173 - Empowering NICU Teams: Identifying and Addressing Breast/Chestfeeding Knowledge Gaps Through a Needs Assessment

Publication Number: 4170.173

Deborah M. Adegbosin, Comer Children's Hospital at University of Chicago Medical Center, Homewood, IL, United States; Gillian Brennan, Comer Children's Hospital at University of Chicago Medical Center, Chicago, IL, United States; Christine Carlos, University of Chicago Division of the Biological Sciences The Pritzker School of Medicine, CHICAGO, IL, United States

Background: Breastfeeding offers critical health and developmental benefits, especially for preterm infants in the Neonatal Intensive Care Units (NICU). Despite this, providers report inconsistent preparation to support lactation due to limited training, competing clinical demands, and maternal-infant separation. Effective support requires all team members, residents, fellows, NNPs, and faculty, to possess standardized, hands-on skills in latch assessment, troubleshooting, and breast pump use.

Objective: Evaluate self-reported confidence and perceived knowledge in key lactation support skills among pediatric residents (PRs) and NICU providers (NPs), identify strengths and deficiencies, and guide the development of targeted education and professional training initiatives.

Design/Methods: Anonymous electronic surveys were distributed to PRs and NPs at our Level IV NICU to assess breastfeeding knowledge, confidence, perceived barriers, and preferred learning modalities. PRs rated their confidence using a 5-point Likert scale, with "Moderately Confident" or higher considered positive. NPs indicated "Confident" or "Not Confident." Descriptive statistics summarized results. The project was IRB-exempt.

Results: 25 of 35 (71%) PRs and 33 of 50 (66%) NPs completed the survey. Among PRs, only 28% reported prior formal breastfeeding education. While 64% were confident communicating breastfeeding benefits, confidence in practical skills was substantially lower: 16% in identifying and troubleshooting problems, 12% in teaching positioning and latch, and 20% in assisting with breast pump use and milk expression (Figure 1). Among NPs, 76% were confident in educating families, but only 39% felt confident in assisting with full breastfeeding sessions, 36% were confident in demonstrating hand expression, and 16% were confident in setting up a Symphony breast pump (Figure 2). Although response formats differed between groups, both demonstrated low confidence with hands-on lactation skills. Commonly cited barriers included limited time, lack of knowledge, comfort, and inadequate personal experience (Figure 3a). Residents identified simulation as the most desired modality for breastfeeding education.

Conclusion(s): Despite recognizing breastfeeding's importance, both pediatric residents and NICU providers exhibit low hands-on confidence in core lactation skills. This needs assessment demonstrates the need and desire for a standardized, simulation-based breastfeeding education program to strengthen technical proficiency, promote interprofessional consistency, and improve maternal-infant outcomes in the NICU.

Figure 1. Pediatric Residents' Confidence in Breastfeeding Support Skills
5-point Likert scale of pediatric residents' confidence in breastfeeding support skills (1 = Not Confident; 5 = Very Confident). Residents were most confident in communicating breastfeeding benefits but less confident in practical skills such as teaching positioning and latch techniques, identifying and troubleshooting problems, and assisting with breast pump use and milk expression.

Figure 2. NICU Providers' Confidence in Breastfeeding Support Skills
Binary survey of NICU providers' confidence in breastfeeding support skills (Confident vs. Not Confident). Providers were most confident educating parents but less confident with hands-on techniques such as assisting sessions, hand expression, and pump use.

Figure 3a-b. (Top) Reported barriers to providing breastfeeding support among pediatric residents and NICU providers. (Bottom) Preferred breastfeeding educational formats among pediatric residents, with hands-on simulation most favored.