A tool to help midwives start families on healthy pathways

Abstract

Best practice standards recommend that babies breastfeed in the first hour of birth and that midwives help mothers begin breastfeeding. Research pertaining to the first breastfeed has predominantly examined outcomes associated with duration of the interval between time of birth and the first breastfeed. Little attention is given to events, which may prevent or interrupt continuous body contact between the newborn and mother to begin breastfeeding. Our national survey of Australian midwives (Cantrill et al. 2004) identified that few understood the significance of continuous skin-to-skin contact for breastfeeding initiation. One third of midwives reported separating mother and baby for routine interventions within the first hour of birth. In response to this gap in knowledge and practice, we developed and piloted a tool that offers midwives a means to evaluate and improve birthing room practices. The tool can be used by midwives to monitor and observe their own birthing room practices and to identify mother baby pairs who may need specialized breastfeeding follow up. The tool was evaluated in an observation study of 85 mother-baby dyads in the birthing room over a 6 month period. Mothers were followed up prior to discharge, at two weeks postpartum and three months and six months to determine satisfaction with care and incidence of common breastfeeding problems. Midwives gave feedback on their perception of the tool. Results will be discussed and recommendations provided for practice and future research.