Original Research Well Established Women of lower socioeconomic status and certain minority women are less likely to initiate breastfeeding and to breastfeed exclusively. Use of educational videos prenatally is a potentially cost-effective strategy to promote breastfeeding. Newly ExpressedThis study tested the effectiveness of a breastfeeding education video in the prenatal clinic. The results suggest that an educational video alone is ineffective in improving the hospital breastfeeding practices of low-income women. BackgroundBreastfeeding provides substantial health, psychosocial, economic, and environmental benefits for both infant and mother, and exclusive breastfeeding grants even greater health benefits than partial breastfeeding. Abstract Background: Guidelines recommend prenatal education to improve breastfeeding rates; however, effective educational interventions targeted at low-income, minority populations are needed as they remain less likely to breastfeed. Objective: To determine whether a low-cost prenatal education video improves hospital rates of breastfeeding initiation and exclusivity in a low-income population. Methods: A total of 522 low-income women were randomized during a prenatal care visit occurring in the third trimester to view an educational video on either breastfeeding or prenatal nutrition and exercise. Using multivariable analyses, breastfeeding initiation rates and exclusivity during the hospital stay were compared. Results: Exposure to the intervention did not affect breastfeeding initiation rates or duration during the hospital stay. The lack of an effect on breastfeeding initiation persisted even after controlling for partner, parent, or other living at home and infant complications (adjusted odds ratio [OR] = 1.05, 95% CI, 0.70-1.56). In addition, breastfeeding exclusivity rates during the hospital stay did not differ between the groups (P = .87). Conclusion: This study suggests that an educational breastfeeding video alone is ineffective in improving the hospital breastfeeding practices of low-income women. Increasing breastfeeding rates in this at-risk population likely requires a multipronged effort begun early in pregnancy or preconception.

Problem-based learning (PBL) continues to be a feature of many nursing programmes and has been the subject of a number of empirical studies. This study explored the experience of PBL of a group of registered nurses undertaking a 1 year children's nursing programme. Focus group interviews at the end of the programme and 6 months post-qualification captured the student's perceptions of how they experienced learning to be a children's nurse on this type of programme and subsequently the impact it had had on them on their return to practice.Themes identified by the focus groups centred on the transitions students have to make to this type of learning and the need to let go of previous education expectations. Adapting to the PBL process led to a range of strategies being employed by the group to cope with the new demand, resulting in largely negative perceptions of PBL on programme completion. The second focus group allowed the group time to reflect on their experience and the impact of it on their role and presented a positive balanced view of their experience. This included increased confidence, assertiveness, being more questioning of practice and likely to search for and use evidence to underpin practice than before this PBL programme.This research demonstrates the need to provide more initial preparation at the start of programmes to support the transition to PBL and provide ongoing mechanisms for listening and responding to student concerns about the PBL process. For those considering PBL in the future, blended approaches rather than curricula wholly delivered by PBL may be more suited to shorter programmes of study. However, the overall message from this research indicates that although the students experienced difficulties in the process, the outcome did in fact meet their needs in the longer term.

These findings suggest breastfeeding promotion should target women early and include sensitive, effective ways to promote breastfeeding among women who have not previously successfully breastfed. Breastfeeding history should be elicited, and plans to pump should be supported prenatally.

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