Breastfeeding Information in Nursing Textbooks Needs Improvement

1. Breastfeeding Information in Nursing Textbooks Needs Improvement Susan P. Davies, IBCLC*, Marcy J. McMahon, RN, IBCLC**, Tina Santos, RN**, Sheina Jean-Marie, BA*, Barbara L. Philipp, MD, FAAP, FABM, IBCLC* *Dept. of Pediatrics, Boston Medical Center/ Boston Medical Center, Boston, MA, **Dept. of Nursing, Boston Medical Center, Boston, MA BACKGROUND METHODS RESULTS RESULTS • Nurses, obstetricians, and pediatricians work together as members of a multidisciplinary team in educating and supporting the breastfeeding mother and baby. • The breastfeeding information in textbooks • used by each specialty needs to be consistent, accurate, and evidence-based. • Two recent studies found breastfeeding information in pediatric textbooks and obstetric textbooks to be highly variable, and at times inaccurate and inconsistent. • Scoring based on 20 basic breastfeeding criteria derived from: • ACOG. Breastfeeding: Maternal and Infant Aspects. Educational Bulletin 2000;258:1-16 • AAP, Section on Breastfeeding. Breastfeeding and the Use of Human Milk. Pediatrics 2005;115(3):496-506 • WHO. Ten Steps to Successful Breastfeeding. 1989 Textbooks Summary 1 2 3 4 5 6 Reviewed, C 11 15 10 11 12 12 Reviewed, I 6 3 8 5 2 7 Omitted, O 3 2 2 4 6 1 Correct/rev, % 65 83 56 73 86 63 Correct/20, % 55 75 50 55 60 60 Textbooks Criteria (key words) 1 2 3 4 5 6 Healthiest feeding choice I CT I I CT I Exclusive 6 months O CT I I I I Duration 1 year or more O CT I CT CT I Benefits for mother C C C O I C Anatomy and physiology CT CT I CT O CT Nurse’s role CT CT CT CT CT CT First hour of life I CB I CT CT I Rooming-in I I CT I CT I Feed on demand I I I I CT I Info on positioning CB CB CB CB CB CT Info on latch CT CB CT CT CT CT Pitfalls/supplementation CT CB CB CB O CT 8-12 feeds in 24 hours CT I O CT CB CT Normal elimination I CT I I CT I F/up in 48-72 hours CT O O O O O Common problems C C C C O C Mastitis CT CT CT O O CT Separation CB CB CB CT CB CT Contraindications I C I C C C Ten Steps O O CB O O CT Score (C+CT+CB)/20 11/20 15/20 10/20 11/20 12/20 12/20 55% 75% 50% 55% 60% 60% Scoring code C=information reviewed and correct (T=thorough/B-brief) I =information reviewed but incorrect or inconsistent O=omitted CONCLUSION Breastfeeding information in nursing textbooks was found to be variable and at times with significant inaccuracies, inconsistencies, and omissions. PURPOSE To determine if breastfeeding information in general nursing textbooks is current and evidence-based IMPLICATION Nurses play a key role in the education and support of the breastfeeding mother and baby. Therefore, nursing educational resources should contain breastfeeding information that is accurate, consistent and evidence-based. METHODS METHODS • Six nursing textbooks, all published since 1999, were reviewed using a standardized scoring sheet. • Five reviewers (1LC, 1RN/LC, 1RN, 1RA, 1MD/LC) examined breastfeeding content as indexed in each text. • Scoring Code used: • C:reviewed and correct (T=thorough/B=brief) • I : reviewed but incorrect or inconsistent • O: omitted Textbooks reviewed: 1 Intro to Maternity & Pediatric Nursing (Leifer, 2003) 2 Intro to Maternity & Pediatric Nursing (Klossner, 2006) 3 Maternal & Child Health Nursing (Pilliteri, 2003) 4 Contemporary Maternal-Newborn Nursing Care (Ladewig, 2006) 5 Child Health Nursing (Ball, 2006) 6 Maternal-Newborn & Child Nursing (London, 2003) DISCLOSURE The authors have no financial interests to disclose.