Improving breastfeeding duration through creation of a breastfeeding-friendly pediatric practice

Background: Breastfeeding is the gold standard for infant feeding. In the United States, 83.2% of women initiate breastfeeding on their infant's birth. When the infant reaches 6 months of age, however, only 57.6% of mothers are still breastfeeding, and a mere 24.9% are breastfeeding exclusively. Local problem: Breastfeeding rates in rural areas are below the national averages. The greatest disparities exist in minorities and individuals with lower educational and socioeconomic status. Methods: A preintervention/postintervention design was used for this quality improvement project. The Model for Improvement's Plan, Do, Study, Act cycle guided the project processes. Breastfeeding rates were obtained at each well-child visit from newborn through 4 months of age. On completion, mean preimplementation and postimplementation breastfeeding rates were compared to determine effectiveness. Interventions: A breastfeeding support initiative was implemented at a multisite rural Illinois pediatric practice. An evidence-based breastfeeding policy was developed, staff education sessions were conducted, private lactation rooms were created, and breastfeeding photographs/posters were displayed throughout the offices. Lactation support services were publicized via signs and social media postings. Results: Overall breastfeeding rates were higher at each time point after implementation. Statistically significant increases occurred at the newborn and 1-month visits, with a modest improvement at 2 and 4 months. Conclusions: This project demonstrated an improvement in breastfeeding duration rates. It is anticipated that this practice-wide standard of care change will promote breastfeeding throughout the first 12 months of life.