Maternal, Child Health and Neonatal Nursing Commons^™

Advancing Exclusive Breastfeeding Through Prenatal Education, Emr Optimization, And Community Partnership: A Champs National Quality Improvement Initiative, Heather Klein, Hannah Koepp

InnovateHER Meeting 2026

CHAMPS National is a CDC-funded quality improvement initiative focused on improving exclusive breastfeeding rates, strengthening maternity care practices, and reducing racial disparities. This project implemented culturally responsive prenatal education, optimized EMR workflows, and strengthened community partnerships to support informed infant feeding decisions and improve breastfeeding equity.

Breastfeeding Promotion For Infants With Neonatal Abstinence Syndrome (Nas), Olivia Czerwonka

Evidence-Based Practice Project Reports

Neonatal abstinence syndrome (NAS) is the exposure in utero to drugs with the incidence in the United States increasing from 4 to 6.3 per 1000 births (Wei et al., 2023). The purpose of this quality improvement project was to implement a breastfeeding support intervention to increase breastfeeding frequency and reduce hospital length of stay of newborns with NAS. A tailored multicomponent guideline based upon the current Ten Steps to Successful Breastfeeding as established by WHO and UNICEF (2017) was implemented. Mothers of infants diagnosed with NAS were recruited using convenience sampling from a Northwest Indiana Hospital. Key stakeholders within the …

Tiny Tusks Internship: Factors That Affect Breastfeeding In Public, Caroline E. Bene

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this review was to explore factors that impact women’s decision to breastfeed in public or not. The PICOT question used was: ‘What Factors Affect Women’s Decision to Breastfeed in Public or Not?’ Two platforms, EBSCOhost and The National Library of Medicine, were used to identify 15 peer-reviewed journal articles on factors affecting women’s decision to breastfeed in public or not. The factors that impact a women’s decision on whether it is acceptable to breastfeed in public stems from the media stigmatizing that breastfeeding should be a private action. Research done yielded results of both positive and negative …

Feeding Mode Is Associated With Infant Night Sleep Trajectories During The First Postnatal Year, Magdalena Olson, Li Liu, Elizabeth Reifsnider, Dean V. Coonrod, Sarada S. Panchanathan, Megan E. Petrov, Corrie M. Whisner

Ellmer School of Nursing Faculty Publications

Background: Short sleep and formula feeding during infancy are associated with increased risk of childhood obesity. Feeding practices and sleep arrangements vary during infancy and may also be dynamic, yet their impact on infant night sleep duration remains unclear. Understanding these relationships is crucial for formulating recommendations to support breastfeeding and address sleep concerns. Objective: We examined the association between feeding mode and parent-reported infant night sleep duration during the first postnatal year, while additionally evaluating night-weaning and bedsharing as contextual sleep-related practices. Methods: Infants in the Phoenix Metropolitan Area (n = 193) were followed up at 3, 8, 13, …

Risk Factors Associated With Delayed Secretory Activation In A Cohort Of Nulliparous Women In Western Australia, Cassandra Cuffe, Giglia, Julie Hill, Matthew N. Cooper, Anita M. Moorhead, Joshua R. Lewis, Deborah Ireson, Therese A. O’Sullivan

Research outputs 2022 to 2026

Background: Delayed secretory activation can negatively impact maternal and child health through increasing the risk of early cessation of breastfeeding. Early cessation of breastfeeding is known to be associated with increased health risks. Aim: To determine the occurrence of, and risk factors associated with, delayed secretory activation in nulliparous women in Western Australia. Methods: This analysis used a subset of participants (n = 183) enrolled in a multicentre trial. Nulliparous low-risk pregnant women were enrolled between 28–32 weeks’ gestation and followed until 1 week after birth. The association between self-reported delayed secretory activation status (onset 4 days or more postpartum) …

Understanding Breastfeeding Practices In Tennessee: Goals, Duration, And Reasons For Discontinuation, Amir Alakaam, Chia-Lin Chang, Hannah Jeffery

Journal of Appalachian Health

Introduction: Breastfeeding is widely recognized as the optimal source of infant nutrition, offering many health benefits.

Purpose: The purpose of this study was to examine goals, exclusivity, and duration of breastfeeding and explore factors that influence breastfeeding practices among individuals in Tennessee (TN).

Methods: A cross-sectional study was conducted among individuals (N = 1,249). Participants were recruited and data were collected from June – September 2021. The data were entered and analyzed from September 2022 – March 2023. Descriptive statistics, chi-square test, and ANOVA were used to analyze the data and identify associations between variables.

Results: About 32% of the …

The Relationship Between Religious Attitude And Breastfeeding Attitude: A Cross-Sectional Study From Türkiye, Melike Yavaş Çelik, Cuma Tunçkaşık

Makara Journal of Health Research

Background: This study aimed to evaluate the relationship between religious attitudes and breastfeeding attitudes and the effect of this relationship on breastfeeding practices.

Methods: This study was conducted with 203 mothers with babies aged 0–24 months. Simple random sampling was used in sample selection. The Religious Attitude Scale and Breastfeeding Attitudes of the Evaluation Scale were used in data collection.

Results: A significant relationship was found between religious attitudes and breastfeeding attitudes. Additionally, mothers' negative breastfeeding attitudes and positive breastfeeding attitudes were found to be close to each other. The time it took for mothers to start breastfeeding their …

Breastfeeding Safety Following Maternal Anesthesia: A Guideline Development, Megan Honea, Mary Johnson

Doctoral Projects

Recommendations regarding breastfeeding following maternal anesthesia are inconsistent and often not up to date with current best practice guidelines. Previous recommendations have led to mothers unnecessarily “pumping and dumping” breast milk has benefits for both mother and baby. These benefits include (a) increasing the infant’s access to colostrum, (b) encouraging mother-baby bonding, (c) improving the mother’s breastfeeding experience, (d) and providing significant health benefits to the infant. The purpose of this scholarly project was to develop a set of evidence-based recommendations that focus on mothers who desire to breastfeed following general anesthesia. These recommendations will highlight maternal- fetal transfer of …

A Comparison Of Cultural Aspects Of Breastfeeding In The United States Vs Italy, Madison P. Wallace

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Healthcare systems internationally differ from policies, funding and resources available, and it is evident when comparing the United States and Italy. Participation in the Nursing Across the Lifespan study abroad program at the University of Arkansas Rome Center and Tiny Tusk Breastfeeding and Infant Support internship inspired a comparative exploration of breastfeeding practices in the United States versus. Italy. The United States has a mixed public- private insurance system, workplace policies and government assistance, while Italy has a universal healthcare system with a mandated maternal work paid leave to support breastfeeding mothers. Italy's program supports education and physical care needed …

Socio-Cultural Correlates Of Breastfeeding Behavior Among Latina Mothers And Its Implications For Child Health, Liliana Davalos, Brisa Rodriguez Alcantar, Marissa Martinez, Christopher Johansen

Social and Behavioral Health Faculty Research

Background: Latina mothers in the United States report lower rates of breastfeeding initiation and exclusivity than their non-Hispanic counterparts. Lower rates of breastfeeding in infancy may lead to a higher rate of excess weight in childhood and adverse health conditions. Breastfeeding disparities in Latina women have been previously correlated with socio-cultural factors such as acculturation, education, income, nativity, and marital status. This study examines whether socio-cultural factors are associated with breastfeeding behaviors in Latina mothers in Nevada. Methods: Participants were Latina mothers [n = 214] over 18 years of age, with a child 2–5 years old. A logistic regression was …

Integrating Kangaroo Care Into Cesarean Delivery Practices: A Pathway To Enhanced Health Outcomes, Julia Swords

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Cesarean deliveries often interrupt early mother-infant bonding, delaying the initiation of breastfeeding and limiting opportunities for skin-to-skin contact. Despite national guidelines promoting immediate postpartum contact, cesarean-born infants receive kangaroo care (KC) at significantly lower rates than those born vaginally. Prior to this project, only 2% of cesarean births at the project site received KC, highlighting a significant gap in care delivery.

Aim of the Project: The aim was to evaluate the feasibility and impact of implementing kangaroo care during cesarean deliveries in a community hospital to improve neonatal outcomes and adherence to evidence-based postpartum practices.

Review of the Evidence: …

Barriers To Breastfeeding In The Workplace As A Nurse And Perceived Support, Juliette Parker

Honors College Theses

This paper explores a literature review of how women are expanding more into the workforce requiring them to balance the demands of both family and work. Attention was given to the importance of breastfeeding, and the current research involving lactation support for working lactating nurses. The goal of this paper was to assess a Southeast Georgia hospital for the barriers and perceived support for working lactating nurses. Based on the available literature investigating this topic, it was hypothesized that nurses would report a lack of resources and support for working lactating mothers. To investigate this, an anonymous survey was conducted …

Exploration Of Advanced Practice Registered Nurses’ Perception Of Barriers To Promoting And Supporting Breastfeeding In Primary Care, Devon L. Stubblefield, Allison L. Scott, Carmel Kruse, Marilou D. Shreve, Hope A. Ballentine

The Eleanor Mann School of Nursing DNP Capstone Projects

Background: Breastfeeding is the biological way to provide active and passive immunity, as well as necessary nutrients, to infants while concurrently providing multiple health benefits for mothers. Even though evidence is readily available to support the argument to breastfeed, United States’ breastfeeding rates fall below Healthy People 2030 goals. Advanced practice registered nurses (APRNs) in primary care settings are in a prime position to give education and create care plans to support breastfeeding mothers to improve breastfeeding rates but literature supports APRNs lack confidence to do so. An APRN is likely to defer care to another provider to address …

What's In It For Me? The Benefits Of Breastfeeding For The Mother, Emily H. Mcmennamy

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this systematic review was to investigate both the short- and long-term benefits that breastfeeding has on maternal physical and mental health. The PICOT question was: In postpartum mothers, how does breastfeeding compared to formula and mixed feeding affect maternal physical and mental health, including outcomes in cardiovascular health, BMI, bleeding risk, and mental health both short term and long term? For this research, EBSCOhost and the National Library of Medicine databases were searched to find relevant studies and systematic reviews. Terms such as “breastfeeding and maternal health benefits,” “breastfeeding and postpartum health,” and “breastfeeding and weight loss” …

Baby-Friendly Hospital Initiative: Becoming Baby-Friendly Designated, Krystal Angelique Mora

Master's Projects and Capstones

Section I: Abstract

Problem Despite efforts to increase breastfeeding rates, the influence of formula companies has contributed to the decrease in rates, affecting the health outcomes of infants. In response, the Baby-Friendly Hospital Initiative (BFHI) introduced standardized education for nursing staff to support infant growth and development. Context Hospital A Birth Center is a 33-bed culturally diverse unit that provides care to mothers in Northern California, delivering approximately 7,400 babies each year and helping patients transition into motherhood. Aim The quality improvement project aims to enhance the retention of BFHI-aligned education provided during hospitalization by 26.2%, raising retention rates among …

Evaluation Of Breastfeeding Interventions To Improve Duration In Women At Risk For Breastfeeding Attrition, Anthonia Anukam

The Corinthian

Children that are optimally breastfed have the healthiest start in life. The World Health Organization and the CDC recommend that mothers optimally breastfeed. Benefits of breastfeeding to children include the receipt of antibodies, reduction of ear, respiratory, and gastrointestinal infections, decreased sudden infant death syndrome, allergies, diabetes, and childhood leukemia. Several research studies have reported a strong positive correlation between breastfeeding and reduced infant morbidity and mortality. Evidence illustrates that the health benefits from breastfeeding are dose-dependent, thus the longer the breastfeeding duration the greater the acquisition of the enumerated benefits. However, premature cessation of breastfeeding less than the WHO …

Barriers To Breastfeeding In Low Socioeconomic Populations, Nikki Goldberg, Paige Daws

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This literature review assessed and determined common themes among vulnerable populations for the initiation and continuation of breastfeeding habits. The barriers identified were divided into four themes including: lack of support, inflexible employment environment, differences of breastfeeding norms and education, and financial burden. Interventions identified in this literature review were community support programs and the implementation of hospital programs and initiatives to encourage breastfeeding. The need for this research and discussion stems from the sub-optimal infant feeding practices that contribute to infant mortality rates (Gallegos et al., 2020).

Increasing Ob/Gyn Clinic Nursing Staff Knowledge And Comfort Level In Providing Breastfeeding Education, Nancy Moore

Doctor of Nursing Practice Projects

There are well known benefits of breastfeeding for both mother and child, yet the educational support from providers during prenatal visits is not consistent or well-documented. An educational presentation discussing guidelines of breastfeeding education, common breastfeeding problems and barriers to breastfeeding was developed and presented to a “Baby Friendly” hospital-based OB/GYN clinic staff at an urban St. Louis hospital. The goal was to increase staff knowledge and comfort providing education and resources surrounding breastfeeding to be used to increase discussion of breastfeeding during prenatal and postpartum visits. Evaluation of pre and posttest data showed an increase in knowledge regarding managing …

The Impact Of Kangaroo Care On Exclusive Breastfeeding In Premature Infants, Colleen Larue

MSN Capstone Projects

This benchmark project emphasizes the crucial imperative of promoting exclusive breastfeeding among preterm and low birth weight infants in neonatal intensive care units (NICUs). Despite the well-documented benefits, exclusive breastfeeding rates remain disappointingly low. This evidence-based project focuses on early intervention through kangaroo care to bolster exclusive breastfeeding rates, with the overarching aim of enhancing infant outcomes and mitigating risks of mortality and morbidity. Engaging key stakeholders, including NICU leadership, nursing staff, lactation consultants, and families, is paramount for the successful implementation of the program. The project presents a detailed implementation plan encompassing various phases, from admission procedures to sustainability …

Nursing Care Regarding Social Determinants Of Health For Breastfeeding In Mothers And Infants, Natalie Jefson

Senior Honors Theses

Breastfeeding is incredibly important to the health and well-being of the mother-infant dyad. Because of this, there are both world-wide and national recommendations and guidelines for breastfeeding in the United States. Although many women choose to initiate breastfeeding, the percentage of women who continue breastfeeding for the recommended duration does not meet the Healthy People goal for the United States. Many factors influence this early breastfeeding cessation, including physical and socioeconomic barriers. Certain populations face increased barriers to reaching these goals related to social determinants of health which can and should be addressed by nurses through preventive measures and education.

Guideline For Breastfeeding Difficulty, Collin Naugher

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background

The American Academy of Pediatrics recommends exclusive breastfeeding for all infants until six months of age. In the United States, the exclusive breastfeeding rate is 52%, with a goal of 73% by Healthy People 2030 at six weeks of age. Breastfeeding difficulty will occur 70% of the time in mother-baby dyads, requiring some intervention by the primary care provider during the breastfeeding course. This study aims to build a clinical practice guideline that can guide interventions to improve successful breastfeeding rates in a birthing center.

Methods

The literature search was performed and condensed to an evidence table where studies …

Breastfeeding Support In Your Pocket: Evaluating The Impact Of A Mobile App On Maternal Success, Maygan Brandt

Nursing | Senior Theses

Background: Breastfeeding has well-known benefits for both the nursing infant and the birthing parent. It bolsters the newborn immune system, and reduces the risk of future health conditions in both parties. Due to these advantages, several health organizations internationally recommend exclusive breastfeeding until 6 months of age. However, only a fraction of infants in the United States meet this goal each year. Improved rates and duration of exclusive breastfeeding will lead to better long-term health outcomes for patients. The use of smartphone applications for breastfeeding education and support has not been thoroughly researched. Objective: This thesis explores the feasibility of …

An Educational Intervention To Improve Neonatal Icu Nurses’ Breastfeeding Support Knowledge, Self-Efficacy, And Breastfeeding Rates At Discharge, Sarah Money

DNP Projects

Background: The benefits of breastfeeding for both mother and baby are known. It is recommended that all infants be exclusively breastfed until six months (Meek & Noble, 2022; North et al., 2021). Despite this, breastfeeding rates remain low, especially in medically fragile infants requiring care in the neonatal intensive care unit (NICU) (Rollins et al., 2016). Receipt of evidence-based breastfeeding support by healthcare providers has been shown to improve breastfeeding success; however, many healthcare providers report not being comfortable or knowledgeable enough to offer support consistently (Mulcahy et al., 2022; Rollins et al., 2016).

Purpose: This study aims …

Study Protocol For A Stepped-Wedge Cluster (Nested) Randomized Controlled Trial Of Antenatal Colostrum Expression (Ace) Instruction In First-Time Mothers: The Ace Study, Cassandra Cuffe, Roslyn Giglia, Matthew N. Cooper, Julie Hill, Desiree Silva, Anita M. Moorhead, Valerie Verhasselt, Joshua R. Lewis, Deborah Ireson, Jill R. Demirci, Talea Cotte, Kathryn Webb, Frances Patey, Therese A. O’Sullivan

Research outputs 2022 to 2026

Background: Although many mothers initiate breastfeeding, supplementation with human-milk substitutes (formula) during the birth hospitalization is common and has been associated with early breastfeeding cessation. Colostrum hand expressed in the last few weeks before birth, known as antenatal colostrum expression (ACE), can be used instead of human-milk substitutes. However, evidence is lacking on the efficacy of ACE on breastfeeding outcomes and in non-diabetic mothers. Methods and Planned Analysis: This multicenter stepped-wedge cluster (nested) randomized controlled trial aims to recruit 945 nulliparous pregnant individuals. The trial is conducted in two phases. During Phase 1, control group participants are under standard care. …

Western Australian Mothers' Experiences Of Breastfeeding Support In Hospital After Birth: A Mixed Methods Study, Justine Van Der Watt

Theses: Doctorates and Masters

Background: The benefits of breastfeeding are well established for infants, mothers and the community, with the World Health Organisation recommending that infants be exclusively breastfed up to six months of age with an achievable goal of 70% globally. Yet in Australia only 15-37% may be reaching that goal. There have also been reported benefits and desires for mothers to be supported with their breastfeeding in order to increase and prolong breastfeeding duration and exclusivity, especially early after birth. However, there is limited research or literature exploring what experiences mothers are having with breastfeeding support, especially during their hospital admissions in …

Breastfeeding In Public: A Review Of Literature And Service Learning Experience, Taylor Jehlik, Makenzie Carney

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This article explores the perceptions and beliefs of first-time expectant mothers, their family members, and their social network about breastfeeding in public places. We used experience through Tiny Tusks and reviewed literature to get a better understanding of what social factors play a role in mothers' decisions to breastfeed in public.

World Allergy Organization (Wao) Diagnosis And Rationale For Action Against Cow's Milk Allergy (Dracma) Guidelines Update – X – Breastfeeding A Baby With Cow's Milk Allergy, Vicki Mcwilliam, Merryn Netting, Evelyn Volders, Debra Palmer, Ignacio Ansotegui, Stefania Arasi, Amal H. Assa'ad, Sami L. Bahna, Antonio Bognanni, Rose Kamenwa

Paediatrics and Child Health, East Africa

Cow’s milk allergy is rare in exclusively breastfed infants. To support the continuation of breastfeeding an infant after diagnosis with a cow’s milk allergy, it is critical to examine the evidence for and against any form of cow’s milk elimination diet for lactating mothers. In this narrative review, we highlight the lack of high-quality evidence, hence subsequent controversy, regarding whether the minuscule quantities of cow’s milk proteins detectable in human milk cause infant cow’s milk allergy symptoms. Current clinical practice recommendations advise a 2–4 week trial of maternal cow’s milk dietary elimination for: a) IgE-mediated cow’s milk allergy only if …

Tiny Tusk Internship: Barriers To Effective Breastfeeding Within Low Socioeconomic Populations, Catherine Johnson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Tiny Tusk Breastfeeding and Infant Support is a program created to facilitate safe and quiet places for mothers to breastfeed at various events at the University of Arkansas. It serves as a platform to spread important and essential information about breastfeeding to mothers and reach various women all from different backgrounds and populations. The purpose of this review of literature is to identify barriers that women within low socioeconomic populations face that influence their decision to breastfeed. These barriers included lack of social support from family, friends, and healthcare providers; latch difficulty; and concerns of milk supply. Altogether, low-income women …

Improving Breastfeeding Rates Through Education, Julianna Youssef

Doctoral Projects

Background: Breastfeeding is beneficial for newborn babies, but there are many challenges that new mothers face that prevent them from exclusively breastfeeding.
Objective: To evaluate if re-educational training in RN’s and LVN’s is an effective way to increase the exclusive breastfeeding rates in the hospital setting.
Methods: We utilized a pretest/post-test quasi-experimental design and had the goal sample size was about 50 nurses. The nurses were given an educational PowerPoint at a monthly staff meeting. Pretests were given to the staff immediately before and posttests two weeks later. Additionally, exclusive breastfeeding rates were monitored for the three months before the …

Effectiveness Of Follow Up Phone Calls On Postpartum Women After Discharge: A Program Evaluation, Camille Williams

Dissertations

After an expectant mother gives birth, they are closely monitored for 48 to 72 hours after delivery and then discharged from the hospital. They are then typically seen by their physician for a postpartum follow up appointment within six to eight weeks for their postpartum follow up visit. Although complications during this postpartum period can still arise, postpartum women are rarely assessed during this time. Follow-up phone calls have been known to improve patient outcomes and communication between patients and providers once patients are discharged from the hospital. In January of 2020, the Mother/Baby Unit at a midwestern metropolitan hospital …