Document Type

DNP Project

Department

School of Nursing

Date of Degree

Spring 2026

Degree

Doctor of Nursing Practice (DNP)

Primary Advisor

Linda Cassar, DNP, RNC-OB, CNE

Keywords

Postpartum care; Lactation Support; Breastfeeding; Newborn Health; Maternal Health

Abstract

Background: There are life-saving health benefits associated with breastfeeding. The receipt of early and consistent lactation support improves breastfeeding outcomes. However, for C-section patients at this site, breastfeeding rates are low, initial lactation consults are delayed, and follow-up consults are sometimes not received.

Aims: This project aimed to implement an early lactation support workflow to decrease missed lactation care and increase exclusive breastfeeding rates among C-section patients on a postpartum unit. Evaluation outcomes were: (1) the receipt of initial consults within 24 hours of delivery, (2) the receipt and timing of follow-up consults, (3) exclusive breastfeeding rates, and (4) staff workflow preference. All variables were assessed pre and post intervention.

Methods: The lactation workflow was redesigned using colors to indicate patient consult status. After education and implementation, chi-square analysis was used to compare the pre and post implementation rates of consults (initial, follow-up, missed) and exclusive breastfeeding. A pre and post intervention staff survey assessed workflow preference.

Results: There were 349 C-section patients from one hospital postpartum unit (165 pre and 184 post intervention). There was a statistically significant reduction in missed consults. There were clinically significant improvements in initial and follow-up (45.8% consults, but this was not statistically significant. The exclusive breastfeeding rate decreased. 13 of the 14 staff survey respondents (92.9%) preferred the early support workflow to the pre intervention workflow.

Recommendations: The workflow significantly reduced missed lactation care and improved the provision of early and consistent lactation support. There was no associated improvement in exclusive breastfeeding rates highlighting the complexities of this measure, the unique challenges that accompany delivery via C-section, and the need for additional improvement strategies.

Open Access

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