Applying systematic review search methods to the grey literature: a review of education and training courses on breastfeeding support for health professionals

Immersive Videos Improve Student Self-Efficacy in Clinical Lactation

The current study examined the use of immersive technology as a way to improve access to high-quality interpersonal breastfeeding interactions in an undergraduate clinical lactation course. In particular, we investigated the impact of immersive consultation videos and related activities on student self-efficacy, motivational beliefs, and perceived skill level. Results indicate that usability was high, with participants rating videos, interactives, and activities positively. Students did report a significant increase in self-efficacy and their perceived ability to meet the course learning objectives; no significant changes in the level of interest or perceived skill were found. Our results demonstrate that high-quality immersive videos can be an important learning tool for teaching clinical skills when access to direct patient care is limited or absent.

How much does it cost to implement the Baby-Friendly Hospital Initiative training step in the United States and Mexico?

The Baby-Friendly Hospital Initiative (BFHI) has been shown to increase breastfeeding rates, improving maternal and child health and driving down healthcare costs via the benefits of breastfeeding. Despite its clear public health and economic benefits, one key challenge of implementing the BFHI is procuring funding to sustain the program. To address this need and help healthcare stakeholders advocate for funds, we developed a structured method to estimate the first-year cost of implementing BFHI staff training, using the United States (US) and Mexico as case studies. The method used a hospital system-wide costing approach, rather than costing an individual hospital, to estimate the average per birth BFHI staff training costs in US and Mexican hospitals with greater than 500 annual births. It was designed to utilize publicly available data. Therefore, we used the 2014 American Hospital Association dataset (n = 1401 hospitals) and the 2018 Mexican Social Security Institute dataset (n = 154 hospitals). Based on our review of the literature, we identified three key training costs and modelled scenarios via an econometric approach to assess the sensitivity of the estimates based on hospital size, level of obstetric care, and training duration and intensity. Our results indicated that BFHI staff training costs ranged from USD 7.27–125.39 per birth in the US and from PPP 2.68–6.14 per birth in Mexico, depending on hospital size and technological capacity. Estimates differed between countries because the US had more hospital staff per birth and higher staff salaries than Mexico. Future studies should examine whether similar, publicly available data exists in other countries to test if our method can be replicated or adapted for use in additional settings. Healthcare stakeholders can better advocate for the funding to implement the entire BFHI program if they are able to generate informed cost estimates for training as we did here.

"One of those things the student is left to do". Student midwives' experience of infant feeding education. A phenomenological study

AIM/OBJECTIVE

To explore final year student midwives' experiences of breastfeeding education and clinical experience during their three year pre-registration midwifery degree course.

BACKGROUND

Despite an increasing research base about what helps or hinders breastfeeding, there is a dramatic drop in breastfeeding prevalence within the first six weeks of birth. Breastfeeding support and education have been identified as influencing factors associated with breastfeeding prevalence, yet there is a paucity of evidence exploring infant feeding education for pre-registration student midwives.

DESIGN

Qualitative data was gathered using semi-structured interviews with seventeen final year midwifery students in a Higher Education Institution in the North of England.

METHODS

Interviews were audio recorded, transcribed verbatim, and analysed using thematic analysis.

RESULTS

Three core themes were identified: The Mentor-Student Relationship, Midwives and student midwives' attitudes towards breastfeeding and Theory-Practice Disassociation. University-based input provided them with underpinning knowledge but provided little opportunity to develop skills. Attitudes towards breastfeeding were predominantly negative, and these negative descriptions were frequently linked by students to time constraints and workload pressures. The relationship between students and mentors had a direct impact on students' development of breastfeeding support skills and confidence: students who had mentors who were enthusiastic about their role in facilitating learning in clinical practice were confident in supporting women with infant feeding. However, many students described the hospital environment as too busy for infant feeding skills teaching and guidance.

CONCLUSIONS

Although few participants were dissatisfied with how their pre-registration midwifery education prepared them for clinical practice in general, the majority would have liked more opportunities to support women with infant feeding in complex and challenging cases, both in University and in clinical practice. There is a need for midwifery students to be provided with a variety of educational experiences such as theoretical classroom-based learning, simulation-based learning, peer learning, clinical care practice and direct service user engagement. These learning experiences need to include artificial feeding and breastfeeding.

Effects of prenatal professional breastfeeding education for the family

Mastering the correct breastfeeding posture remains a challenge for many new mothers. Generalized pregnancy breastfeeding education plays a role in helping mothers master breastfeeding positions and prevent nipple damage. This study prospectively analyzed the effects of prenatal professional breastfeeding education for the family on mastering the lactation latch and preventing nipple damage. Medical records of pregnant women in the authors' hospital from April 2020 to July 2020 were prospectively analyzed. A total of 342 patients were enrolled and divided into experimental and control groups according to whether or not they had received prenatal professional breastfeeding education for the family by the random number table method. The difference in the mastery rate of the postpartum breastfeeding posture and nipple damage was examined three days postpartum. The mastery rate in the experimental group (88.5%) was significantly higher than that in the control group (63.8%), whereas the rate of nipple damage in the experimental group (23.1%) was significantly lower than that in the control group (46.9%). Prenatal professional breastfeeding education for the family can promote mothers' mastery of breastfeeding latch skills and reduce the risk of nipple damage.