Main Article Content
birth kangaroo mother care, breastfeeding on cue, exclusive breastfeeding, breastfeeding education
Objective: To examine if a perinatal breastfeeding program would improve the exclusive breastfeeding rate at a baby-friendly hospital. Background: The Ten Steps to Successful Breastfeeding and Baby-Friendly Hospital Initiative have been widely used to improve breastfeeding outcomes worldwide. A hospital-based multi-strategy intervention may provide an opportunity to increase breastfeeding in different countries. Study design and methods: The study used a quasi-experimental design. Data was collected in a Baby Friendly hospital. A total of 60 mother-infant dyads were included. The experimental group took part in the multi-component perinatal breastfeeding program, while the control group received routine care. The multi-strategy program included prenatal breastfeeding education, birth kangaroo mother care (skin-to-skin contact and non-separation practices) at first breastfeed, continuous 24-hour rooming-in, ongoing kangaroo mother care with breastfeeding on cue, and hospital support visits. The exclusive breastfeeding rate was measured at hospital discharge, and one-month postpartum. Results: The mothers who participated in the intervention had a greater exclusive breastfeeding rate at hospital discharge and one month postpartum than those in the control group. In the experimental group, 90% of the infants completed the first feeding within two hours after birth. At discharge, 93.3% of the mothers in the experimental group and 53.3% in the control group were exclusively breastfeeding. At one month postpartum, 83.3% of the mothers in the experimental group and 36.7% in the control group were still exclusively breastfeeding. Discussion: The intervention program used in the current study is different to previous studies. The current intervention not only included prenatal education and postpartum support, but also included birth kangaroo mother care at first breastfeed and ongoing kangaroo mother care with breastfeeding on cue. Breastfeeding should be promoted through perinatal comprehensive clinical and social support starting in the prenatal period and continuing through intrapartal, postpartum, and follow-up periods. Conclusion: This study was the first study to use a hospital-based multi-strategy intervention including the non-separation of mother-infant dyads and other breastfeeding support for mothers in Taiwan. The program was associated with a significant improvement in the exclusive breastfeeding rate at one month postpartum.
Implication for practice: This study provided initial evidence to support the implementation of mother-infant non-separation practices in improving breastfeeding outcomes. Health professionals can be re-educated regarding birth kangaroo mother care at first breastfeed and ongoing kangaroo mother care with breastfeeding on cue without increasing nursing workloads while infants’ fathers and other family members (eg. mothers-in-law/mothers’ mothers) can be encouraged to participate in order to achieve family-centred maternity care.
What is already known about the topic?
• Early and exclusive breast feeding and ongoing breast feeding is the optimal form of nutrition for newborn babies and promotes positive infant and mother outcomes.
• Birth kangaroo mother care plays an important role in providing the optimal atmosphere for a baby’s instinctive reflex ability to breastfeed effectively in order to help infant imprinting and suckling.
What this paper adds:
• The newly developed hospital-based perinatal breastfeeding program has demonstrated effectiveness in promoting exclusive breastfeeding rate at one month postpartum.
• Including birth kangaroo mother care at first breastfeed and ongoing kangaroo mother care with
breastfeeding on cue in a perinatal breastfeeding program may lead to more positive breastfeeding experiences for new mothers.