; (2) implement a breastfeeding education program and provide support information for six weeks to prenatal women; and (3) evaluate intent to exclusively breastfeed after implementation of the breastfeeding education program with the support information packet. Project Methods: This project was conducted at Ottawa Family Physicians (OFP), a rural primary care clinic. Icek Ajzen’s theory of planned behavior was used as a theoretical framework to guide this project. The participants included 20 prenatal women seen at OFP during a six-week period. Intent to exclusive breastfeeding was measured using the Infant Feeding Intentions (IFI) scale before and after the breastfeeding education and support information packet was provided. The IFI scores of intent to exclusive breastfeeding before and after the intervention were reported and compared using descriptive statistics. Findings: The majority of the participants (n = 20) were non-Hispanic White with a mean age of 27 years and a gestational age of 33.7 weeks. The mean total IFI score at baseline (n = 15) was 12.6. After six-weeks of the implementation of the breastfeeding education and support information packet, the mean total IFI score increased to 13.8 (n = 5), which was a 10% increase from baseline. The sub-item IFI scores at one, three, and six months were 3.2, 3.0, and 2.6, respectively at baseline and 3.8, 3.4, and 3.2, respectively at post implementation. Conclusion: The breastfeeding education and support information packet is effective to improve exclusive breastfeeding intention among prenatal women in a rural primary care setting. New strategies to promote the implementation of the breastfeeding education and support information packets are warranted.