Nurse Work Environments and Exclusive Breast Milk Feeding during the Birth Hospitalization

To examine whether hospital variation in the nurse work environment during labor and birth is associated with variation in the rate of exclusive breast milk feeding during the birth hospitalization.

Cross-sectional analysis of nurse survey, hospital, and exclusive breast milk feeding outcome data in a sample of 258 hospitals in five states. Sequential multivariate linear regression models were used to model the relationship between the outcome of exclusive breast milk feeding and the nurse work environment.

A good or mixed nurse work environment is significantly ssociated with higher hospital-level exclusive breast milk feeding rates in unadjusted and adjusted regression models. A hospital's Baby-Friendly status was not significantly associated with exclusive breast milk feeding rates.

Improvements to nurses' work environments can potentially increase hospital-level exclusive breast milk feeding rates.