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The World Health Organization (2011) reports that nearly 40% of all deaths of children five years of age and younger occurred during the neonatal period. Furthermore, among the 3.1 million deaths that occurred among neonates in 2008, about a third was related to infections. This is disconcerting because many infections that occur in the neonate are preventable. A well-known prevention strategy to fight infection in the newborn is breastfeeding. The advantages of breastfeeding have been well-documented with respect to the immunological benefits (American Academy of Pediatrics, 2005; Horta et al., 2007). Thus, the Healthy People 2020 initiative aims to increase the proportion of mothers who breastfeed their infants to 82% (United States Department of Health and Human Resources, 2011). However, although the benefit of breastfeeding to decrease infection and infant mortality are clear, there are numerous challenges and barriers to breastfeeding that impede this natural feeding behavior. The American College of Obstetricians and Gynecologists [ACOG] (2007) strongly encourage all health professionals caring for breastfeeding women to use their knowledge and skills to encourage and support women to breastfeed. With more than 3 million members, nurses play a critical role in this process. Comprising the largest segment of the healthcare workforce (Institute of Medicine [IOM], 2010), nurses have been reported to have substantial influence on new mothers, both on their decision to breastfeed and on their continuance during the postpartum period (Wambach et al., 2005). Accordingly, breastfeeding initiation must be aggressively targeted by the many nurses that provide care during the neonatal period to improve the health of newborns. Research has shown breastfeeding can reduce infant mortality and mortality by 21% in infants who were exclusively breastfed for 6 months (Chen and Rogan, 2004). However, there are multiple barriers that influence the ability of a mother to successfully breastfeed. These barriers can be multifaceted and can arise from the very providers that care for them. Adequate knowledge of these barriers can improve breastfeeding during the neonatal period and in turn decrease infections, morbidity, and mortality. Therefore, this article will address challenges and barriers to exclusive breastfeeding during the neonatal period and provide strategies to overcome these barriers during the first four weeks of a newborn's life. |
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