Penn Nursing Expert on Nutrition and Breastfeeding is Guest Editor of Special Edition of the "Journal of Obstetric, Gynecologic, and Neonatal Nursing" Focusing on Lactation

Newswise — PHILADELPHIA (May 15, 2015) -- Diane L. Spatz, PhD, RN-BC, FAAN, University of Pennsylvania School of Nursing Professor of Perinatal Nursing and Helen M. Shearer Term Professor of Nutrition is guest editor of the May/June 2015 issue of The Journal of Obstetric, Gynecologic, and Neonatal Nursing (JOGNN), the publication of the Association of Women’s Health Obstetric and Neonatal Nurses (AWHONN).

“This special edition focuses on innovative models of care to improve evidence-based lactation support and care for hospitalized infants and human milk and breastfeeding outcomes post-discharge from neonatal intensive care,” says Dr. Spatz.

In the opening editorial, Dr. Spatz emphasizes the need to utilize the evidence regarding the science of human milk and breastfeeding to transform care. “It is essential that nurses and health care providers possess key competencies regarding the use of human milk and breastfeeding,” says Spatz.

In the first article, “Improving Practice at the Point of Care through the Optimization of the Breastfeeding Resource Nurse Model,” by Spatz and colleagues, outcomes of the Breastfeeding Resource Nurse (BRN) program that Dr. Spatz developed at the Children’s Hospital of Philadelphia in 2001 are described. This study found that nurses who received the specialized BRN education and training integrated the provision of evidence-based breastfeeding support and care into their daily routines. Ninety percent of the BRNs responded that they regularly assisted mothers with direct breastfeeding which is a significantly different finding than reported by Hallowell and colleagues (2014) who found that only 13-14 percent of NICU infants received nurse-reported breastfeeding support.

In the second article, “The Voices of Breastfeeding Resource Nurses,” by Elizabeth B. Froh, PhD, RN, and colleagues, rich data from interviews with 18 key informant BRNs describes how nurses who received the education and training integrated their knowledge into daily professional and personal life. Four major themes emerged from the data: empowering through evidence, advocacy, going the extra mile, and personal connections to breastfeeding. These two compelling studies make a strong case that other hospitals should consider replicating/implementing BRN programming.

In the third article, “Improving Human Milk and Breastfeeding Practices in the NICU”, by Karen Fugate, BSN, RNC-NIC, CPHQ, and colleagues describe implementation of the Spatz (2004) 10-step model for the use of human milk and breastfeeding in vulnerable infants at Tampa General Hospital’s NICU. Through a continuous quality improvement implementing the steps, the hospital had a three-fold increase in infants receiving human milk at discharge.

The fourth article, “Making Meaning of Pumping for Mothers of Infants with Congenital Diaphragmatic Hernia”, by Froh and colleagues, describes qualitative research findings from a study of mothers of infants with congenital diaphragmatic hernia. This research is the first to describe the benefits of performing human milk oral care for the family and mother. Four major themes emerged from the data; it motivates me; I’m part of my baby getting better; we do it together, and we’re getting somewhere. Mothers universally articulated that by having the opportunity to participate in human milk oral care, they were motivated to keep pumping and build their milk supply for their critically ill infant.

The fifth article, “Post-discharge Breastfeeding Outcomes of Infants with Complex Anomalies That Require Surgery”, by Kimberly Martino (a December 2015 BSN graduate of University of Pennsylvania School of Nursing) and colleagues, describes the human milk and breastfeeding outcomes of mothers and their surgical infant NICU graduates. The median breastfeeding duration of these mothers was eight months (range 0.25 to 30 months). Infants in this study received more exclusive human milk at both three and six months when compared to state and national data. Another key finding of this research was that mothers needed to use more than one feeding mode (breast, bottle, tube).

“The findings from this issue show that through innovative practices and research, human milk and breastfeeding outcomes can be improved for even the most vulnerable of infants,” says Dr. Spatz.

Note to editors: PDFs of the journal articles are available upon request.