This paper reports on two surveys of nurses and midwives working in a large pediatric hospital and three neonatal units in London, England, regarding support for mothers to provide breast milk. One hundred and twenty-two pediatric staff and 55 neonatal staff returned the questionnaires. Fifty-three percent of pediatric staff had received no training in breastfeeding during or after nursing school. Twenty-two percent of neonatal staff had no relevant training, yet they frequently were asked to help mothers in providing breast milk for their infant. Some respondents demonstrated lack of relevant knowledge including the importance of breast milk, ideal frequencies for milk expression, and the potential to establish lactation at any time. There was a wide range of comments on the barriers in providing breast milk. These results illustrate the need for appropriate breastfeeding policies and staff training. There is a particular lack of studies based in the United Kingdom on breastfeeding in pediatric units. It is hoped that this article will generate discussion among staff about the breastfeeding support they offer and ways to strengthen it.
1. British Paediatric Association. Is breastfeeding beneficial in the UK?Arch Dis Child1994; 71:376-380.
2.
2. Lawrence PB. Breast milk-Best source of nutrition for term and preterm infants. Pediatr Clin N Amer1994; 5:925-941.
3.
3. Foster K, Lader D, Cheesbrough S.Infant Feeding 1995. London: Office for National Statistics, HMSO, 1997.
4.
4. White A, Freeth S, O'Brien M.Infant feeding 1990. London: Office of Population Censuses and Surveys, HMSO, 1992.
5.
5. Jaeger MC, Lawson MS, Filteau S.The impact of prematurity and neonatal illness on the decision to breastfeed. J Adv Nursing1997; 25:729-737.
6.
6. Hauck Y, Dimmock J.Evaluation of an information booklet on breastfeeding duration: A clinical trial. J Adv Nurs1994; 20:836-845.
7.
7. Helsing E.Feeding practices in Europe: Beliefs and motivations and possibilities for change. J Trop Pediat1984. 30:244-252.
8.
8. McNatt M, Freston M.Social support and lactation outcomes in postpartum women. J Hum Lact1992; 8:73-77.
9.
9. Mulford C.Swimming upstream: Breastfeeding care in a non breastfeeding culture. J Obstet Gyn Neonat Nurs1995; 24:464-474.
10.
10. Dean AG et al. Epi Info Version 6: A word processing, database and statistics program for epidemiology on microcomputers. Atlanta, GA: Centers for Disease Control and Prevention, 1994.
11.
11. Jones D.Attitudes of breastfeeding mothers: A survey of 649 mothers. Soc Sci Med1986; 23:1151-1156.
12.
12. Dix D.Why women decide not to breastfeed. Birth1991; 18:222-225.
13.
13. Kaufman K, Hall L.Influences of the social network on choice and duration of breastfeeding in mothers of preterm infants. Research in Nursing and Health1989; 12:149-159.
14.
14. Stewart A.Carers or outsiders? The role of parents on a neonatal unit. Midwives Chronicle and Nursing Notes1991; April: 118-124.
15.
15. Barnett E, Sienkiewicz M, Roholt S.Beliefs about breastfeeding: A statewide survey of health professionals. Birth1995; 22(1):15-20.
16.
16. Isabella P, Isabella R. (1994) Correlates of successful breastfeeding: A study of social and personal factors. J Hum Lact1994; 10:257-264.
17.
17. Beeken S, Waterston T.Health service support of breastfeeding Are we practising what we preach?Brit Med J1992; 305:285-287.
18.
18. Rodriguez-Garcia R, Schaefer L.Breastfeeding: An old practice or a new technique?Hygiene1991; 10:5-10.
19.
19. Jelliffe D, Jelliffe P.Breastfeeding: World significance in obstetric practice. J Trop Ped1983; 29:130-132.
20.
20. Becker G.Breastfeeding knowledge of hospital staff in rural maternity units in Ireland. J Hum Lact1992; 8:137-142.
21.
21. Williams E, Hammer L.Breastfeeding attitudes and knowledge of paediatricians-in-training. Amer J Prevent Med1995; 11 (I):26-33.
22.
22. Lewinski C. (1992) Nurses' knowledge of breastfeeding in a clinical setting. J Hum Lact1992; 8:143-148.
23.
23. Morley R, Cole TJ, Powell R et al. Mother's choice to provide breast milk and developmental outcome. Arch Dis Child1988; 63:1382-1385.
24.
24. Lucas A, Cole T.Breast milk and neonatal necrotizing enterocolitis. Lancet1990; 336:1519-1523.
25.
25. Lucas A, Morley R, Cole T.Breast milk and subsequent intelligence quotient in children born preterm. Lancet1992; 339:261-264.
26.
26. Williams AF. Human milk and the preterm baby. Brit Med J1993; 306:1628-1629.
27.
27. Welford H.Breastfeeding: Promoting good practice. Modern Midwife1995; 5(11):290-230.
28.
28. Heidberg-Endresen E, Helsing E.Changes in breastfeeding practices in Norwegian maternity wards: National surveys 1973, 1982 & 1991. Acta Paed Scand1995; 84:719-724.
29.
29. Lancet Editorial. (1994) A warm chain for breastfeeding. Lancet1994; 344:1239-1241.
30.
30. Danner S.How do we influence the breastfeeding decision?Birth1991; 18(4):227-228.
31.
31. Auerbach K, Walker M.When the mother of a premature infant uses a breast pump: What every NICU nurse needs to know. Neonatal Network1994; 13(4):23-29.
32.
32. Spiro A, Robinson J.Promoting breastfeeding in a hospital neonatal unit. Health Visitor1994; 67(5):169-169.
33.
33. Swanepoel C.Breastfeeding your premature baby. Nursing RSA Verpleging1990; 5(2):35-37.
34.
34. Meir P, Engstrom J, Mangurten H, Estrada E, Zimmerman B, Kopparthi R.Breastfeeding support services in the Neonatal Intensive-Care Unit. J Obstet Gyn Neonat Nurs1993; 22:338-347.
35.
35. Hill P, Anderson J, Ledbetter R.Delayed initiation of breastfeeding the preterm infant. J Perinat Neonat Nurs1995; 9(2):10-20.
36.
36. Ziemer M, George C.Breastfeeding the low-birthweight infant. Neonatal Network1990; 9(4):33-38.
37.
37. National Breastfeeding Working Group. Breastfeeding: Good Practice Guidance to the NHS. London: Department of Health, HMSO, May 1997.
38.
38. Valaitis R.An evaluation of breastfeeding promotion literature: Does it really promote breastfeeding?Can J Pub Health1993; 84(1):24-27.
39.
39. Royal College of Midwives (RCM). Successful breastfeeding-A practical guide for midwives. London: Edward Mortimer, 1989.
