Scholarship & Research
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Item Standardizing lactation education for home visiting staff to improve breastfeeding duration rates(Montana State University - Bozeman, College of Nursing, 2020) Reed, Samantha Alicia; Chairperson, Graduate Committee: Angela JukkalaBreastfeeding has been shown to improve short-and long-term health outcomes to both mother and child. Health departments are in a unique role to provide community level support in breastfeeding. Gallatin-City County Health Department provides breastfeeding support through multiple programs within the community, including maternal child health home visiting. Based on a recent survey, results showed that half of home visitors did not feel confident in educating prenatal clients on breastfeeding. In addition to this, home visitors did not feel they were providing the same education on breastfeeding. Stemming from this, the need for a standardized lactation curriculum was researched. Ready, Set, Baby is an evidence-based standardized curriculum that increases a mother's knowledge of breastfeeding benefits and practices. This scholarly project examines home visiting staff education on Ready, Set, Baby curriculum, improved breastfeeding education with home visiting families, and improved breastfeeding duration rates.Item Delivering prenatal breastfeeding education to a vulnerable population in rural Montana(Montana State University - Bozeman, College of Nursing, 2019) Young, Cindy Rae; Chairperson, Graduate Committee: Julie Ruff; Helen Melland (co-chair)The educational project aimed to document the efficacy of delivering prenatal breastfeeding education on exclusive breastfeeding (EBF) rates of mothers identified as vulnerable in a rural western Montana community. A convenience sample was utilized to implement the pilot project that included three educational sessions, taught by certified lactation counselors scheduled to coincide with routine prenatal appointment. A control group (CG) was established from a two-month sample of mothers delivering at the implementation site one year before implementation. The education was expected to enhance breastfeeding intentions as evidenced by the scores on the Infant Feeding Intentions (IFI) Scale, thus leading to higher rates of EBF in the participant group (PG) versus a control group. The PG mothers had slightly higher rates of EBF at both hospital discharge (PG 62% vs. CG 59%) and 7-10 days after birth (PG 57% vs. CG 53%), which failed to show statistically significant differences. One statistically significant difference was noted in the higher rates of EBF at 7-10 after birth for PG first-time mothers versus CG first-time mothers (73% vs. 0%, p < .001, 95% CL), indicating prenatal breastfeeding education may have made a more significant impact with first-time mothers. However, the efficacy of delivering prenatal breastfeeding education to impact EBF rates in this vulnerable population can neither be supported nor refuted based on the project results. A review of medical records showed that over 90% of the participant mothers attempted to breastfeed in the hospital (control 76%) and 75% of participant mothers who were not EBF while in the hospital were still giving their infant their breast milk versus 33% of the CG mothers. Seventy-five percent of the PG and CG mothers who were not EBF at 7-10 days were offering breast milk with formula supplementation. Due to acknowledged limitations in design, measurement and data collection, it is not possible to credit the statistically significant results mentioned above to the educational project. This project did provide useful information to guide future project modifications in implementation design and significant suggestions for further study.Item Prenatal breastfeeding education toolkit for baby-friendly hospitals(Montana State University - Bozeman, College of Nursing, 2017) Olivo, Elizabeth Ann; Chairperson, Graduate Committee: Maria WinesStudies suggest that approximately half of women do not meet their breastfeeding goal. The objectives of this study were to implement a prenatal breastfeeding education toolkit, assess prenatal breastfeeding goals, gauge breastfeeding goal attainment at 10 weeks postpartum, and evaluate patient variables that may impact goal attainment. The educational information was compiled into a toolkit and divided into three sections, one for each trimester. After completing at least one trimester of education, patients were then asked to fill out a survey on their breastfeeding goals. They were contacted by phone at approximately 10 weeks postpartum to assess how their breastfeeding was progressing and if they were still on track to meeting their goals. A total of 20 participants were included in data analysis. The reported goal duration of the whole cohort ranged from 16 weeks to two years with an average of approximately 50 weeks. The majority (75%) reported that they planned to breastfeed exclusively. At 10 weeks postpartum, 65% of subjects were on track to or had met their goal breastfeeding duration. Subsequently, 35% reported early cessation of breastfeeding prior to reaching their goal. Of the 15 participants who planned to breastfeed exclusively, only about half (53%) were still exclusively breastfeeding at the time of follow-up. Patients who planned to supplement with formula from an early stage were more than twice as likely (60%) to have early cessation of breastfeeding compared to those who planned to breastfeed exclusively (27%). The results of this study suggest that most women would like to breastfeed exclusively and for longer periods of time. Unfortunately, many continue to fall short of their goals. Planning to breastfeed exclusively appears to increase the mother's chance of reaching her goals at ten weeks postpartum. The literature has shown that prenatal education has a positive impact on breastfeeding rates. Unfortunately, due to time constraints, this study was unable to evaluate the impact of the entire prenatal breastfeeding education toolkit on breastfeeding goal attainment.Item Prenatal lactation counselor effect on breastfeeding duration for mothers at risk for early weaning(Montana State University - Bozeman, College of Nursing, 2016) Havens, Jessica Mary Evelyn; Chairperson, Graduate Committee: Maria WinesThe main objective of this project was to determine the effectiveness of a prenatal consult with a Certified Lactation Counselor (CLC) on breastfeeding duration for mothers at risk for early weaning. We conducted a cohort study that utilized a blinded control trial design. Mothers were recruited from two large OBY/GYN clinics in the northwest United States, and participants were divided into a control group and an experimental group. The experimental group received the prenatal intervention which consisted of one consult with a CLC. The results of the study indicated that mothers with lower scores on the BAPT (Breastfeeding Attrition Prediction Tool) control section showed a slight trend for decreased breastfeeding intensity at eight weeks postpartum as measured by the Index of Breastfeeding Status (IBS). Experimental and control groups had similar patterns in BAPT scores and IBS rates at eight weeks. With the results in mind, the BAPT control section may be a useful tool for prenatal care providers to utilize to help identify mothers who are at high risk to not meet their breastfeeding goal. The results of this study neither support nor discourage the practice of referring high risk mothers to a lactation expert prenatally, but providers can consider this an option for providing additional breastfeeding education and support for their patients.Item A survey to determine the differences in child rearing practices and child development of a selected group of bottle and breast fed infants during the first year of life(Montana State University - Bozeman, College of Professional Schools, 1966) Dyas, Beverly JeanItem A survey of the incidence of child rearing practices of bottle and breast feeding in a selected community(Montana State University - Bozeman, 1964) Winslow, Lucille Jane Shipley; Chairperson, Graduate Committee: Eleanore L. ModeItem Factors that influence successful breastfeeding in low-income women(Montana State University - Bozeman, College of Nursing, 1993) Meyer, Joyce HultmanItem Change in practice used to quantify breast milk intake of pre-term infants in a neonatal intensive care unit : test-weighing to 'Salt Lake City Feed Plan'(Montana State University - Bozeman, College of Nursing, 2009) Treloar, Allison Kirsch; Chairperson, Graduate Committee: Elizabeth S. KinionA local community hospital in Montana expressed a desire to establish a written clinical guideline for transitioning preterm infants from enteral gavage feedings to oral feedings. This desire was prompted by a change in the method of quantifying breast milk intake of preterm infants when transitioning them from enteral gavage feedings to at-breast feedings in a Neonatal Intensive Care Unit (NICU). The hospital changed from the practice of test-weighing as a clinical indicator to quantify breast milk intake to the "Salt Lake City Feed Plan". Procedures: Retrospective data from four consecutive years were collected from quality assessment chart audit data provided to the author in aggregate form. Twenty-nine records met the selection criteria. A descriptive presentation of the aggregate data follows. Results: The average number of total deliveries per year was 1,151. The average percentage of preterm deliveries that occurred between 32 - 37 completed weeks of gestation was 16.3 percent. Of the twenty-nine records that met the selection criteria, 17 were male and 12 were female. The birth weight ranged from 1.75 kilograms (kg) to 2.31 kg. Weight at discharge ranged from 2.66 kg. to 2.99 kg., indicating a weight gain of 0.68 kg. to 0.91 kg. at discharge. Number of days with an indwelling nasogastric enteral feeding tube ranged from 1 to 23 days. Length of hospital stay ranged from 7 to 29 days. The length of stay for exclusively bottle fed preterm infants ranged from 13 to 27 days, whereas the breastfeeding preterm infants who utilized test -weighing or the "Salt Lake City Feed Plan" ranged from 7 to 29 days. Breast fed preterm infants in whom test-weighing or the "Salt Lake City Feed Plan" was utilized had 4 to 4.315 fewer days of hospitalization compared to preterm infants who were exclusively bottle-fed. Conclusion: The literature review and the aggregate data collected by the rural community hospital provide baseline information to create, implement and support an evidence-based clinical guideline to transition preterm infants from enteral gavage feedings to oral feeding.Item How do knowledge and attitudes relate to the initiation of breastfeeding in Native American women in a North Dakota health care facility?(Montana State University - Bozeman, College of Nursing, 2012) Thomas, Jennifer Lee; Chairperson, Graduate Committee: Barbara Derwinski-RobinsonDespite research consistently demonstrating the benefits of breastfeeding, Native American women in North Central North Dakota have the lowest rate of breastfeeding in North Dakota with a rate of 8.24%. The reasons why these women are not breastfeeding are not known. There have been no studies regarding the attitudes and knowledge about breastfeeding of these women or their health care professionals. The purpose of this study was to assess the knowledge and attitudes about breastfeeding in this population. Thirteen pregnant women, ten women who have given birth, and twelve health care professionals who provide care to these women comprised the sample of this descriptive study. The results of the surveys demonstrated that these women knew the benefits of breastfeeding but the majority of them did not breastfeed their infants. Attitudes seem to be a more relevant factor than knowledge in influencing breastfeeding initiation in this sample of women. Health care providers should be aware that their own attitude toward breastfeeding may affect a woman's choice to breastfeed. Results also demonstrated the health care professionals had limited education about infant feeding, lactation, and breastfeeding. These health care providers may be providing conflicting and possibly incorrect knowledge about breastfeeding. Current evidence based breastfeeding recommendations and practices should be incorporated into continuing education so consistent and correct information is provided. Health systems should establish a baby friendly environment that supports and encourages breastfeeding. In addition, the unique characteristics of the Native American women in North Central North Dakota, or any community in which one lives or works, should be considered to better plan interventions that will be effective and sustainable. It is not one identifiable factor that the decision to breastfeed is dependent upon, but factors that may interact and overlap in ways to influence a women's decision to breastfeed. Understanding context is vital to designing and implementing successful interventions in breastfeeding promotion. Culturally relevant information gathered from this population may not be transferable to others in this particular tribe who may live somewhere else or to other Native American tribes, as their specific cultural attributes may be different from this particular tribe.