Home Visits by Nurses Greatly Improve Breastfeeding Rates
Leading Nursing Journal Published Study on Using Home Visits to Provide Breastfeeding Support and Screen for Jaundice
New mothers’ concerns or problems with breastfeeding peak three to seven days after birth. At that time, the mother has typically left the hospital and lacks professional breastfeeding support. However, home-visiting nurses can help mothers navigate breastfeeding challenges. Having a nurse to address concerns like infant feeding problems or worries about milk quantity can help increase breastfeeding rates among mothers. It also enables them to maintain breastfeeding for longer, with numerous health benefits to their babies.
In the U.S., about 76% of women initiate breastfeeding after birth while at the hospital, but the rate drops to 38% at six months. Only 16% of U.S. newborns are exclusively breastfed at six months. With the goal of increasing rates of breastfeeding at six months and identifying any maternal or newborn health issues promptly, nurses in a Florida health system implemented an evidence-based nurse home visitation program for new mothers.
In “Enhancing Neonatal Wellness with Home Visitation,” Carlo Parker, PhD, RN, CNL; Geene Warmuskerken, RN; and Lorna Sinclair, BA, RN, describe how the program implemented nurse home visits to evaluate the health of mothers and infants while also educating mothers about breastfeeding. This article appears in the February/March 2015 issue of Nursing for Women’s Health, the clinical practice journal of the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN).
The Mother Baby Home Visitation Project (MBHVP) paired mothers and their newborns with registered nurses for home visits at three to seven days postpartum to encourage exclusive breastfeeding and provide an overall health assessment, including monitoring infants for jaundice. Research shows that new mothers’ concerns or problems with breastfeeding peak during this time period, which results in many mothers stopping breastfeeding within the first two months of the postpartum period.
“It appears that the need for breastfeeding support extends past the time that most mothers have access to that support, suggesting that home or community-based interventions after discharge may offer the opportunity to continue and reinforce education and support on breastfeeding and neonatal care,” wrote the authors.
Although research overwhelmingly shows that breastfeeding provides the best nutrition for newborns, 24% of mothers never breastfeed their babies. Current guidelines from nursing and physician organizations recommend exclusive breastfeeding during the first six months of life, followed by continued breastfeeding during the first year or more as new foods are introduced.
“Early nurse visits to the home setting help build the patient relationship to address important health issues for mothers and their newborns,” said AWHONN’s CEO, Lynn Erdman, MN, RN, FAAN. “Supporting mothers in meeting their breastfeeding goals is central to the role of the nurse.”
Adequate nutrition reduces the risk of the most common threats to newborn health during the first few months of life, including jaundice, weight loss and dehydration. For infants, breastfeeding is associated with reductions in obesity, sudden infant death syndrome (SIDS), diabetes, asthma, respiratory tract infections, and other conditions.
In-home or community-based breastfeeding support has been recommended as a strategy to reduce the incidence of newborn readmission of newborns for malnutrition, dehydration and jaundice. Previous research shows that support services can have a positive effect on breastfeeding rates. Being face-to-face in a home setting facilitates a therapeutic nurse-patient relationship and helps nurses address important health needs for mothers and newborns. It also provides the opportunity for nurses to evaluate the home environment and educate mothers as needed.
The evaluation of the Florida program found that breastfeeding was started at a rate of 80% and at six months 56% of mothers were still breastfeeding. Additionally jaundice was better recognized, leading to quicker readmission and shorter average hospital stays for treatment. All participants reported satisfaction following the first visit and reported the program had helped them with continuing to breastfeed.