Prenatal Breastfeeding Education for families of neonates with congenital heart disease

by Christi Avella

Coauthors: Jennifer Baird, PhD, MPH, MSW, RN


Breastfeeding initiation and duration rates for most hospitalized infants are far below those for healthy newborns. Breastfeeding has been shown to decrease rates of both common and deadly risk factors, including necrotizing enterocolitis for immunocompromised neonates. Several modifiable barriers to successful breastfeeding have been identified as strongly contributing to lower breastfeeding initiation, duration, and exclusivity rates, including lack of prenatal education for mothers of those vulnerable infants. Currently at Children's Hospital Los Angeles (CHLA), there is no standardized practice for offering prenatal breastfeeding education to our families of a neonate diagnosed with congenital heart disease before birth.

EBP Question
This project plans to investigate if prenatal breastfeeding education offered to families of babies diagnosed with congenital heart disease will increase rates of breastfeeding initiation, length of breastfeeding duration, and breastfeeding exclusivity. ​

This project will utilize the Johns Hopkins Model of Evidence Based Practice. Families of neonates will be identified during their first appointment to see a fetal cardiologist for need of a postnatal admission to the CHLA Heart Institute. During their second appointment, families will be given lactation education in the form of individualized experiential education, an educational handout, and a video to watch. Outcome data looking at change in parent knowledge and comfort, parent satisfaction with lactation education, and clinical outcomes (diet orders, amount of breastmilk per feeding, and breastfeeding duration) will be collected.

This study is a work in progress with retrospective and prospective data being collected. Previous literature has shown positive results when families have been offered prenatal lactation education with increased rates of breastfeeding initiation, duration, and exclusivity. Initial results will be available in October of 2023.

Prenatal breastfeeding education has been shown to be a cost-effective and innovative strategy to promote increased breastfeeding exclusivity for hospitalized infants. This project will provide basic prenatal lactation education for this population of families. Next steps will involve creating a tool that identifies specific education needs to provide personalized, patient and family-centered care.