Develop an implementation plan (1,500-2,000 words) using the "Topic 3: Checklist" resource. The elements that should be included in your plan are listed below:

Running head: LITERATURE REVIEW 1

Rosen, I. M., Krueger, M. V., Carney, L. M., & Graham, J. A. (2008). Prenatal breastfeeding education and breastfeeding outcomes. MCN, The American Journal of Maternal/Child Nursing, 33(5), 315-319.

Summary of Article: the authors of this article examine the impact of various breastfeeding outcomes of three cohorts receiving different methods of prenatal breastfeeding education.

Research Elements: Design, Methods, Population, Strengths, Limitations:

Methods: Retrospective cohort design with patients attending a breastfeeding education class at an Army medical center. One hundred ninety-four mothers who expressed intent to breastfeed received breastfeeding education in three different methods; video demonstration and group teaching, one on one and a third group were educated but no teaching. The data was analyzed using the Descriptive statistics, chi-square, ANOVA, unpaired t test, and logistic regression. The findings were that there was a significant increase in the breastfeeding rate for the women who received breastfeeding education at six months compares to those who did not receive education (Rosen, Krueger, Carney. & Graham. 2008, p. xx).

Significance to Nursing and Patient Care: How Nurses Can Support Breastfeeding Providing health education, including on such topics as breastfeeding, is a vital part of the professional role of a nurse. Nurses are also in a unique position to enhance a mother’s breastfeeding success as she transitions into the workplace.

Udgiri, R., K. J., S., & Sorganvi, V. (2015). Breast feeding practices among postnatal mothers-a hospital based study. Journal of Advanced Scientific Research, 6(1), 10- 13.

Summary of Article: Udgiri & Sorganvi (2015) Carried out a study in which they assessed the knowledge and practices of mothers about breastfeeding Practices by interviewing postpartum mothers admitted to the general ward of OBG department (within 5 days) in Shri B. M. Patil medical college. The study indicates there are many inappropriate feeding practices and knowledge among mothers. There was association with prenatal education for the mothers who did exclusive breastfeeding compared to know education and moms who fed their babies with pre-lacteal feeds.

Research Elements: Cross- sectional study was carried out in one month. The sample size consists of 162 postpartum moms admitted to a postpartum unit. The study further indicates that 21(12.9%) of the babies were fed with pre-lacteal feeds like honey and sugar water.

Significance to Nursing and Patient Care: Therefore reinforcement and sensitization is required for health care providers as well as mothers. Knowledge alone is not going to determine successful breastfeeding practice, for early initiation of breastfeeding even in a hospital background (Udgiri & Sorganvi, 2015).

# 3

Asfaw, M. M., Argaw, M. D., & Kefene, Z. K. (2015). Factors associated with exclusive breastfeeding practices in Debre Berhan District, Central Ethiopia: a cross sectional community based study. Int Breastfeed J, 10(23),.. doi: 10.1186/s13006-015-0049-2

Summary of Article: (Asfaw, Argaw, & Kefene, 2015, p. xx), in this article, researched into the factors associated with EBF practices among mothers who have an infant aged below 12 months in Debre Berhan District, Ethiopia. The purpose was that Ethiopia adopted the WHO recommendations to breastfeed infants exclusively for the first six months of life due to the high mortality rate of children under five years of age (Asfaw, Argaw, & Kefene, 2015, p. xx).

Research Elements: Design, Methods, Population, Strengths, and Limitations: the authors used a cross sectional community based quantitative survey method, by collecting data for a four month period from January through April 2014.the strength of the methodology of this research is that the authors where able to identify to various practices affecting EB practices. The limitations of mothers who didn't receive infant feeding counselling was 0.42 times less likely to practice EBF than those who received Counselling services 

Outcome(s): Research Results: 634 mothers with their index infant aged less than 12 months. The knowledge and attitude of mothers towards EBF was found to be very high in the mothers who received some form of education about breastfeeding in the prenatal period. And those who did not receive cancelling services were less likely to practice EBF.

Significance to Nursing and Patient Care: Breastfeeding education and counselling is very important to mothers who intend to breastfeed. Nurses provide health education to their patients and have the power to influence their health promoting and disease prevention behaviors.

#4

Onah, S., Osuorah, D. I., Ebenebe, J., Ezechukwu, C., Ekwochi, U., & Ndukwu, I. (2014). Infant feeding practices and maternal socio-demographic factors that influence the practice of exclusive breastfeeding among mothers in Nnewi South-East Nigeria: a cross- sectional and analytical study. International Breastfeeding Journal, 9(1), 1- 18.Retrieved from Doi: 10.1186/1746-4358-9-6.

Summary of Article: The article describes the feeding practices of infants below six months of age and determines maternal socio-demographic factors that influence the practice of exclusive breastfeeding (EBF) among mothers in Nnewi, southeast Nigeria. Information on breastfeeding was based on infant feeding practices.

Research Elements: Design, Methods, Population, Strengths, Limitations: Review of Literature. Reviewed 71 articles regarding breastfeeding initiation.

Outcome(s): Research Results: Practices in the intrapartum and early postpartum period affect breastfeeding initiation. A mother’s intentions regarding breastfeeding are a strong predictor of breast feeding initiation. Most women who decide early to breastfeed were those who received prenatal education. The earlier that a woman decides to breastfeed the greater the likelihood that breastfeeding will be initiated. Onah, Osuorah, Ebenebe, Ezechukwu, Ekwochi, & Ndukwu, (2014).

Significance to Nursing and Patient Care: Improving mother’s awareness of breastfeeding recommendations and strengthening their intention to initiate breastfeeding could lead to increased breastfeeding initiation and duration rates.

#5

Gladius, J. H., & Muthukumar, K. (2012). A Cross-sectional descriptive study to the aim of the study was to estimate the prevalence of early initiation and exclusive breast feeding in the rural health training center of a medical college in Tamilnadu, Southern India. Journal of Clinical & Diagnostic Research, 6(9), 1514-1517.

Gladius & Muthukumar (2012) carried out a study to estimate the occurrence of the early initiation and exclusive breastfeeding; following the recommendations of the world health organizations (WHO). The objective of this study was to estimate the prevalence of the early initiation of and exclusive breast feeding.

The strength of this study is that it identified prenatal education as a contributory factor for the 97.5% rate of breastfeeding Initiation, a 68% for exclusive breast feeding in the study population. It shows that education of the antenatal mothers on the benefits of breastfeeding and hygienic feeding practices. These will help to achieve 80% exclusive breastfeeding as per the national guidelines on infant and young child feeding (Gladius, & Muthukumar 2012).

The significance to nursing and patient care is that the education of the antenatal mothers on the benefits of breast feeding and hygienic feeding practices and making all hospitals baby friendly have to be focused on, in order to achieve 80% exclusive breast feeding as per the national guidelines on infant and young child feeding. We need to strengthen the MCH services in the study area in order to achieve 100% immunization.

#6

Mohite, R. V., Mohite, V. R., & Kakade, S. V. (2012). Knowledge of breastfeeding among primigravida mothers. Bangladesh Journal of Medical Science, 11(4), 312-316.

The article provides an appraisal on the familiarity of breastfeeding among primigravida mothers attending an ante-natal clinic. Additionally, it determines the association between socio-demographic variables with their knowledge. Socio-demographic frequency percentage distribution, knowledge scoring, and a statistical association were analyzed by using chi-square test. Out of 590 primi gravida mothers, 59.66% showed a fair quality of knowledge about breastfeeding. Bottom line is that the study identified a relationship between prenatal breastfeeding education and breastfeeding initiation among first-time moms. What this means to nursing and patient is the need to push for high quality prenatal breastfeeding education so that the WHO recommendations of 80% exclusive breastfeeding will be achieved.

#7

Danilova, V., Joventino, E., Arcanjo, D., Veras, J., Dodt, R., Oriá, M., & Ximenes, L. (2009). Postpartum women's knowledge about breastfeeding -- a descriptive study [English]. Online Brazilian Journal of Nursing, 8(3).

The authors of this study conducted this research to confirm that there is a relationship between educational level and prenatal education on breastfeeding compliance. The study shows that some mothers do not comply with breastfeeding due to lack of knowledge of that practice. The study was conducted at a local maternity by interviewing 150 postpartum women between the eighteen and thirty-five years of age. The findings of the study were able to detect that some of the factors that influence breastfeeding outcome is the breastfeeding instructions and prenatal consultations.

Significance to Nursing and Patient Care: There is a need to, therefore, strengthen prenatal care awareness and education towards breastfeeding. Improving mother’s awareness of breastfeeding recommendations and strengthening their intention to initiate breastfeeding could lead to increased breastfeeding initiation and duration rates.

#8

Russell, B. K., Aviles, M., & Brion, L. P. (1999). Relationship between perinatal counseling and Incidence of breastfeeding in an inner-city population. Journal of Perinatology, 19(7), 501.

Russell, Aviles, & Brion, (1999), conducted a retrospective study of breastfeeding among 7942 mothers whose new born infants were admitted to the well-baby nursery at Jacobi Medical Center (JMC) over a period forty-four-month. Mothers were further classified into three groups according to location of prenatal care and attendance at breastfeeding education sessions. There was an increase in the breastfeeding rate among those who received breastfeeding education through counseling, with prenatal care and with breastfeeding education sessions.

Significance to Nursing and Patient Care: There is a need to, strengthen prenatal care awareness and education towards breastfeeding. Improving mother’s awareness of breastfeeding recommendations and strengthening their intention to initiate breastfeeding could lead to increased breastfeeding initiation and duration rates. In this case, breastfeeding was considerably linked with counseling by obstetric staff, the antenatal care at JMC, and with the breastfeeding education classes.

#9

Goodling, G., Ott, A., & Rapp, B. (2014, May 6). Does Prenatal Breastfeeding Education Increase the Breastfeeding Initiation Rate? Retrieved from http://pennstatehershey.org

(Goodling, Ott, & Rapp, 2014), conducted a literature search to investigate the influence of prenatal breastfeeding education in increasing breastfeeding a mother’s to initiate and continue breastfeeding. Her method was to review previous articles on this subject. Only five articles were included in the study out of the twenty nine articles that she reviewed.

The results of the research conducted suggest that prenatal education can have a great impact on the decision to breastfeed as well as actual duration of breastfeeding. Mothers who were aware of the specific recommendations to breastfeed were more likely to initiate breastfeeding. The significance of this to nursing and the patients is that healthcare providers, especially nurses should provide introduces breastfeeding education to all pregnant women early in the antenatal period. This might considerably lead to a significant increase in the breast feeding rates.

#10

Briere, C., McGrath, J., Cong, X., & Cuss on, R. (2014). An integrative review of factors that influence breastfeeding duration for premature infants after NICU hospitalization. JOGNN: Journal of Obstetric, Gynecologic & Neonatal Nursing, 43(3), 272-281. Doi:10.1111/1552-6909.12297

Briere, McGrath, Cong, & Cusson, (2014) in this article, identified prenatal education as a factor affecting the duration of breastfeeding in week one after discharge from a hospital. A mother’s Breastfeeding knowledge from prenatal education influences her desire to continue to breast.

The authors selected 292 articles which were relevant to the research topic through abstract review; in the final analysis only fifty two articles were included in the study out of which only twenty-four articles were perfect fit for the inclusion and exclusion criteria.

The strength of this study is that the researchers were able to identify prenatal education, among other factors such exposure to kangaroo mother care and quantity of maternal breast milk supply during the first week after discharge as a most crucial factor affecting breastfeeding rate.

Significance to Nursing and Patient Care: In the final analysis, nurses should provide and introduce breastfeeding education to all pregnant women early in the antenatal period. The nurse's role in support of breast feeding varies with the time and place where patient care is provided. In each setting, however, the nurse plays a significant role in helping the mother to begin breast feeding and to enjoy it, at the same time providing her infant with optimum nutrition for his early growth and development. This might considerably lead to a significant increase in the breast feeding rates even among women of preterm babies (Auerbach, 2015).

#11

Su, L. L., Chong, Y. S., Chan, Y. H., Chan, Y. S., Fok, D., Tun, K. T., . . . Ng, F. S. (2007). Antenatal education and postnatal support strategies for improving rates of exclusive breast feeding: randomised controlled trial. Retrieved from http://www.ncbi.nlm.nih.gov/

(Su et al., 2007) Performed a research to investigate whether prenatal breastfeeding education and postnatal lactation support have any effect on the rates of exclusive breastfeeding to six months post-delivery. The findings were that not only did they improve breastfeeding rates, but the postnatal support was more effective in promoting breastfeeding than prenatal teachings. Inclusion criteria for this study were healthy pregnant mothers, who were attending the prenatal clinic of the tertiary hospital, must deliver at the least 34 weeks gestation. These were divided into three groups. 450 women were recruited from February 2004 to September 2005. 151 were randomized to receive standard hospital care, a second group of 150 to receive prenatal care, and 149 to receive post-delivery breastfeeding support. Both prenatal and education and postnatal lactation support created a significant improvement in the exclusive breastfeeding rates up to six months after delivery compared with routine care in a tertiary hospital setting. The significance of this to nursing and patient care is that Improving mother’s awareness of breastfeeding recommendations and strengthening their intention to initiate breastfeeding could lead to increased breastfeeding initiation and duration rates.

#12

Ishak, S., Adzan, N. A. M., Quan, L. K., Shafie, M. H., Rani, N. A., & Ramli, K. G. (2014). Knowledge and Beliefs About Breastfeeding Are Not Determinants for Successful Breastfeeding. Breastfeeding Medicine, 9(6), 308–312. http://doi.org/10.1089/bfm.2013.0124

Ishak, Adzan, Quan, Shafie, Rani, & Ramli, (2014) performed a cross-sectional prospective study to determine the knowledge and attitudes breastfeeding mothers toward breastfeeding in a Malaysia hospital, and how it influence their breastfeeding practices. Of the 690 mothers between the ages of 16 to 44years of age eligible for inclusion in the studies, only 213 agreed to participate. The study was for a period of three months, and only mothers who delivered healthy babies at full term were included. The research made the authors to find that more than half of these women had received prenatal or postnatal breastfeeding counselling. These women had a positive attitude towards breastfeeding; the duration of breastfeeding was not significantly affected.

What this implies to nursing and patient care is that there is a need for continued breastfeeding education and encouragement even post-delivery.

#13

Imdad, A., Yakoob, M. Y., & Bhutta, Z. A. (2011). Effect of breastfeeding promotion interventions on breastfeeding rates, with the special focus on developing countries. BMC Public Health, 11(Suppl 3), S24. Doi: 10.1186/1471-2458-11-S3-S24

Imdad, Yakoob, & Bhutta, (2011) performed a literature review to identify how breastfeeding education impart breastfeeding rates in the third world countries. Occurrence of EBF is low internationally in several third world countries all over the world. Much is given to encourage breastfeeding practices in early infancy, and the researcher noticed an increase of forty –three percent in this outcome, with eight-nine percent and twenty percent significant increases in developing and developed countries respectively.

Significance to Nursing and Patient Care: Breastfeeding encouragement interventions increased exclusive and any breastfeeding rates at 4-6 weeks and six months.

#14

Lin, S. S., Chien, L. Y., Tai, C. J., & Lee, C. E. (2008, February 17). Effectiveness of a prenatal education programme on breastfeeding outcomes in Taiwan. Retrieved from http://www.ncbi.nlm.nih.gov/

(Lin, Chien, Tai, & Lee, 2008) conducted a research based on the effectiveness of a structured prenatal education program. The Kirkpatrick’s Training and Evaluation model was used to determine effectiveness with the program. The study group consists of 46 pregnant women in their 20th to 36th week gestation. The control group did not receive any form of education or counselling. A self-administered questionnaire was used to collect data. The result was high, the experimental group showed higher breastfeeding satisfaction at three days and one month postpartum. Which indicates that prenatal education and intervention is significant to the to the behavior, and successful breastfeeding.

Significance to Nursing and Patient Care: There is a need for other health care facilities to tryout this model in other to evaluate their antenatal education programs. Breastfeeding should be pushed in all hospitals in other to meet the WHO standard of eight % exclusive breastfeeding for up to six months.

#15

Nwaru, B. I., & Hemminki, E (2011). Infant Care practice in rural China and their relation to prenatal care utilization.Global Public Health, 6(1), 1-14. Retrieved from Doi: 10.1080/17441691003667307.

In this article, Nwaru, & Hemminki, (2011) conducted a study explaining how the effect of prenatal care affects postpartum childcare practices and infant care outcomes in rural China. Inadequate care was positively associated with not breastfeeding, early introduction of milk formula and cereal/porridge, and early start of work after delivery. It provides statistical information to demonstrate the gravity of the issue. Data were available for Knowledge, Attitude and Perception cross-sectional survey collected from 2001 to 2003.These were after a prenatal care intervention in Anhui County, China, with a response rate of 97%. Whereas this article has not fully supported the writer's PICOT question, it discusses how lack of prenatal care/ education can affect a mother's desire to breastfeed among other health care practices. Nurses are also in a unique position to enhance a mother’s breastfeeding success as she transitions into the workplace.