Implementing an education program for nurse-midwives focused on early essential care for breast milk expression among mothers of preterm infants

Implementing an education program for nurse-midwives focused on early essential care for breast milk expression among mothers of preterm infants | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Implementing an education program for nurse-midwives focused on early essential care for breast milk expression among mothers of preterm infants Rie Tanaka, Shigeko Horiuchi This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-136755/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 12 You are reading this latest preprint version Abstract Background Although breastfeeding guidelines for infants admitted to the neonatal intensive care unit (NICU) have been introduced in Japan, these guidelines have not been reflected in practice. To improve this situation, it is important for nurses and nurse-midwives to acquire knowledge of appropriate care. This study examined changes in the knowledge of appropriate care of nurse-midwives after implementing an educational program focused on early essential care for breast milk expression among mothers of preterm infants. Methods This before-after study using a single group enrolled 36 nurse-midwives in one perinatal medical center. The educational program content included nurses’ roles in early essential care for milk expression and the necessary care to promoting breast milk production among mothers of preterm infants. The nurse-midwives' knowledge and attitude on care were investigated three months before (pre-1), just before (pre-2), just after (post-1), and three months after (post-2) the program. The nurse-midwives’ care implementation was investigated at pre-1, pre-2, and post-2. During this time, 11 mothers (before: 7, after: 4) reported the status of milk expression for 10 days after birth. Results The mean knowledge scores of the nurse-midwives at post-1 and post-2 were significantly higher than that at pre-2 (post-1: p < 0.001, post-2: p < 0.001). The attitude on care scores at post-1 and post-2 were significantly higher than that at pre-2 (post-1: p < 0.001, post-2: p = 0.010). The care implementation score at post-2 was significantly higher than that at pre-2 in eight items (e.g., Q7 Explain about the effect of initiating milk expression early and assist mothers in it). However, the educational program did not cause any changes in the mothers’ initiation and frequency of milk expression, and breast milk volume after birth. Conclusions The significant increases in the knowledge, attitude on care, and care implementation scores of the nurse-midwives suggest the beneficial effects of the educational program. Further detailed examination of the effects of the program on nurses and nurse-midwives, and identification of methods to reduce barriers to the practice of best evidence in the clinical setting are warranted to improve mothers’ status of milk expression. Sexual & Reproductive Medicine Preterm infants Mothers Breast milk expression Obstetric nursing Education Figures Figure 1 Figure 2 Figure 3 Figure 4 Full Text Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Major revision 23 Jan, 2021 Review # 2 received at journal 21 Jan, 2021 Review # 3 received at journal 21 Jan, 2021 Review # 1 received at journal 12 Jan, 2021 Reviewer # 2 agreed at journal 06 Jan, 2021 Reviewer # 3 agreed at journal 06 Jan, 2021 Reviewers invited by journal 03 Jan, 2021 Reviewer # 1 agreed at journal 03 Jan, 2021 Editor assigned by journal 25 Dec, 2020 Submission checks completed at journal 25 Dec, 2020 Editor invited by journal 25 Dec, 2020 First submitted to journal 21 Dec, 2020 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-136755","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research","associatedPublications":[],"authors":[{"id":7133611,"identity":"9eafa53e-e341-411a-9ff8-2f7e2eabc4a0","order_by":0,"name":"Rie 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16:17:24","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":109254,"visible":true,"origin":"","legend":"Attitude scores (median and IQR) of nurse-midwives at four time-points","description":"","filename":"Fig2.png","url":"https://assets-eu.researchsquare.com/files/rs-136755/v1/5c6364d3566dabefd293f7f3.png"},{"id":4633778,"identity":"1c958ca9-4b8f-4b4b-9261-a49eae5c7942","added_by":"auto","created_at":"2020-12-31 16:20:24","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":44519,"visible":true,"origin":"","legend":"Number of hours before initiation of milk expression in mothers","description":"","filename":"Fig3.png","url":"https://assets-eu.researchsquare.com/files/rs-136755/v1/66405ad1e8bd4c0f8c8f1332.png"},{"id":4633538,"identity":"720b156f-9ca5-48c8-8003-8188788cc352","added_by":"auto","created_at":"2020-12-31 16:17:24","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":26776,"visible":true,"origin":"","legend":"Frequency of milk expression per day for 10 days after birth by each mother","description":"","filename":"Fig4.png","url":"https://assets-eu.researchsquare.com/files/rs-136755/v1/a699d3f0f5add1ce7d5b6cd4.png"},{"id":13643286,"identity":"d80c10ff-09bf-4cfd-9ef5-e4e93b809ad3","added_by":"auto","created_at":"2021-09-17 09:11:03","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":456699,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-136755/v1/30e90f38-322f-4efe-b2a5-cf1276e51f76.pdf"}],"financialInterests":"","formattedTitle":"Implementing an education program for nurse-midwives focused on early essential care for breast milk expression among mothers of preterm infants","fulltext":[{"header":"Full Text","content":"\u003cp\u003eThis preprint is available for \u003ca href='/article/rs-136755/latest.pdf' target='_blank'\u003edownload as a PDF\u003c/a\u003e.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"international-breastfeeding-journal","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ibfj","sideBox":"Learn more about [International Breastfeeding Journal](http://internationalbreastfeedingjournal.biomedcentral.com/)","snPcode":"13006","submissionUrl":"https://submission.nature.com/new-submission/13006/3","title":"International Breastfeeding Journal","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Preterm infants, Mothers, Breast milk expression, Obstetric nursing, Education","lastPublishedDoi":"10.21203/rs.3.rs-136755/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-136755/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground\u003c/p\u003e\u003cp\u003eAlthough breastfeeding guidelines for infants admitted to the neonatal intensive care unit (NICU) have been introduced in Japan, these guidelines have not been reflected in practice. To improve this situation, it is important for nurses and nurse-midwives to acquire knowledge of appropriate care. This study examined changes in the knowledge of appropriate care of nurse-midwives after implementing an educational program focused on early essential care for breast milk expression among mothers of preterm infants. \u003c/p\u003e\u003cp\u003eMethods\u003c/p\u003e\u003cp\u003eThis before-after study using a single group enrolled 36 nurse-midwives in one perinatal medical center. The educational program content included nurses’ roles in early essential care for milk expression and the necessary care to promoting breast milk production among mothers of preterm infants. The nurse-midwives' knowledge and attitude on care were investigated three months before (pre-1), just before (pre-2), just after (post-1), and three months after (post-2) the program. The nurse-midwives’ care implementation was investigated at pre-1, pre-2, and post-2. During this time, 11 mothers (before: 7, after: 4) reported the status of milk expression for 10 days after birth. \u003c/p\u003e\u003cp\u003eResults\u003c/p\u003e\u003cp\u003eThe mean knowledge scores of the nurse-midwives at post-1 and post-2 were significantly higher than that at pre-2 (post-1: p \u0026lt; 0.001, post-2: p \u0026lt; 0.001). The attitude on care scores at post-1 and post-2 were significantly higher than that at pre-2 (post-1: p \u0026lt; 0.001, post-2: p = 0.010). The care implementation score at post-2 was significantly higher than that at pre-2 in eight items (e.g., Q7 Explain about the effect of initiating milk expression early and assist mothers in it). However, the educational program did not cause any changes in the mothers’ initiation and frequency of milk expression, and breast milk volume after birth. \u003c/p\u003e\u003cp\u003eConclusions\u003c/p\u003e\u003cp\u003eThe significant increases in the knowledge, attitude on care, and care implementation scores of the nurse-midwives suggest the beneficial effects of the educational program. Further detailed examination of the effects of the program on nurses and nurse-midwives, and identification of methods to reduce barriers to the practice of best evidence in the clinical setting are warranted to improve mothers’ status of milk expression.\u003c/p\u003e","manuscriptTitle":"Implementing an education program for nurse-midwives focused on early essential care for breast milk expression among mothers of preterm infants","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-12-31 16:17:23","doi":"10.21203/rs.3.rs-136755/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2021-01-24T00:00:00+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2021-01-22T00:00:00+00:00","index":2,"fulltext":"Recommendation: Reviewer's comments unavailable due to the journal's policy.\n"},{"type":"editorInvitedReview","content":"","date":"2021-01-22T00:00:00+00:00","index":3,"fulltext":"Recommendation: Reviewer's comments unavailable due to the journal's policy.\n"},{"type":"editorInvitedReview","content":"","date":"2021-01-13T00:00:00+00:00","index":1,"fulltext":"Recommendation: Reviewer's comments unavailable due to the journal's policy.\n"},{"type":"reviewerAgreed","content":"","date":"2021-01-07T00:00:00+00:00","index":2,"fulltext":""},{"type":"reviewerAgreed","content":"","date":"2021-01-07T00:00:00+00:00","index":3,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2021-01-04T00:00:00+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"","date":"2021-01-04T00:00:00+00:00","index":1,"fulltext":""},{"type":"editorAssigned","content":"","date":"2020-12-26T00:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2020-12-25T23:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2020-12-25T23:00:00+00:00","index":"","fulltext":""},{"type":"submitted","content":"","date":"2020-12-22T00:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"international-breastfeeding-journal","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ibfj","sideBox":"Learn more about [International Breastfeeding Journal](http://internationalbreastfeedingjournal.biomedcentral.com/)","snPcode":"13006","submissionUrl":"https://submission.nature.com/new-submission/13006/3","title":"International Breastfeeding Journal","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"73daf27a-19fa-4963-a203-5b0c4b602b4a","owner":[],"postedDate":"December 31st, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":1652095,"name":"Sexual \u0026 Reproductive Medicine"}],"tags":[],"updatedAt":"2021-05-22T22:03:36+00:00","versionOfRecord":[],"versionCreatedAt":"2020-12-31 16:17:23","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-136755","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-136755","identity":"rs-136755","version":["v1"]},"buildId":"-HB7Z8yhvgn0wM9Nzuekk","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}