title: Hospital Education in Lactation Practices (Project HELP): does clinician education affect breastfeeding initiation and exclusivity in the hospital?
abstract: BACKGROUND
  A woman's decision to breastfeed may be influenced by her health care practitioners, but breastfeeding knowledge among clinicians is often lacking. Project HELP (Hospital Education in Lactation Practices) was an intensive education program designed to increase breastfeeding knowledge among health care practitioners. The purpose of this study was to determine whether educating practitioners affected breastfeeding initiation and exclusivity rates at hospitals with low breastfeeding rates.
  
  
  METHODS
  Between March 31, 2005, and April 24, 2006, we taught courses at four Massachusetts hospitals with low breastfeeding rates. Each course consisted of three, 4-hour teaching sessions and was offered nine times. The training, taught by public health professionals, perinatal clinicians, and peer counselors, covered a broad range of breastfeeding-related topics, from managing hyperbilirubinemia to providing culturally competent care. Medical records of infants born before and after the intervention were reviewed to determine demographics and infant feeding patterns.
  
  
  RESULTS
  Combining data from all hospitals, breastfeeding initiation increased postintervention from 58.5 to 64.7 percent (p = 0.02). An overall increase in exclusive breastfeeding rates was not statistically significant. In multivariate logistic regression for all hospitals combined, infants born postintervention were significantly more likely to initiate breastfeeding than infants born preintervention (adjusted OR 1.32, 95% CI 1.03-1.69).
  
  
  CONCLUSIONS
  Intensive breastfeeding education for health care practitioners can increase breastfeeding initiation rates.
authors.affiliation: Division of General Pediatrics at the Boston University School of Medicine, Boston Medical Center, 88 East Newton Street, Boston, MA 02118, USA.
authors.forename: Xena
authors.initials: X
authors.lastname: Grossman
authors.forename: Jana
authors.initials: J
authors.lastname: Chaudhuri
authors.forename: Lori
authors.initials: L
authors.lastname: Feldman-Winter
authors.forename: Jessica
authors.initials: J
authors.lastname: Abrams
authors.forename: Kimberly Niles
authors.initials: KN
authors.lastname: Newton
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Philipp
authors.forename: Anne
authors.initials: A
authors.lastname: Merewood
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D004496:Education, Continuing / Q000379:methods; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008404:Massachusetts; D015999:Multivariate Analysis; D009775:Obstetrics and Gynecology Department, Hospital; D010043:Outcome and Process Assessment, Health Care; D055815:Young Adult