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Strengthening the evidence base for maternal and child health programs

New: MCH Best strategies database for sample ESMs

Evidence Tools
MCH Best. NPM 4: Breastfeeding

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baby feeding at it's mother's breastProvider Training (Stand-Alone)

MCH Strategy. Provide training to health care providers around breastfeeding best practices.

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Overview. There has been promising research to show that intensive breastfeeding education for health care practitioners may increase breastfeeding initiation rates. This training for providers may have less of an impact on exclusive breastfeeding rates.1,2

Evidence. Emerging Evidence. There is some evidence of the effectiveness for provider training only on breastfeeding initiation and exclusivity at 6 months. More research is needed for conclusive results. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Provider/Practice.

Outcome. Initiation, Duration, and Exclusivity. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.

Examples from the Field. There are currently 6 ESMs across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. Access descriptions of these ESMs through the MCH Digital Library. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the strategy “Provide training to health care providers around breastfeeding best practices,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies). Note that these examples also tease out addressing health equity by focusing on providers from minority groups as a possible way to more effectively influence vulnerable families to breastfeed:

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of health providers participating in certified lactation counselors training who are minority women.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of health providers participating in certified lactation counselors training who are minority women.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of health providers participating in certified lactation counselors training who are minority women that report an increase in confidence in promoting breastfeeding best practices.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of health providers participating in certified lactation counselors training who are minority women that report an increase in confidence in promoting breastfeeding best practices.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


Reference:

1 Rosen-Carole, C., Allen, K., Thompson, J., Martin, H., Goldstein, N., & Lawrence, R. A. (2019). Prenatal Provider Support for Breastfeeding: Changes in Attitudes, Practices and Recommendations Over 22 Years. Journal of Human Lactation, 0890334419830996.

2 Grossman X, Chaudhuri J, Feldman-Winter L, et al. Hospital Education in Lactation Practices (Project HELP): does clinician education affect breastfeeding initiation and exclusivity in the hospital? Birth. 2009; 36(1):54-59.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.