Document Type

DNP Project

Department

School of Nursing

Date of Degree

Spring 2026

Degree

Doctor of Nursing Practice (DNP)

Primary Advisor

Mercedes Echevarria, DNP, APRN, CPHQ, CDCES, CNE

Keywords

Breastfeeding; Healthy People 2030; Patient Education; Human Donor Breast Milk; Infant Care; Lactation Nurses

Abstract

Background: Exclusive breastfeeding provides significant health benefits for infants and lactating individuals; however, national rates remain below Healthy People 2030 targets. Evidence suggests that infants supplemented with pasteurized human donor breast milk (HDBM) during postpartum hospitalization have higher exclusive breastfeeding rates at discharge and at six months. At a suburban Maryland hospital, formal HDBM education was not routinely provided, contributing to low utilization and stagnant breastfeeding rates.

Purpose: To determine whether implementing a structured HDBM education program for postpartum parents increases HDBM supplementation among breastfed infants and improves exclusive breastfeeding rates at discharge.

Methods: This pre-/post-test quality improvement project was guided by the Plan-Do-Study- Act framework. Five IBCLC-certified lactation nurses delivered standardized verbal and written HDBM education to eligible maternal-infant dyads (≥37 weeks’ gestation with intention to breastfeed) on a 36-bed postpartum unit within a 266-bed community hospital. Data were collected using lactation daily report sheets documenting education delivery, HDBM use, and feeding type at discharge. Descriptive statistics summarized outcomes. Independent t-tests compared continuous variables, and chi-square analyses evaluated categorical outcomes, including education receipt, HDBM use, and exclusive breastfeeding rates.

Results: During the 16-week implementation period, 56% of eligible parents received structured HDBM education. Among 363 patients requiring supplementation, 122 (33%) chose HDBM rather than formula, demonstrating increased donor milk utilization following the intervention. Of 821 total patients, 577 (70%) were exclusively feeding human milk at discharge, reflecting improvement from baseline rates. Among those exclusively breastfeeding at discharge, 411 (71%) had received HDBM education within 24 hours of admission.

Conclusion: Early, standardized HDBM education delivered by IBCLC nurses is feasible and associated with increased donor milk utilization and improved exclusive breastfeeding rates at discharge. Broader implementation of structured HDBM education may enhance breastfeeding outcomes and support hospital and national breastfeeding goals.

Open Access

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