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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Breastfeeding.

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Strategy. Breastfeeding Education Programs

Approach. Offer professional support and educational opportunities via videos, trainings, and resources to promote breastfeeding

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Overview. Research indicates that patient care is an essential component of hospital care with providers increasingly relying on the support of both interdisciplinary colleagues and technology to aid in teaching patients and their families before hospital discharge.[1] Studies examined the impact of educational videos delivered bedside to postpartum mothers,[2] one-on-one breastfeeding training during the prenatal and postnatal periods,[3] and providing eHealth resources to mothers and their co-parents[4] to support exclusive breastfeeding.

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).
  • Environmental Health. This strategy improves the impact of physical, chemical, and biological factors in the environment on health.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Health Teaching (Education and Promotion) (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy or aligned components.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

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

  • Number of breastfeeding education programs aligned with WHO/UNICEF Baby-Friendly Hospital Initiative standards. (Assesses alignment with global best practices) Number of educational programs co-designed with input from a variety of community members and breastfeeding supporters. (Evaluates authentic engagement)

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

  • Percent of breastfeeding education sessions incorporating hands-on skills practice and problem-solving scenarios. (Evaluates adherence to adult learning principles) Percent of educational materials reviewed for health literacy and usability for various populations. (Assesses use of health literacy principles)

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

  • Number of cross-disciplinary trainings conducted to integrate breastfeeding education into various healthcare settings (e.g., prenatal care, pediatrics). (Shows provider training and capacity) Number of local health improvement plans incorporating comprehensive breastfeeding education programs. (Assesses integration into existing plans) Number of breastfeeding-related complications prevented through timely education and early intervention. (Measures clinical impact) Number of organizational policies changed to support breastfeeding education and practices based on program outcomes. (Assesses system-level improvements)

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

  • Percent of breastfeeding educators recruited from communities experiencing low breastfeeding rates. (Evaluates representation) Percent of program resources allocated to addressing social challenges affecting breastfeeding (e.g., workplace support, food security). (Assesses strategic deployment) Percent reduction in breastfeeding initiation and duration gaps across socioeconomic groups participating in education programs. (Measures changes in health outcomes) Percent improvement in breastfeeding rates in communities with low prevalence after implementation of tailored education programs. (Assesses population-level health impacts)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

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

References

1 Shealy KR, Li R, Benton-Davis S, Grummer-Strawn L. The CDC Guide to Breastfeeding Interventions. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2005.

2 Marmet, J., Schmiesing, A., Scheuer, J., Osborn, C., Lunos, S. A., & Pitt, M. B. (2020). Prescribing Video-Based Patient Education in the Hospital Setting: Can Bedside Breastfeeding Videos Affect Exclusive Breastfeeding at Postpartum Discharge?. Hospital pediatrics, 10(3), 266-271.

3 Yılmaz, M., & Aykut, M. (2021). The effect of breastfeeding training on exclusive breastfeeding: a randomized controlled trial. The Journal of Maternal-Fetal & Neonatal Medicine, 34(6), 925-932.

4 Abbass-Dick, J., Sun, W., Newport, A., Xie, F., Godfrey, D., & Goodman, W. M. (2020). The comparison of access to an eHealth resource to current practice on mother and co-parent teamwork and breastfeeding rates: A randomized controlled trial. Midwifery, 90, 102812.

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.