Exploring Australian intensive care unit nurses' experiences, confidence, and knowledge in supporting breastfeeding...

The number of pregnant and postpartum women admitted to intensive care units (ICUs) in Australia and New Zealand has doubled over the past decade, creating unique challenges for ICU nurses, particularly in supporting breastfeeding. This study aimed to explore ICU nurses' experience, confidence, and knowledge in supporting breastfeeding women in the early postpartum period.

A descriptive cross-sectional survey was conducted among nurses working in adult Australian ICUs. Data were collected from January 30th to March 18th, 2024, via an online anonymous survey distributed by the Australian College of Critical Care Nurses, online networks, and snowball sampling. The survey included both qualitative and quantitative questions, with nurses self-rating their confidence and knowledge from 0 to 10. Descriptive statistics were undertaken, and a thematic analysis of free-text responses was performed.

Seventy-nine ICU nurses participated. The median self-rated confidence was 4.54 (interquartile range [IQR]: 1.62-7.18), and the median knowledge score was 3.69 (IQR: 1.19-6.67). Nurses reported high agreement on being knowledgeable about the benefits of breastfeeding (8.34, IQR: 6.43-9.59) and that the ICU is appropriate for a healthy term baby to visit (8.66, IQR: 5.56-9.83). However, confidence in practical breastfeeding support was lower, with a median score of 3.75 (IQR: 0.07-6.28) for demonstrating breastfeeding techniques and 3.07 (IQR: 0.07-5.18) for knowledge of safe breastfeeding medications. Barriers identified included lack of breastfeeding-specific education, reliance on midwives, and competing priorities.

ICU nurses are willing to support breastfeeding but face barriers that limit their ability to provide optimal care. Addressing these issues through targeted education, collaboration with maternity services, and ICU-specific breastfeeding policies is essential.