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The lactation skill gaps of multidisciplinary paediatric healthcare professionals in the United Kingdom

LYNDSEY HOOKWAY, Amy Brown Orcid Logo

Journal of Human Nutrition and Dietetics, Volume: 36, Issue: 3

Swansea University Authors: LYNDSEY HOOKWAY, Amy Brown Orcid Logo

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DOI (Published version): 10.1111/jhn.13172

Abstract

Background: Breastfeeding is an important public health priority and may be particularly beneficial for medically complex infants and children. However, childhood illness and disability are associated with increased challenges and lower breastfeeding rates. The Baby Friendly Initiative has been show...

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Published in: Journal of Human Nutrition and Dietetics
ISSN: 0952-3871 1365-277X
Published: Wiley 2023
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URI: https://cronfa.swan.ac.uk/Record/cronfa63190
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However, childhood illness and disability are associated with increased challenges and lower breastfeeding rates. The Baby Friendly Initiative has been shown to increase initiation of breastfeeding and improve health professional skills although as yet the standards have not been adopted in paediatrics. Previous studies have found breastfeeding knowledge gaps among paediatric nurses, and a recent systematic review highlighted insufficient lactation support, discouragement by healthcare professionals and lack of resources. The aim of this survey of UK paediatric professionals was to establish their self‐defined confidence and skills supporting breastfeeding. Methods: An online survey was developed to explore associations between level of training and staff confidence and perceived skill, to establish whether there is evidence that more training and/or higher breastfeeding training credentials improve skill. In total, 409 professionals, including paediatric doctors at all grades, paediatric nurses and allied health professionals, were included in the analysis. Results: This study identified specific skill gaps among professionals. Many healthcare professionals felt that different skills and specific training are required to support medically complex children. Several professionals noted that existing breastfeeding training focuses on establishing breastfeeding in healthy newborns rather than sick children in paediatrics. Participants were asked about 13 clinical competencies, and an aggregate skill score was calculated. Multiple univariate analysis of variance found that more extensive training and higher credentials are correlated with higher skill scores(p≤0.001), whereas type of professional was not. Conclusions: Despite this being a relatively motivated sample of healthcare professionals, the findings of this study suggest that breastfeeding skills are patchy and inconsistent, and particularly lacking when it comes to more complex clinical scenarios. This is significant, because it may mean that children who have more significant illness or medical complexity are disproportionately affected by gaps in knowledge and skill. Medically complex children encounter many barriers to optimal feeding−including absence of designated paediatric lactation staff, resources and support−and may have challenges such as low tone, higher calorie need and transitioning to the breast after ventilation or enteral feeding. Current skill gaps indicate that existing training would be insufficient, and bespoke paediatric breastfeeding training based on identified clinical challenges is thus justified.</abstract><type>Journal Article</type><journal>Journal of Human Nutrition and Dietetics</journal><volume>36</volume><journalNumber>3</journalNumber><paginationStart/><paginationEnd/><publisher>Wiley</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0952-3871</issnPrint><issnElectronic>1365-277X</issnElectronic><keywords>breastfeeding, clinical competencies, infant nutrition, paediatrics, public health.</keywords><publishedDay>17</publishedDay><publishedMonth>5</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-05-17</publishedDate><doi>10.1111/jhn.13172</doi><url>http://dx.doi.org/10.1111/jhn.13172</url><notes/><college>COLLEGE NANME</college><CollegeCode>COLLEGE CODE</CollegeCode><institution>Swansea University</institution><apcterm/><funders/><projectreference/><lastEdited>2023-12-20T15:45:30.0508711</lastEdited><Created>2023-04-18T14:44:28.7029211</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">School of Health and Social Care - Healthcare Science</level></path><authors><author><firstname>LYNDSEY</firstname><surname>HOOKWAY</surname><order>1</order></author><author><firstname>Amy</firstname><surname>Brown</surname><orcid>0000-0002-0438-0157</orcid><order>2</order></author></authors><documents><document><filename>63190__27111__e8697fd2392c4d17ab3b8543122afea7.pdf</filename><originalFilename>63190.VOR.pdf</originalFilename><uploaded>2023-04-18T14:54:50.8767948</uploaded><type>Output</type><contentLength>618652</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>Distributed under the terms of a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>https://creativecommons.org/licenses/by-nc-nd/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling v2 63190 2023-04-18 The lactation skill gaps of multidisciplinary paediatric healthcare professionals in the United Kingdom 5b6a46f227828ab6507622903e48f98f LYNDSEY HOOKWAY LYNDSEY HOOKWAY true false 37aea6965461cb0510473d109411a0c3 0000-0002-0438-0157 Amy Brown Amy Brown true false 2023-04-18 Background: Breastfeeding is an important public health priority and may be particularly beneficial for medically complex infants and children. However, childhood illness and disability are associated with increased challenges and lower breastfeeding rates. The Baby Friendly Initiative has been shown to increase initiation of breastfeeding and improve health professional skills although as yet the standards have not been adopted in paediatrics. Previous studies have found breastfeeding knowledge gaps among paediatric nurses, and a recent systematic review highlighted insufficient lactation support, discouragement by healthcare professionals and lack of resources. The aim of this survey of UK paediatric professionals was to establish their self‐defined confidence and skills supporting breastfeeding. Methods: An online survey was developed to explore associations between level of training and staff confidence and perceived skill, to establish whether there is evidence that more training and/or higher breastfeeding training credentials improve skill. In total, 409 professionals, including paediatric doctors at all grades, paediatric nurses and allied health professionals, were included in the analysis. Results: This study identified specific skill gaps among professionals. Many healthcare professionals felt that different skills and specific training are required to support medically complex children. Several professionals noted that existing breastfeeding training focuses on establishing breastfeeding in healthy newborns rather than sick children in paediatrics. Participants were asked about 13 clinical competencies, and an aggregate skill score was calculated. Multiple univariate analysis of variance found that more extensive training and higher credentials are correlated with higher skill scores(p≤0.001), whereas type of professional was not. Conclusions: Despite this being a relatively motivated sample of healthcare professionals, the findings of this study suggest that breastfeeding skills are patchy and inconsistent, and particularly lacking when it comes to more complex clinical scenarios. This is significant, because it may mean that children who have more significant illness or medical complexity are disproportionately affected by gaps in knowledge and skill. Medically complex children encounter many barriers to optimal feeding−including absence of designated paediatric lactation staff, resources and support−and may have challenges such as low tone, higher calorie need and transitioning to the breast after ventilation or enteral feeding. Current skill gaps indicate that existing training would be insufficient, and bespoke paediatric breastfeeding training based on identified clinical challenges is thus justified. Journal Article Journal of Human Nutrition and Dietetics 36 3 Wiley 0952-3871 1365-277X breastfeeding, clinical competencies, infant nutrition, paediatrics, public health. 17 5 2023 2023-05-17 10.1111/jhn.13172 http://dx.doi.org/10.1111/jhn.13172 COLLEGE NANME COLLEGE CODE Swansea University 2023-12-20T15:45:30.0508711 2023-04-18T14:44:28.7029211 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Healthcare Science LYNDSEY HOOKWAY 1 Amy Brown 0000-0002-0438-0157 2 63190__27111__e8697fd2392c4d17ab3b8543122afea7.pdf 63190.VOR.pdf 2023-04-18T14:54:50.8767948 Output 618652 application/pdf Version of Record true Distributed under the terms of a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. true eng https://creativecommons.org/licenses/by-nc-nd/4.0/
title The lactation skill gaps of multidisciplinary paediatric healthcare professionals in the United Kingdom
spellingShingle The lactation skill gaps of multidisciplinary paediatric healthcare professionals in the United Kingdom
LYNDSEY HOOKWAY
Amy Brown
title_short The lactation skill gaps of multidisciplinary paediatric healthcare professionals in the United Kingdom
title_full The lactation skill gaps of multidisciplinary paediatric healthcare professionals in the United Kingdom
title_fullStr The lactation skill gaps of multidisciplinary paediatric healthcare professionals in the United Kingdom
title_full_unstemmed The lactation skill gaps of multidisciplinary paediatric healthcare professionals in the United Kingdom
title_sort The lactation skill gaps of multidisciplinary paediatric healthcare professionals in the United Kingdom
author_id_str_mv 5b6a46f227828ab6507622903e48f98f
37aea6965461cb0510473d109411a0c3
author_id_fullname_str_mv 5b6a46f227828ab6507622903e48f98f_***_LYNDSEY HOOKWAY
37aea6965461cb0510473d109411a0c3_***_Amy Brown
author LYNDSEY HOOKWAY
Amy Brown
author2 LYNDSEY HOOKWAY
Amy Brown
format Journal article
container_title Journal of Human Nutrition and Dietetics
container_volume 36
container_issue 3
publishDate 2023
institution Swansea University
issn 0952-3871
1365-277X
doi_str_mv 10.1111/jhn.13172
publisher Wiley
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Healthcare Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Healthcare Science
url http://dx.doi.org/10.1111/jhn.13172
document_store_str 1
active_str 0
description Background: Breastfeeding is an important public health priority and may be particularly beneficial for medically complex infants and children. However, childhood illness and disability are associated with increased challenges and lower breastfeeding rates. The Baby Friendly Initiative has been shown to increase initiation of breastfeeding and improve health professional skills although as yet the standards have not been adopted in paediatrics. Previous studies have found breastfeeding knowledge gaps among paediatric nurses, and a recent systematic review highlighted insufficient lactation support, discouragement by healthcare professionals and lack of resources. The aim of this survey of UK paediatric professionals was to establish their self‐defined confidence and skills supporting breastfeeding. Methods: An online survey was developed to explore associations between level of training and staff confidence and perceived skill, to establish whether there is evidence that more training and/or higher breastfeeding training credentials improve skill. In total, 409 professionals, including paediatric doctors at all grades, paediatric nurses and allied health professionals, were included in the analysis. Results: This study identified specific skill gaps among professionals. Many healthcare professionals felt that different skills and specific training are required to support medically complex children. Several professionals noted that existing breastfeeding training focuses on establishing breastfeeding in healthy newborns rather than sick children in paediatrics. Participants were asked about 13 clinical competencies, and an aggregate skill score was calculated. Multiple univariate analysis of variance found that more extensive training and higher credentials are correlated with higher skill scores(p≤0.001), whereas type of professional was not. Conclusions: Despite this being a relatively motivated sample of healthcare professionals, the findings of this study suggest that breastfeeding skills are patchy and inconsistent, and particularly lacking when it comes to more complex clinical scenarios. This is significant, because it may mean that children who have more significant illness or medical complexity are disproportionately affected by gaps in knowledge and skill. Medically complex children encounter many barriers to optimal feeding−including absence of designated paediatric lactation staff, resources and support−and may have challenges such as low tone, higher calorie need and transitioning to the breast after ventilation or enteral feeding. Current skill gaps indicate that existing training would be insufficient, and bespoke paediatric breastfeeding training based on identified clinical challenges is thus justified.
published_date 2023-05-17T15:45:30Z
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score 11.012924

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