Fok Doris, Chang Hsin Fang, Meng Ling Yan, Ng Yvonne Peng Mei
Department of Obstetrics and Gynaecology, National University of Singapore, Yong Loo Lin School of Medicine, Singapore, Singapore.
Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore.
Am J Perinatol. 2022 Mar;39(4):379-386. doi: 10.1055/s-0040-1716489. Epub 2020 Sep 10.
The Baby-Friendly Hospital Initiative (BFHI) enables maternity units to be centers of breastfeeding support to increase breastfeeding rates. This study evaluates the impact of the 20-hour BFHI training course on nurses' breastfeeding knowledge, attitude, and confidence in breastfeeding practice in a tertiary hospital in Singapore.
Seventeen sessions of the 20-hour BFHI training course were conducted by lactation consultants from 2010 to 2013 at the National University Hospital, Singapore. An anonymous self-administered survey on knowledge, attitude, and confidence in breastfeeding practices were distributed to nurses before (2009) and after (2014) the training courses to assess effectiveness of training.
One-hundred forty nurses and one hundred forty-eight nurses participated in the surveys in 2009 and 2014, respectively. Majority were registered nurses who worked in the postnatal wards and the neonatal intensive care unit. After training, there were significant improvements for five of eight items in infant feeding knowledge, including greater awareness of the International Code of Marketing of Breastmilk Substitutes and medical contraindication for breastfeeding. Participants reported more confidence in assisting mothers on breastfeeding, 77.1 to 88.5% ( = 0.019); advising hand expressing breast milk, 75.7 to 86.5% ( = 0.012); and advising attachment to the breast, 75.7 to 89.2% ( = 0.004) in 2014 compared with 2009. However, despite having high levels of confidence, only about half the nurses reported being able to assist mothers in breastfeeding, mainly due to time constraints.
Implementation of the 20-hour BFHI training program positively influenced nurses' breastfeeding knowledge, attitude, and confidence in breastfeeding practices. Hospital procedures and manpower requirements should be re-examined to overcome nursing constraints in providing breastfeeding help to postpartum mothers.
· Nurses have low breastfeeding knowledge pretraining.. · The 20-hour BFHI training course is effective.. · Nurses have inadequate time to support breastfeeding..
爱婴医院倡议（BFHI）使产科病房成为母乳喂养支持中心，以提高母乳喂养率。本研究评估了20小时的BFHI培训课程对新加坡一家三级医院护士的母乳喂养知识、态度及母乳喂养实践信心的影响。
2010年至2013年，新加坡国立大学医院的泌乳顾问举办了17期20小时的BFHI培训课程。在培训课程之前（2009年）和之后（2014年），向护士发放了一份关于母乳喂养实践知识、态度和信心的匿名自填式调查问卷，以评估培训效果。
2009年和2014年分别有140名和148名护士参与了调查。大多数是在产后病房和新生儿重症监护病房工作的注册护士。培训后，八项婴儿喂养知识中的五项有显著改善，包括对《国际母乳代用品销售守则》和母乳喂养医学禁忌的认识提高。与2009年相比，2014年参与者在协助母亲进行母乳喂养方面更有信心（从77.1%升至88.5%，P = 0.019）；在指导手挤母乳方面（从75.7%升至86.5%，P = 0.012）；在指导正确含接乳房方面（从75.7%升至89.2%，P = 0.004）。然而，尽管信心水平较高，但只有约一半的护士报告能够协助母亲进行母乳喂养，主要原因是时间限制。
实施20小时的BFHI培训计划对护士的母乳喂养知识、态度及母乳喂养实践信心产生了积极影响。应重新审视医院程序和人力需求，以克服护士在为产后母亲提供母乳喂养帮助时的限制。
·护士在培训前母乳喂养知识水平较低。·20小时的BFHI培训课程有效。·护士没有足够时间支持母乳喂养。
