Guest Post: Duval County Nurse-Family Partnership breastfeeding initiative

Cyndia Estime is the Continuous Quality Improvement (QCI) Coordinator for the Nurse-Family Partnership at the Coalition. Cyndia wanted to find out the different type of support womeiStock_000000548251Small b&wn needed to to increase their duration of breastfeeding. Cyndia created a three-question survey, and yielded results which exceeded her set goal.

The Duval County Nurse-Family Partnership is a free, voluntary and evidence-based home visiting program for first-time moms. Each mother is partnered with a registered nurse early in pregnanc
y and receives home visits through the child’s second birthday.
In May 2014, our team joined the National Home Visiting Collaborative Improvement and Innovation Network (HV CoIIN), selecting a breastfeeding topic for improvement as our focus of work in the collaborative charter. The primary goal of the HV CoIIN is to improve rates of initiation
and duration of breastfeeding. Collaboratively, our specific, measurable, achievable, relevant and time-bound (SMART) aim is 30 percent of children will be fed breastmilk exclusively until three months and 15 percent until six months. Activities of the collaborative network include learning sessions, webinars, conference/topic calls, emails and utilizing the Plan-Do-Study-Act (PDSA) model of improvement to test changes moving toward improvement.
This two-year collaborative learning effort results in the development of reliable, effective policies and practices that support families through critical windows for breastfeeding decision-making, which involve the provision of breastfeeding education at enrollment, 36 weeks gestation and ensuring mothers complete infant feeding plan prior to delivery. Our data shows 92 percent of pregnant women reported intention to breastfeed at enrollment and 100 percent at 36 weeks gestation. The data also shows 71 percent initiated breastfeeding at delivery.

To increase the duration of breastfeeding, we created a questionnaire. Eight women who are currently breastfeeding, at different lengths of time, participated in the questionnaire.

The questionnaire asked:
1. What is helping you to BF until now?
2. What do you think might stop you from breastfeeding in the next few weeks?
3. What support do you think might make it easier for you to continue breastfeeding?
We then analyzed the results and the clients’ needs were identified.

Their responses include:

1. Support from International Board Certified Lactation Consultant (IBCLC) and
Nurse-Home Visitor
2. Support to pump regularly/having a better pump
3. Good family support and acceptance to breastfeed
4. Support to breastfeed for one year
5. How to stop baby from biting during feeding
6. Scheduling time for house chores and child care
7. Support to breastfeed as long as possible

We decided to give each client the necessary support in order to increase the duration of breastfeeding. At the end of this project, six mothers have breastfed for three months and two mothers have reached six months of breastfeeding.