Date of Award

Summer 5-25-2019

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Joseph Burkard, DNSc, CRNA

Abstract

Background: The World Health Organization (WHO), American Academy of Pediatrics (AAP), and the literature supports exclusive breastfeeding for newborns until six months of age and continued breastfeeding until 12 months of age. Postpartum maternal breastfeeding support has been insufficient in the pediatric clinic to support exclusive breastfeeding recommendations. Shared Medical Appointments (SMA) are an alternative approach to individual well-child appointments that provide lactation consultants sufficient time to conduct breastfeeding education during the extended appointment.

Objective: Through utilization of a shared medical appointment (SMA), a southern California military pediatric clinic will increase exclusive breastfeeding rates (EBF) of new mothers by 10% at the two-month, four-month, and six-month well-child appointments.

Methods: SMA breastfeeding data was collected longitudinally at the infant’s two-, four-, and six-month visits. Random sample of 129 mothers not participating in the SMA completed a breastfeeding survey at well-child visits. A multidisciplinary team of a Provider (MD or NP), Registered Nurse, Lactation Consultant, and two Medical Assistants (MA) conducted two weekly 45-minute SMA for the two-week well- child appointment for up to ten two-week infants total.

Results: During the five-month project, 95 two-week infants participated in the SMA. Mothers who attended the SMA had higher EBF rates vs. individual two-week well-child appointments at the two-, four-, and six-month visits. Maternal satisfaction scores and free text comments showed immense satisfaction of the SMA.

Conclusions: Through utilization of a shared medical appointment (SMA), a southern California military pediatric clinic increased exclusive breastfeeding rates of new mothers.

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Nursing Commons

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