Midwives' and maternity nurses' knowledge and practice in relation to breastfeeding initiation in Sohar Hospital, Oman

Midwives and maternity nurses have a major role in supporting babies’ health. An important strategy to achieve this includes promoting breastfeeding initiation by implementing early skin-to-skin contact (SSC) between mothers and their babies immediately after birth. The aim of this study is to investigate the knowledge and clinical practice regarding SSC and breastfeeding initiation, among a group of (national and non-national) midwives and maternity nurses working in Oman. The study used a modified version of the Newborn Feeding Ability (NFA) questionnaire and the Breastfeeding Initiation Practices (BIP) tool to survey 136 midwives and nurses. The response rate obtained was 65.4% (n=89). Findings from the study revealed that there is insufficient knowledge and lack of practice about SSC and initiation of breastfeeding. The participants reported that these practices are not implemented due to lack of time and shortage of staff in the maternity area. In particular the survey found, a total of 87.5% of respondents correctly reported that a normal full-term baby is born with an instinctive reflex ability to breastfeed effectively. Almost 75% understood that SSC helps the flow of colostrum. The majority of respondents (70.8%) reported that they always/mostly teach the mother to position and attach the baby for optimal breastfeeding. However, approximately half (49.4%) agreed/strongly agreed that there is no time after birth to allow for uninterrupted SSC until the first breastfeed and only 55.1% would always/mostly help the mother to hold her naked baby during SSC. Most respondents (59.0%) reported putting the baby on the breast for the mother. Approximately one third (31%) reported that they always/ mostly routinely suction babies soon after birth. Furthermore, less than half of respondents (45.7%) showed significant knowledge regarding the stabilisation of a newborn's blood sugar levels by SSC. The findings from this study indicate that this group of midwives and maternity nurses would benefit from additional educational support and the appropriate resources (including time) to enable them to undertake evidence-based best practice regarding breast feeding initiation.