Breastfeeding Resources in Maternity Hospitals and Birth Centers in the Commonwealth of Massachusetts (USA): A Content Analysis of Discharge Packets.
BACKGROUND
Few studies have analyzed patient education materials provided at discharge. To the best of our knowledge, there are no comprehensive studies analyzing and reporting the content of breastfeeding discharge packets within the United States.


OBJECTIVE
This study analyzed the extent to which patient education materials provided at discharge from maternity facilities in Massachusetts cover topics that support successful breastfeeding.


METHODS
We collected discharge packets from all 48 maternity hospitals/birth centers. Topics for analysis were based on recommendations associated with the Baby-Friendly Hospital Initiative and content identified for discharge packets generally. Materials were reviewed independently and scored according to 39 criteria that we assembled from various sources for optimal breastfeeding information at discharge. Bivariate and multivariate analyses were used to explore if any hospital characteristics predicted presence of breastfeeding education topics in written information provided at discharge.


RESULTS
An average of 25.4 of 39 criteria (65.2%, ranging from 30.7%-97.4%) were included in packets submitted by all 48 facilities. Exploratory multivariate analyses did not show relationships of hospital characteristics to contents of packets. Each facility received a 2-page report noting strengths, suggestions for improvement, and individual scores on all 39 criteria.


CONCLUSIONS
Discharge packet contents varied widely; whereas some institutions' information met and/or exceeded recommended content, others were limited and/or missing information. These analyses provide a thorough review of discharge packet content for all facilities in Massachusetts; however, further study is needed to identify the implications of such variation for breastfeeding outcomes.
Department of Sociology, Northeastern University, Boston, MA, USA.
Jill
J
Eshelman
Consultant, Massachusetts Department of Public Health, Boston, MA, USA.
Roger A
RA
Edwards
Nutrition Division, Massachusetts Department of Public Health, Boston, MA, USA.
Kara
K
Ghiringhelli
Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA.
Kristen
K
Mainello
Nutrition Division, Massachusetts Department of Public Health, Boston, MA, USA.
Rachel
R
Colchamiro
Nutrition Division, Massachusetts Department of Public Health, Boston, MA, USA.
Julie
J
Forgit
Nutrition Division, Massachusetts Department of Public Health, Boston, MA, USA.
Ellen
E
Tolan
Division of Prevention and Wellness, Massachusetts Department of Public Health, Boston, MA, USA Christina.Nordstrom@state.ma.us.
Christina
C
Nordstrom
D001942:Breast Feeding; D005260:Female; D006293:Health Promotion / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006771:Hospitals, Maternity / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008404:Massachusetts; D015999:Multivariate Analysis; D010351:Patient Discharge; D010353:Patient Education as Topic / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D011181:Postnatal Care / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D011247:Pregnancy; D011785:Quality Assurance, Health Care
Baby-Friendly Hospital Initiative; breastfeeding; breastfeeding information; breastfeeding support; discharge materials; hospital discharge; lactation support; patient education