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Implementing a Breastfeeding Toolkit for Nursing Education

Folker-Maglaya, Catherine DNP, APRN, CNM, IBCLC; Pylman, Maureen E. PhD; Couch, Kimberly A. DNP, APRN, CNM, FNP-BC; Spatz, Diane L. PhD, RN-BC, FAAN; Marzalik, Penny R. PhD, APRN, CNM, IBCLC

The Journal of Perinatal & Neonatal Nursing: April/June 2018 - Volume 32 - Issue 2 - p 153–163
doi: 10.1097/JPN.0000000000000330
Feature Articles: Continuing Education

All health professional organizations recommend exclusive breastfeeding for at least 6 months, with continued breastfeeding for 1 year or more after birth. Women cite lack of support from health professionals as a barrier to breastfeeding. Meanwhile, breastfeeding education is not considered essential to basic nursing education and students are not adequately prepared to support breastfeeding women. Therefore, a toolkit of comprehensive evidence-based breastfeeding educational materials was developed to provide essential breastfeeding knowledge. A study was performed to determine the effectiveness of the breastfeeding toolkit education in an associate degree nursing program. A pretest/posttest survey design with intervention and comparison groups was used. One hundred fourteen students completed pre- and posttests. Student knowledge was measured using a 12-item survey derived with minor modifications from Marzalik's 2004 instrument measuring breastfeeding knowledge. When pre- and posttests scores were compared within groups, both groups' knowledge scores increased. A change score was calculated with a significantly higher mean score for the intervention group. When regression analysis was used to control for the pretest score, belonging to the intervention group increased student scores but not significantly. The toolkit was developed to provide a curriculum that demonstrates enhanced learning to prepare nursing students for practice. The toolkit could be used in other settings, such as to educate staff nurses working with childbearing families.

School of Nursing, City Colleges of Chicago-Malcolm X College, Illinois (Dr Folker-Maglaya); Research and Planning, City Colleges of Chicago-Harry S. Truman College, Illinois (Dr Pylman); Phoenix Indian Medical Center, US Public Health Service, Phoenix, Arizona, and Frontier Nursing University, Hyden, Kentucky (Dr Couch); School of Nursing, University of Pennsylvania, Philadelphia, and The Children's Hospital of Philadelphia, Pennsylvania (Dr Spatz); and Nurse-Midwifery and Women's Health Specialty Tracks, College of Nursing, The Ohio State University, Columbus (Dr Marzalik).

Corresponding Author: Catherine Folker-Maglaya, DNP, APRN, CNM, IBCLC, School of Nursing, City Colleges of Chicago-Malcolm X College, 1900 W. Jackson Blvd, Chicago, IL 60612 (

The authors thank the district academic affairs specialist and the college administration for their support; nursing leadership and maternal-newborn faculty for welcoming the “toolkit” education into the classroom and curriculum; and the nursing students for participating in the study.

Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Submitted for publication: December 22, 2017; accepted for publication: January 24, 2018.

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