ArticleAdvances in neonatal care : official journal of the National Association of Neonatal Nurses2014
Characteristics of the NICU work environment associated with breastfeeding support.
Article in Advances in neonatal care : official journal of the National Association of Neonatal Nurses, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 92 citations in OpenAlex.
- Long-term outcomes of preterm infants admitted to single-family rooms versus an open-bay neonatal intensive care unit: A randomized controlled trial.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- NICU nurses' knowledge, attitudes, practices, and influencing factors regarding breastfeeding of newborns: a scoping review.International breastfeeding journal · 2026Review
- Development and prevalence of breastfeeding initiation in a tertiary obstetric center and its influencing factors.International breastfeeding journal · 2025Article
- The Relationship Between Nursing Work Environment and Breastfeeding Prevalence During Child Hospitalization: A Multicenter Study.Healthcare (Basel, Switzerland) · 2024Article
- A Longitudinal Observation of Antenatal Milk Expression in Mothers of Infants with Congenital Anomalies.Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine · 2024Observational
- Lactation support in neonatal intensive care units in Germany from the mothers' perspective - a mixed-method study of the current status and needs.BMC pregnancy and childbirth · 2024Article
- Proactive Lactation Care is Associated With Improved Outcomes in a Referral NICU.Journal of human lactation : official journal of International Lactation Consultant Association · 2022Article
- Supporting Premature Infants' Oral Feeding in the NICU-A Qualitative Study of Nurses' Perspectives.Children (Basel, Switzerland) · 2021Article
- Knowledge and attitude of health staff towards breastfeeding in NICU setting: are we there yet? An Italian survey.European journal of pediatrics · 2020Article
- Linking the work environment to missed nursing care in labour and delivery.Journal of nursing management · 2020Article
- Managerial features and outcome in neonatal intensive care units: results from a cluster analysis.BMC health services research · 2020Article
- Association of Patient Acuity and Missed Nursing Care in U.S. Neonatal Intensive Care Units.Medical care research and review : MCRR · 2020Article
- Racial and Ethnic Disparities in Human Milk Intake at Neonatal Intensive Care Unit Discharge among Very Low Birth Weight Infants in California.The Journal of pediatrics · 2020Article
- Vermont Oxford Network: a worldwide learning community.Translational pediatrics · 2019Review
- How Nurse Work Environments Relate to the Presence of Parents in Neonatal Intensive Care.Advances in neonatal care : official journal of the National Association of Neonatal Nurses · 2019Observational
- Exploring the Gap Between Needs and Practice in Facilitating Breastfeeding Within the Neonatal Intensive Care Setting: An Italian Survey on Organizational Factors.Frontiers in pediatrics · 2019Article
- Nursing Care Disparities in Neonatal Intensive Care Units.Health services research · 2018Article
- The experience of breastfeeding infants affected by congenital diaphragmatic hernia or esophageal atresia.Italian journal of pediatrics · 2018Article
- Observational
- Factors associated with infant feeding of human milk at discharge from neonatal intensive care: Cross-sectional analysis of nurse survey and infant outcomes data.International journal of nursing studies · 2016Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
purposeThe provision of breastfeeding support in the neonatal intensive care unit (NICU) may assist a mother to develop a milk supply for the NICU infant. Human milk offers unique benefits and its provision unique challenges in this highly vulnerable population. The provision of breastfeeding support in this setting has not been studied in a large, multihospital study. We describe the frequency of breastfeeding support provided by nurses and examined relationships between NICU nursing characteristics, the availability of a lactation consultant (LC), and breastfeeding support. SUBJECTS AND
designThis was a secondary analysis of 2008 survey data from 6060 registered nurses in 104 NICUs nationally. Nurse managers provided data on LCs. These NICUs were members of the Vermont Oxford Network, a voluntary quality and safety collaborative.
methodsNurses reported on the infants (n = 15,233) they cared for on their last shift, including whether breastfeeding support was provided to parents. Breastfeeding support was measured as a percentage of infants on the unit. The denominator was all infants assigned to all nurse respondents on that NICU. The numerator was the number of infants that nurses reported providing breastfeeding support. Nurses also completed the Practice Environment Scale of the Nursing Work Index (PES-NWI), a nationally endorsed nursing care performance measure. The NICU nursing characteristics include the percentages of nurses with a BSN or higher degree and with 5 or more years of NICU experience, an acuity-adjusted staffing ratio, and PES-NWI subscale scores. Lactation consultant availability was measured as any/none and in full-time equivalent positions per 10 beds.
resultsThe parents of 14% of infants received breastfeeding support from the nurse. Half of the NICUs had an LC. Multiple regression analysis showed a significant relationship between 2 measures of nurse staffing and breastfeeding support. A 1 SD higher acuity-adjusted staffing ratio was associated with a 2% increase in infants provided breastfeeding support. A 1 SD higher score on the Staffing and Resource Adequacy PES-NWI subscale was associated with a 2% increase in infants provided breastfeeding support. There was no association between other NICU nursing characteristics or LCs and nurse-provided breastfeeding support.
conclusionsNurses provide breastfeeding support around the clock. On a typical shift, about 1 in 7 NICU infants receives breastfeeding support from a nurse. Lactation consultants are not routinely available in NICUs, and their presence does not influence whether nurses provide breastfeeding support. Better nurse staffing fosters nurse provision of breastfeeding support.
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