Formative Infant Feeding Experiences and Education of NICU Nurses

Purpose: To explore the formative infant feeding experiences and education of NICU nurses. Study Design and Methods: An ethnography was undertaken over 14 months in a level IV NICU in a free standing pediatric hospital in the Northeastern U.S. Purposeful sampling was used to select informants. General informants included 114 NICU nurses who were observed and informally interviewed an average of 3.5 times. Eighteen of these served as key informants and each was formally interviewed once with an additional average of 12 observations/informal interviews. Descriptions of feeding experiences and education were coded and analyzed for recurring patterns using NUD*IST software. Findings: The NICU nurses identified a norm for formula feeding during their formative experiences as children. The nurses described increased exposure to varied feeding methods during their adulthood, but breastfeeding was often associated with difficulties among their families and friends. The nurses in this study recounted minimal exposure to breastfeeding in nursing school. The nurses' personal experiences with breastfeeding were laden with strong emotional reactions intertwined with their feelings about motherhood. Clinical Implications: Nurses' past experiences and education must be addressed if efforts are to be made to promote breastfeeding in the NICU. Breastfeeding education programs for nurses should include reflective components to help nurses identify structural barriers and reframe any negative personal experiences.