Hispanic Birthing Parents' Experiences With Lactation Support Received In-Hospital: A Quality Improvement Needs Assessment

Abstract

Background: Human milk-feeding benefits infants and parents. Exclusive human milk (EHM) feeding is recommended for infants younger than 6 months; however, many U.S. infants do not receive this recommendation. Documented disparities exist between White and historically marginalized populations, including Hispanic/Latino parents.Quality Improvement Needs Assessment Aims:To explore Hispanic birthing parents' experiences with human milk-feeding and lactation support as part of a quality improvement needs assessment project, identifying barriers and facilitators during post-birth hospital recovery.

Methods: We collected and triangulated three data sources for 37 interviews: (1) in-hospital observations that included opportunistic informal interviews, as well as telephone interviews with (2) English- and Spanish-language-preferring Hispanic birthing parents, and (3) pediatric clinician interviews (via snowball sampling recruitment). In-hospital observations were collected in March 2022 at a Northern California academic medical center. Interviews included birthing parents, physicians, nurses, clinical trainees, administrators, and lactation consultants. Telephone interviews occurred between March and May 2022. We used rapid and thematic analysis, subsequently mapping themes to the socioecological model as an organizing framework.

Results: Interpersonal growth opportunities were identified: trust-building through deep listening, better communication between patients and clinicians, particularly at night, and better cross-language understanding. At the hospital level, identified needs included supportive maternity care practices, lactation staff availability, and more perinatal lactation education and resources (e.g., iPads, pumps). Spanish-language-preferring patients reported needing better interpretation services.

Conclusion: This quality improvement project identified opportunities for improvement in relationships with patients, clinician communication, and training and physical resources.

Keywords: Hispanic; Latino; Socio-Ecological Model; breastfeeding; health equity; lactation; quality improvement.