Guideline 5.1 of Step 5 of the Ten Steps to Successful Breastfeeding1 details the education all breastfeeding mothers should receive prior to discharge from the birthing facility. In addition to basic breastfeeding techniques of positioning and latch/attachment, this includes:
The importance of exclusive breastfeeding.
The first Breastfeeding Self-efficacy Scale (BSES) was developed in 1999 by Dennis and Faux2 and although this appears to be a very dated piece of research, it has been replicated and cited multiple times since its development. The use of this scale can assist health care providers to predict high-risk mothers and may “guide the development and evaluation of interventions” for modifiable factors such as maternal confidence. Based on Bandura’s social learning theory, “self-efficacy is a dynamic cognitive process in which an individual evaluates his or her capability to perform a given behavior”2. Using this scale can be helpful to identify new mothers with low breastfeeding confidence who are likely at high risk for premature weaning and not meeting their own breastfeeding goals.
With knowledge derived from the BSES, hospital or birth facility staff can provide individualized education and follow-up planning for higher risk breastfeeding individuals, possibly increasing breastfeeding initiation, exclusivity, and duration.
One important aspect to discharge education is to individualize it for each new family. Yes, we health care providers may be teaching much of the same information 3 or 5 or 20 times each day to each patient being discharged. However, each new parent is an individual, bringing their own family culture, history, support, environment, and more to this breastfeeding experience. Ask questions, involve the family in the teaching, provide hands-on learning, and plan follow-up for each new dyad. They deserve it!
Keep safe and know that you are valued and appreciated for the work you are doing in the lives of these breastfeeding families. You are making a difference in their world.
Kathy Parkes, MSN-Ed, RN, IBCLC, FILCA CHC
Professional Development Educator
1. Baby-Friendly USA, Inc. (2020). The Baby-Friendly Hospital Initiative. Interim Guidelines and Evaluation Criteria for Facilities Seeking and Sustaining Baby Friendly Designation. https://www.babyfriendlyusa.org/news/bfusa-releases-interim-guidelines-and-evaluation-criteria/
2. Dennis, C.L. and Faux, S. (2009). Development and psychometric testing of the breastfeeding self-efficacy scale. Research in Nursing & Health;22: 399-409. https://onlinelibrary.wiley.com/doi/abs/10.1002/(SICI)1098-240X(199910)22:5%3C399::AID-NUR6%3E3.0.CO;2-4
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Last Updated: September 2018