Institutional Educational and Support Intervention in Breastfeeding in a Postnatal Unit in Spain. A Quasi-Experimental Pre-Post Study

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Abstract
Background/Objectives: There is international consensus that breastfeeding is the best form of nutrition for newborns. Many studies demonstrate the effectiveness of educa-tional interventions in maintaining exclusive breastfeeding up to 6 months. The aim was to assess the effectiveness of an educational and support intervention in breastfeeding by a lead midwife on the postnatal ward. Methods: A retrospective quasi-experimental pre-post study using a mixed-methods approach was conducted at a tertiary hospital in southern Spain with women (N = 136) who expressed a desire to breastfeed their babies. An institutional intervention, consisting of the presence of a leading midwife in breastfeeding for a period of two months, was carried out. An inferential analysis was performed using the corresponding statistics. A multiple logistic regression analysis was performed to identify potential confounding variables and determine factors associated with the dependent variable of exclusive breastfeeding at 6 months. In addition, a brief institutional survey was conducted among these women after the first 6 months post-partum as a complementary component to the quantitative analysis. Results: Exclusive breastfeeding at discharge and at two months postpartum was higher in the intervention group than in the control group (97.8% versus 83.2%; p= 0.031). The need for supple-mentary feeding and phototherapy among infants was lower in the intervention group (1.5% versus 11.8%, P=0.033). A higher level of satisfaction was also observed among mothers in the intervention group (95.7% versus 63%; p< 0.001). However, we did not detect a between-group difference in exclusive breastfeeding at six months. Conclusions: The presence of a breastfeeding-specialist midwife was associated with higher early breastfeeding rates and maternal satisfaction during hospitalization. Sustained effects are likely to require ongoing support after discharge.

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