Implementing an education program for nurse-midwives focused on early essential care for breast milk expression among mothers of preterm infants

Abstract

Background Although breastfeeding guidelines for infants admitted to the neonatal intensive care unit (NICU) have been introduced in Japan, these guidelines have not been reflected in practice. To improve this situation, it is important for nurses and nurse-midwives to acquire knowledge of appropriate care. This study examined changes in nurse-midwives’ knowledge, attitude, and implementation of appropriate care after implementing an education program focused on early essential care for breast milk expression among mothers of preterm infants. Methods This pre- and post-intervention study using a single group was conducted from June 2018 to May 2019 and enrolled 36 nurse-midwives in one perinatal medical center. The education program content included nurses’ roles in early essential care for milk expression and the necessary care to promoting breast milk production among mothers of preterm infants. The nurse-midwives’ knowledge and attitude on care were investigated 3 months before (pre-1), just before (pre-2), just after (post-1), and 3 months after (post-2) the program. The nurse-midwives’ care implementation was investigated at pre-1, pre-2, and post-2. During this time, 11 mothers (before: 7, after: 4) reported the status of milk expression for 10 days after birth. Results The mean knowledge scores of the nurse-midwives at post-1 and post-2 were significantly higher than that at pre-2 (post-1: p < 0.001, post-2: p < 0.001). The attitude on care scores at post-1 and post-2 were significantly higher than that at pre-2 (post-1: p < 0.001, post-2: p = 0.010). The care implementation score at post-2 was significantly higher than that at pre-2 in eight items (e.g., Q7 Explain about the effect of initiating milk expression early and assist mothers in it). However, the education program did not cause any changes in the mothers’ initiation and frequency of milk expression, and breast milk volume after birth. Conclusions The significant increases in the knowledge, attitude on care, and care implementation scores of the nurse-midwives suggest the beneficial effects of the education program. The small number of mothers in the survey on the practice of breast milk expression limited the full determination of the benefits of the education program for nurse-midwives.

Benefits and issues of education program for nurse-midwives on milk expression care for preterm mothers in postpartum period

“…We performed an exploratory secondary analysis of the data obtained in our previous pre-post interventional study in one group [ 27 ]. In our previous study, the primary outcome was the difference in knowledge score between just before and just after the education program at a sample size of 34.…”

“…The education program included nursing care which should be implemented mainly in the obstetric ward after birth for preterm mothers. We indicated the contents of the education program in Box 1 [ 27 ]. Lecture materials were created as slides and distributed to the participants.…”

“…Therefore, we previously designed and implemented an education program for nursing professionals on the importance of milk expression care for preterm mothers in the early puerperium period using a pre-post interventional study in one group. The implementation of the education program significantly enhanced the knowledge, attitude, and care implementation of nurse-midwives [ 27 ].…”

“…In the present study, we performed a secondary analysis of the data of our previous study [ 27 ], which involved the assessment of 20 knowledge items of the developed education program. Our specific aims were to assess the effects of our educational program on nurse-midwives' knowledge of breast milk expression care for preterm mothers in terms of changes in their correct answer rates for 20 specific knowledge items before and after implementation of the education program, and to identify program-related issues based on the nurse-midwives' comments that can be considered for improving the program.…”

Breastfeeding and Human Lactation Curriculum Survey of Midwifery Programs in the United States

“…Previous published reports have described breastfeeding knowledge and attitudes of individual midwives in the United States, 19,20 as well as in other countries. 21,22 These studies found that although participants were generally supportive of breastfeeding, they exhibited knowledge deficits specifically related to breastfeeding management. Recommendations in these studies included the need for increased breastfeeding and lactation education for midwives.…”