title: Evaluation of an office protocol to increase exclusivity of breastfeeding.
abstract: OBJECTIVE
  The purpose of this study was to determine whether implementing a program based on a clinical protocol affects breastfeeding rates within a pediatric primary care setting. Increasing breastfeeding rates is an important public health initiative identified by multiple agencies.
  
  
  METHODS
  The Academy of Breastfeeding Medicine (ABM) clinical protocol ("The Breastfeeding-Friendly Physician's Office, Part 1: Optimizing Care for Infants and Children") was used as a template for the provision of breastfeeding services within a pediatric primary care clinic. There were 757 mother-infant pairs included in the study. A retrospective before-and-after study design was used. Data collection points included the hospital stay, the newborn visit, and the 2-, 4-, and 6-month health maintenance visits. The 2 groups were compared to estimate the protocol's effectiveness as a method of increasing breastfeeding rates.
  
  
  RESULTS
  The results of this evaluation were positive for exclusive breastfeeding, with group comparisons showing a statistically significant increase in exclusive breastfeeding rates at all 5 time points.
  
  
  CONCLUSIONS
  Our diverse patient population within a pediatric practice had increased initiation rates and exclusive breastfeeding rates after implementation of the ABM's breastfeeding-friendly protocol. Families who receive care in a pediatric primary care setting that has implemented the ABM clinical protocol may have increased rates of exclusive breastfeeding.
authors.affiliation: Loudoun Pediatric Associates, Leesburg, Virginia, USA. sharcorr@aol.com
authors.forename: Sharon K
authors.initials: SK
authors.lastname: Corriveau
authors.forename: Emily E
authors.initials: EE
authors.lastname: Drake
authors.forename: Ann L
authors.initials: AL
authors.lastname: Kellams
authors.forename: Virginia G
authors.initials: VG
authors.lastname: Rovnyak
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data*; D015331:Cohort Studies; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007224:Infant Care / Q000458:organization & administration*; D007229:Infant Welfare; D007231:Infant, Newborn; D016015:Logistic Models; D016389:Maternal-Child Nursing / Q000193:education*; D008875:Middle Aged; D010353:Patient Education as Topic / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D012189:Retrospective Studies; D018570:Risk Assessment; D014481:United States; D055815:Young Adult
keywords: baby-friendly; breastfeeding; breastfeeding education; breastfeeding exclusive; evidence-based health care; primary health care