The Effects of Anticipatory Guidance on the Initiation of Breastfeeding the Preterm Infant

Abstract
Numerous policy statements have been issued to guide healthcare professionals on the initiation and maintenance of breastfeeding. However, mothers of preterm infants have additional challenges regarding breastfeeding initiation and many do not continue breastfeeding when their infants are discharged home. A review of the literature suggested that clinicians and other healthcare providers can play an influential role in breastfeeding initiation and duration. Breastfeeding support during pregnancy and early postpartum period has also been associated with successful breastfeeding. The purposes of this scholarly project were to describe the implementation and to evaluate the outcomes of a program to promote breastfeeding for mothers of late preterm infants. We examined the effects of anticipatory guidance related to breastfeeding provided to expectant women hospitalized during their high-risk pregnancies. The Modified Breastfeeding Self-Efficacy Scale (Short Form) Among Mothers of Ill or Preterm Infants (BSES) was used to measure the effects of anticipatory guidance by comparing maternal confidence and self-efficacy before and after the anticipatory guidance intervention. Twenty expectant women participated in this pilot study. Wilcoxan Rank Sums Test was used to assess rank differences between pre and post intervention. Study outcomes included participants’ perceived self-efficacy and confidence in their ability to provide breastmilk or to breastfeed their preterm infant. There were more positive rank scores (13) than negative (4), which indicates that significantly more participants had improved BSES scores than those who had a tie, or had lower scores after the intervention (p value 0.019). This work suggests that an individualized educational anticipatory guidance intervention can improve maternal confidence and may result in positive breastfeeding outcomes.