Recently at the Perinatal Society of Australia and New Zealand Conference 2018, research nurse Marg Broom from the Neonatal Intensive Care Unit and Special Care Nursery (NICU/SCN) at Canberra’s Centenary Hospital for Women and Children presented a project that evaluated the “Impact of Lactation Consultant on staff education and lactation support.” funded by the NICU Foundation.

The study results showed how having a Lactation Consultant (LC) on staff has improved all aspects of education and support for NICU/SCN mothers and staff. Staff now perceive that it is easy to organise a lactation consult for mothers and that this has a positive impact on meeting maternal needs during their admission. Marg was awarded the New Investigator Award for Best Oral Presentation – Neonatal Nursing. The project aim was to assess the relationship between having a lactation consultant included on-staff in the NICU, and the early provision of breast milk for neonates, breastfeeding practices of mothers during their babies’ admission and post discharge. The Newborn Intensive Care Foundation help fund the Project

Project Design

The project had a three phase approach: 

Phase I: Collect baseline Data

  1. Retrospective Chart Audit

Prior to the project commencing a retrospective chart audit using NICUS and CRIS databases was undertaken to gain baseline demographics on breastfeeding rates and factors related to breastfeeding, both at hospital discharge. Data collected included

  • day breast feeding/ expressing initiated
  • first breast milk and first breast feed
  • amount of formula required prior to enough breast milk being available
  • day fully breast feeding
  • breast feeding status at discharge
  • documentation of lactation consultant appointment
  • audit of number of times, hours staff spend providing lactation education and support
  • Length of stay and/or corrected age at discharge.

a) Maternal Satisfaction Survey

To assess maternal satisfaction of the current services a telephone interview was undertaken with 25 past mothers included in retrospective audit to gain information related to:

  • skin to skin contact
  • breastfeeding education
  • lactation support in the NICU
  • preparation to breast feed once discharged
  • breastfeeding since discharge

 

b) Staff Baseline Surveys

  • Breastfeeding education
  • Perceptions of maternal needs

Phase 2: Introduction of Lactation Consultant

Phase 2 was divided into two core periods:

a) Investigation (2 months).

The LC worked with staff, mothers and management to outline the requirements of the role and develop the NICU/ SCN Lactation Service including:

  • Provide one to one consultation and lactation support
  • Develop staff and parent education programs
  • Progress existing NICU/SCN policies and guidelines related to breastfeeding and the LC ‘s role in the NICU/SCN

b) Embedding (3 months)

The LC was engage with staff, mothers and management to embed an organised process of assessment, referral, and education to facilitate a supportive, standardised breastfeeding environment in the NICU/SCN. 

Phase 3: Evaluation

During the final month a project evaluation was undertaken by the Lactation Consultant and the Neonatal Research Nurse.

This included:

  • Prospective chart audit to compare pre and post data
  • Parent phone interviews as per pre program survey
  • Staff Surveys and Feedback sessions.

Project Outcomes

This project aim was to provide data and feedback to assess the benefits of an LC joining the NICU/SCN staff. Clearly, this was the final result.

Pictured are Research Nurse Marg Broom and Lactation Consultant Mary-Ellen Youseman