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MCN Am J Matern Child Nurs. 2011 Mar-Apr;36(2):82-8; quiz 89-90. doi: 10.1097/NMC.0b013e318205589e.

Impact of a formal breastfeeding education program.

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Morristown Memorial Hospital Morristown, NJ, USA.



To investigate whether implementation of a formal breastfeeding education program including a breastfeeding protocol, a resource guide, and educational presentations would have an impact on knowledge, comfort level, and attitudes toward breastfeeding among healthcare providers, and on amount of exclusive breastfeeding at our hospital.


Quasi-experimental study that included a survey to obtain a preintervention baseline measurement and a postintervention measurement 6 months after the implementation of the formal breastfeeding education program. The sample was obstetricians, pediatricians, and nurses who interact with breastfeeding mothers at our hospital. Additionally, we surveyed breastfeeding mothers who gave birth at our hospital to determine the impact on the nurse observation of breastfeeding, exclusivity of breastfeeding, and nighttime feedings.


Healthcare providers showed increased levels of knowledge and comfort dealing with breastfeeding issues after the education program. Knowledge scores were significantly improved (pre- vs. postimplementation scores were 20.2 vs. 22.2, p < .05). Comfort level scores were also significantly improved (pre- vs. postimplementation scores were 20.7 vs. 29.4, p < .05). There was no statistically significant change in attitude toward breastfeeding (preimplementation score = 43.8, postimplementation score = 43.4, p = .075). For the mothers, the preintervention group reported exclusive breastfeeding 55% of the time versus 63% (p = .046) in the postintervention group. There was an increase in nurse observation of breastfeeding after the intervention: 84% versus 92% (p = .046), and breastfeeding patients reported an increase in nighttime breastfeeding after the intervention (55% vs. 71%, p = 0.001), with a resulting decrease in formula supplementation in the nursery at night (28% vs. 21%, p = .006).


This study shows how an educational program and adherence to protocols can increase exclusive breastfeeding as well as improve healthcare provider knowledge, comfort level, and attitudes about breastfeeding. Our interventions also resulted in an increase in nurse observation of breastfeeding, nighttime breastfeeding, and a decrease in the use of formula supplementation at night. This study suggests that positive changes can be made with an educational program and protocols.

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