Graduation Semester and Year

Spring 2024



Document Type


Degree Name

Doctor of Nursing Practice



First Advisor

Sara Moore



The American Academy of Pediatrics recommends exclusive breastfeeding for all infants until six months of age. In the United States, the exclusive breastfeeding rate is 52%, with a goal of 73% by Healthy People 2030 at six weeks of age. Breastfeeding difficulty will occur 70% of the time in mother-baby dyads, requiring some intervention by the primary care provider during the breastfeeding course. This study aims to build a clinical practice guideline that can guide interventions to improve successful breastfeeding rates in a birthing center.


The literature search was performed and condensed to an evidence table where studies were graded by evidence level and quality. The evidence gathered guided the development of nine guideline statements focused on successful interventions for clinicians in the birthing center to address breastfeeding difficulty for the mother-infant dyad.


When ranked by the stakeholders, the nine guideline statements had a mean range from 3.4 to 4.0 (scale of 1-4), with an average mean of 3.8, indicating an overall excellent or high recommendation based on the stakeholders’ rankings. The data was analyzed with the Related-Samples Friedman’s Two-Way Analysis of Variance by Ranks test to evaluate the stakeholder rankings and found that there were no statistically significant differences (significance of .376, significance level of .05) between the rankings showing statically similar rankings by all stakeholders.


The project aim was successful in developing a guideline by using a diverse guideline development team and evidence-based literature from a systematic literature review that was guided by stakeholder input. Optimistically, this guideline can be a foundation for similar birthing centers and other outpatient facilities caring for the mother-infant dyad experiencing breastfeeding difficulty to build and implement new clinical practices.


Breastfeeding, Breastfeeding difficulty, Infant health, Maternal health, Practice guideline


Maternal, Child Health and Neonatal Nursing | Pediatric Nursing



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