Breast-feeding training for health professionals and resultant institutional changes

Bull World Health Organ. 1995;73(4):461-8.

Abstract

Assessed is a breast-feeding training course that was attended by health professionals at the Santos Lactation Center (SLC), Santos, São Paulo, Brazil, as well as its impact on the implementation of breast-feeding programmes in maternity hospitals. Eight maternity hospitals were studied--four were randomly allocated to the experimental group and sent three health professionals to attend an 18-day course at SLC; the remaining four institutions constituted the control group. The compliance of all eight hospitals with WHO/UNICEF's "Ten steps for successful breast-feeding" was determined using scores obtained before and 6 months after the training course. Institutions in the experimental group had an improved score, but those in the control group did not. The SLC training course was efficient since it enabled the participants to promote breast-feeding practices. However, in order to succeed in implementing breast-feeding programmes, health professionals require also to develop skills to apply the knowledge they acquire in the course, as well as to involve the whole maternity unit team in the activities.

PIP: A breast-feeding training course was assessed that was attended by health professionals at the Santos Lactation Center (SLC), Santos, Sao Paulo, Brazil, as well as its impact on the implementation of breast-feeding programs in maternity hospitals. Eight maternity hospitals were studied, 4 were randomly allocated to the experimental group with 3 health professionals to attend an 18-day course at SLC; the remaining 4 institutions constituted the control group. The course consisted of 45 units that covered theoretical and practical aspects of breast-feeding over a 133-hour period. The compliance of all 8 hospitals with the World Health Organization (WHO)/UNICEF's 10 steps for successful breast-feeding was determined using scores obtained before and 6 months after the training course. Individual interviews were held 6 months after the SLC course with directors in participating institutions, with administrative managers, and with professionals in charge of antenatal, nursery, and outpatient services. 16 focus group sessions were also held with 6-15 persons of the staff 6 months after the course. Pre- and postcourse test results showed that in general there was improvement in the students' knowledge on breast-feeding (the average number of correct answers were 20.27 precourse and 26.92 postcourse). Institutions in the experimental group had an improved score, but those in the control group did not. Changes were more particularly in relation to steps 2 (train all health care staff in skills necessary to implement this policy) and 10 (foster the establishment of breast-feeding support groups and refer mother to them upon discharge from hospital). Among graduate-level professionals interpersonal conflicts limited the possibilities for change. The SLC training course enabled the participants to promote breast-feeding practices. However, in order to succeed in implementing breast-feeding programs, health professionals also have to apply the knowledge they acquire in the course as well as involve the whole maternity unit team in the activities.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brazil
  • Breast Feeding*
  • Cooperative Behavior
  • Female
  • Health Personnel / education*
  • Health Promotion
  • Hospitals, Maternity
  • Humans
  • Infant
  • Infant, Newborn
  • Organizational Policy