2018 Research Forum

Impact of Multidisciplinary Interventions on Exclusive Breastfeeding Rates Presenter: Melissa Fujan DO Principal Investigator & Faculty Sponsor: Thomas W Moxley MD

Melissa Fujan DO 1 , Thomas W Moxley MD 2 1 Chief Resident R4 2 Associate Faculty

INTRODUCTION Given the recognizedbenefits of breastfeeding for the healthof themother and infants, theWorldHealth Organization recommends exclusive breastfeeding for the first six months. However, the prevalence of exclusive breastfeeding is low in the United States and particularly low in low socioeconomic status patients. There is much interest in the effectiveness of breastfeeding promotion interventions on breastfeeding rates in early infancy. PURPOSE To aim of this investigation was to compare which types of interventions - Health provider education, Lactation consultant coverage, or patient access to formula created the most significant impact on breastfeeding rates in the Central Valley patient population. METHOD The hospital’s monthly exclusive breastfeeding (from birth to discharge) rates were monitored from 2011 to 2018. Changes in exclusive breastfeeding rates before and after each intervention were compared using a Cumulative Effects Logistic Regression Model. RESULTS For every 1.8 patients where staff received breastfeeding education that breastfeed exclusively, only 1 patient breastfeed exclusively that did not receive the benefit of these procedures. For every 3.6 patients once LC became available 7 days/week that breastfeed exclusively, only 1 patient breastfeed exclusively that did not receive the benefit of these procedures. For every 6.0241 patients that received Patient Education that breastfeed exclusively, only 1 patient breastfeed exclusively that did not receive the benefit of all new procedures implemented DISCUSSION The study population benefited significantly from interventions resulting in increased exclusive lactation rates from delivery to discharge. It appears based on the data there was a correlation between the chronology of interventions and their effectiveness. with the early interventions having a weaker/ not statistically significant impact while the final interventions had the strongest influence (increased exclusive breastfeeding rate by 15.29%). CONCLUSIONS While all interventions resulted in increased rates of exclusive breastfeeding, the data demonstrated a higher impact on percent of mothers who were able to exclusively breastfeed with increased LC availability relative to all other interventions. Conversely, all interventions were cumulative so it is not possible to isolate one intervention fromanother. Thus, having received the benefit of the prior interventions could theoretically lead to higher or lower responses to subsequent interventions. While the statistical analysis proved challenging, it might be concluded that multidisciplinary interventions provide the greatest benefit to the patient and newborn.

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