Date of Conferral



Doctor of Nursing Practice (DNP)




Deborah Lewis


The World Health Organization advocates that newborn babies require exclusive breastfeeding until 6 months of age to attain a desired level of growth. Despite this recommendation, exclusive breastfeeding rates continue to be at low levels globally. The purpose of this DNP project was to examine best practices for increasing the breastfeeding knowledge of health care workers, and to understand how breastfeeding is promoted in different healthcare systems. The Critical Appraisal Checklist and the Cochrane Handbook for Systematic Reviews framed this systematic literature review. Additionally, Melnyk's levels of evidence was used to evaluate each article. Articles for inclusion were limited to adults over the age of 18, nurses as providers, and literature published in English between 2012 and 2017. Keywords used in the literature search included breastfeeding promotion, breastfeeding support, breastfeeding outcomes, and breastfeeding education. The search identified 159 articles, of which 40 were selected for the final review. Twenty-two articles met the criteria for levels V-VI (qualitative), 11 met the criteria for levels III-IV (case control or cohort), 1 met the criteria for level II (randomized control trials), and 6 were level 1 (systematic review). The analysis of evidence demonstrated the importance of exclusive breastfeeding and led to the development of breastfeeding education recommendations. The recommendations will be presented to the organization and will provide nurses with the tools to support breastfeeding education. Application of the findings may lead to social change because new mothers will receive enhanced breastfeeding information, which will result in higher rates of breastfeeding of newborns and increased benefits for both infants and mothers.

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