Impact of Training Healthcare Providers on Alternatives to Bottle Feeding: Implications on Public Health Policy

Background: Nipple confusion happens when a baby experiences problems adapting ‎between breast-feeding and bottle-feeding. It can be overcome using techniques such as ‎lactation aid and feeding by finger, syringe, spoon, cup, or paced bottle. Objective: To ‎improve knowledge and practice of healthcare providers at neonatal intensive care unit ‎‎(NICU) regarding nipple confusion and alternative feeding methods of bottle feeding. ‎Methods: A quasi-experimental study was conducted among healthcare providers in NICU ‎at Beni-Suef University Hospital, conducted from March 2023 to October 2024. A self-‎administered questionnaire was administered before and after a structured educational ‎intervention. It covered the knowledge regarding breastfeeding and bottle feeding, nipple ‎confusion, alternative feeding methods of bottle feeding, and own clinical practice. Results: ‎The study included 126 participants; 77 nurses and 49 physicians. The mean age of ‎participants was 27.1±5.7 years and 83.3% were females. The mean knowledge and practice ‎scores of the study participants were 12.24±3.44 and 14.25±5.24, respectively. Following ‎the educational intervention, there was a statistically significant increase in the mean ‎knowledge and practice scores (18.56±2.53 and 15.98±2.95, respectively). The percentages ‎of changes in knowledge and practice scores were 73.46%±83.46 and 27.47%±48.24, ‎respectively. There was a large effect size of knowledge score (Cohen’s D=2.09), while the ‎effect size for practice was small (Cohen’s D=0.41). Conclusions: The educational ‎intervention has improved the knowledge and practice of healthcare providers at NICU ‎setting. it is recommended that a Baby-Friendly Hospital Initiative should be implemented ‎in Beni-Suef University Hospitals to promote breastfeeding and prevent nipple confusion.‎