Enhancing student public health nurses’ breastfeeding support competency: A Pilot initiative

Helen Mulcahy, Mary O'Connor, Patricia Leahy-Warren


Breastfeeding is best for the health and well-being of mothers and babies and is recommended to continue for up to two years. The overwhelming evidence demonstrates its important contribution to public health in both developed and under developed countries and yet rates remain lower than the accepted norm. The determinants of breastfeeding are multifactorial and thus require varying supportive measures at many levels. Education is often perceived to be the key to success, however, applying breastfeeding education to practice for health care practitioners is complex, challenging and not easily translated. A competency framework which was developed to assess breastfeeding support was applied to a clinical educational package for student public health nurses (PHN). This paper describes how this pilot initiative was developed, achieved and evaluated. The competency package was used during clinical practice placements, over an 8-month period, to capture indicators of breastfeeding support achieved at both awareness and generalist levels. Evidence of assessing breastfeeding in practice supported by preceptor public health nurses or midwives was also recorded. Preliminary results indicate that student PHNs positively evaluated this initiative. The ease of application of this intervention warrants further examination with a larger more diverse cohort of HCPs and inclusion of breastfeeding outcome measures beyond the educators.

Full Text:




World Health Organisation. Global strategy on infant and young child feeding. The optimal duration of exclusive breastfeeding. The 54th world health assembly. Geneva: World Health Organisation; 2001.

Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, Piwoz EG, Richter LM, Victora CG, Group TL. Why invest, and what it will take to improve breastfeeding practices? The Lancet. 2016 Feb 5; 387(10017):491-504.

Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J, Murch S, Sankar MJ, Walker N, Rollins NC, Group TL. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet. 2016 Feb 5;387 (10017):475-90.

Horta BL, Victora CG. Long-term effects of breastfeeding-a systematic review. http://biblio.szoptatasert.hu/sites/default/files/Long-term_effects_of_breastfeeding_WHO2013.pdf [accessed 4/09/2017]

Yan J, Liu L, Zhu Y, Huang G, Wang PP. The association between breastfeeding and childhood obesity: a meta-analysis. BMC Public Health. 2014 Dec 13;14(1):1267.

Breda J, Webber L, Kirby T. Proportion of overweight and obese males and female to increase in most European countries by 2030, say latest projections by WHO. World Health Organisation; 2015. [cited 2016 May 13]; Available from: http:// nhfshare.heartforum.org.uk/RMAssets/NHFMediaReleases/2015/ECO2015- WEDSPRESSWHO4.pdf.

Economic and Social Research Institute. National perinatal statistics report 2013. Dublin: Health Service Executive; 2013 http://www.hse.ie/eng/services/ publications/Perinatal_Statistics_Report_2013.pdf; [accessed 28.03.16].

Economic and Social Research Institute. Perinatal statistics report 2011. Economic and Social Research Institute; 2011. [cited 2015 June 1]; Available from: https://www.esri.ie/pubs/SUSTAT46.pdf. [accessed 28.03.16]

Leahy-Warren P, Mulcahy H, Phelan A, Corcoran P. Factors influencing initiation and duration of breastfeeding in Ireland. Midwifery 2014;30 (3):345– 5210.1016/jmidw.2013.01.008.

Tarrant R, Younger K, Sheridan-Pereira M, White M, Kearney J. The prevalence and determinants of breastfeeding initiation and duration in a sample of women in Ireland. Public Health Nutr 2009; 6:760–70.

Dyson L, Renfrew MJ, McFadden A, McCormick F, Herbert G, Thomas J. Policy and public health recommendations to promote the initiation and duration of breast-feeding in developed country settings. Public health nutrition. 2010 Jan;13 (1):137-44.

Alderdice F, Hamilton K, McNeill J, Lynn F, Curran R & Redshaw M (2016)

Birth NI: A Survey of Women’s Experience of Maternity Care in Northern Ireland

http://www.qub.ac.uk/schools/SchoolofNursingandMidwifery/FileStore/Filetoupload,670193,en.pdf?platform=hootsuite [accessed 3rd Sept 2017]

Health Services Executive (2016) Breastfeeding in a Healthy Ireland Health Service Breastfeeding Action Plan 2016 - 2021https://www.breastfeeding.ie/Uploads/breastfeeding-in-a-healthy-ireland.pdf (accessed 4/09/2017).

Humphreys, K. (2017) Seanad Éireann Debate - Wednesday, 12 July 2017 http://beta.oireachtas.ie/en/debates/debate/seanad/2017-07-12/3/ )

Leahy-Warren P, Creedon M, O’Mahony A, Mulcahy H. Normalising breastfeeding within a formula feeding culture: An Irish qualitative study. Women and Birth. 2017 Apr 1;30 (2):e103-10.

Hannula, L., Kaunonen, M. and Tarkka, M.-T. (2008), A systematic review of professional support interventions for breastfeeding. Journal of Clinical Nursing, 17: 1132–1143. doi:10.1111/j.1365-2702.2007.02239.x

, Mulcahy, H., Phelan, A., Corcoran, P., & Leahy-Warren, P. (2012). Examining the breastfeeding support resources of the public health nursing services in Ireland. Journal of Clinical Nursing, 21(7-8), 1097-1108. doi:10.1111/j.1365-2702.2011.03975.x

McFadden A, Gavine A, Renfrew M, Wade A, Buchanan P, Taylor JL, Veitch E, Rennie A, Crowther SA, Neiman S, MacGillivray S. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database of Systematic Reviews 2017, Issue 2. Art. No.: CD001141. DOI: 10.1002/14651858.CD001141.pub5

HSE (2014) HSE Guideline PHN Service CHO Area 9 Guideline for the Observation of a Breastfeed & the Breastfeeding Observation Assessment Tool. Document Reference No: PHNCHO9/1, Revision No. 1 Approval Date: November 2014

Gallagher L, Muldoon k and McGuinness D (2015) Competence. Framework for Breastfeeding Support. The University of Dublin, Trinity College Dublin. Available at http://www.alcireland.ie/wp-content/uploads/2015/09/COMPETENCE-FRAMEWORK-FOR-BREASTFEEDING-SUPPORT.pdf [accessed 17th August 2017]

Britton, C., McCormick F., Renfrew M., Wade A., & King S. (2009). Support for Breastfeeding mothers (review). London: The Cochrane Collaboration Wiley Publishers

Gerd AT, Bergman S, Dahlgren J, Roswall J, Alm B. (2012) Factors associated with discontinuation of breastfeeding before 1 month of age. Acta Paediatr.101(1):55-60. doi: 10.1111/j.1651-2227.2011.02405.x. Epub 2011 Jul 22.

DOI: http://dx.doi.org/10.18103/imr.v3i10.580


  • There are currently no refbacks.
Copyright 2016. All rights reserved.