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Knowledge and attitude of health staff towards breastfeeding in NICU setting: are we there yet? An Italian survey

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Abstract

The benefits of human milk in preterm infants, a population at high risk for developing adverse outcomes for which breast milk is a protective factor, are widely acknowledged. However, preterms’ admission in a neonatal intensive care unit (NICU) and newborn’s clinical conditions have been described as significant barriers, leading to lower rates of breastfeeding initiation and duration. Healthcare workers play a crucial role in encouraging breastfeeding. We conducted a cross-sectional survey among nurses working in six Italian NICUs, exploring their knowledge and attitude towards breastfeeding. Although the majority of nurses had a specific breastfeeding education, our results show still some variations among answers regarding aspects of breastfeeding support in this setting. Specifically, family-centered care, transition feeding to the breast, and skin-to-skin practice, despite being extensively addressed by the Neo Baby-Friendly Hospital Initiative, are the items that highlighted a range of answers that could result in conflicting information to mothers.

Conclusion: By underlining the gaps of knowledge and attitude towards breastfeeding of nurses working in NICUs, this study provides an insight into what needs to be improved, with the aim of promoting higher rates of breastfeeding in the preterm population.

What is Known:

• Breastfeeding is particularly challenging in the preterm population, despite its universally recognized health benefits.

• Improving healthcare professionals’ knowledge and attitude towards breastfeeding has been shown to be crucial for promoting breastfeeding in NICUs.

What is New:

• Our results provide useful insight into nurses’ knowledge and attitude towards breastfeeding in NICU settings.

• By acknowledging strengths and weaknesses highlighted by this study, tailored strategies could be developed to improve health staff breastfeeding education and support to parents in NICU settings.

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Abbreviations

BFHI:

Baby-Friendly Hospital Initiative

IBCLC:

International Board Certified Lactation Consultant

NICU:

Neonatal intensive care unit

SNS:

Supplemental nursing system

UNICEF:

United Nations International Children’s Emergency Fund

WHO:

World Health Organization

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Acknowledgments

The authors would like to thank the NICU nurses who participated in the present study.

Author information

Authors and Affiliations

  1. Department of Clinical Sciences and Community Health, University of Milan, Via Commenda, 19, Milan, Italy

    Giulia Vizzari, Alessandra Consales, Fabio Mosca & Maria Lorella Giannì

  2. NICU, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122, Milan, Italy

    Daniela Morniroli, Alessandra Consales, Valentina Capelli, Beatrice Letizia Crippa, Lorenzo Colombo, Gabriele Sorrentino, Elena Bezze, Valeria Andrea Soldi, Laura Plevani, Fabio Mosca & Maria Lorella Giannì

  3. Direzione Professioni Sanitarie, Fondazione I.R.C.C.S. Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 28, 20122, Milan, Italy

    Patrizio Sannino

Authors
  1. Giulia Vizzari
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  2. Daniela Morniroli
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Contributions

GV and DM designed the study and wrote the first draft of the manuscript. GS and BLC contributed to data collection and analysis. VC and VAS collected the data and contributed to the interpretation of results. LC, PS, and EB contributed to the interpretation of results, reviewed, and revised the manuscript. AC carried out the statistical analysis and contributed to the interpretation of results. LP, FM, and MLG contributed to design the study, supervised data collection, contributed to the interpretation of results, reviewed, and revised the manuscript. All authors read and approved the final manuscript as submitted.

Corresponding author

Correspondence to Daniela Morniroli.

Ethics declarations

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca’ Granda Ospedale Maggiore Policlinico.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Communicated by Daniele De Luca

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Vizzari, G., Morniroli, D., Consales, A. et al. Knowledge and attitude of health staff towards breastfeeding in NICU setting: are we there yet? An Italian survey. Eur J Pediatr 179, 1751–1759 (2020). https://doi.org/10.1007/s00431-020-03678-5

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  • DOI: https://doi.org/10.1007/s00431-020-03678-5

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