New Research Confirms Benefit of HUG Your Baby with WIC Latina Mothers

LaKasha White, DNP and Jan Tedder, BSN, FNP, IBCLC with HUG Your Baby

Congratulations to LaKasher White who just completed the Doctors of Nursing Practice at UNC Chapel Hill. She worked to bring HUG Your Baby to peer counselors and Latina mothers in a North Carolina Public Health Department. LaKasha shared this important work at a poster presentation right before graduation. Though we expect the entirety of her work to soon be published in a peer-reviewed journal, below is a brief description of her efforts.

Although breastfeeding initiation has improved in the United States, disparities continue among minority populations such as Latina women (CDC, 2016). Misperceptions of normal infant behaviors may decrease exclusive breastfeeding during the first six months of life. Though Latina women are more likely than other minority populations to start breastfeeding, “Los Dos,” the use of both breast and formula feeding, is a common practice.

Research confirms that Latinas worry about insufficient breastmilk and practice “Los Dos” in response to infant crying, nipple trauma, and concerns about infant weight. The purposes of Ms. White’s DNP Quality Improvement project were: 1) to improve exclusive breastfeeding rates among Latina women using strategies and resources from HUG your Baby’s evidence-based program, “The Roadmap to Breastfeeding Success”; 2) to evaluate the impact of WIC peer counselors’ use of this HUG Your Baby program in prenatal teaching.

Three WIC peer counselors from a public health setting completed the two-hour online course, “The Roadmap to BreastfeedingSuccess,” and participated in a two-hour follow-up workshop.  They then used these HUG resources and strategies with Latina women during the prenatal and postpartum period. All peer counselors were female, from diverse cultures (Black, White, Hispanic), and had work experience in this capacity ranging from two months to eleven years. 

After eight months, the peer counselors demonstrated increased knowledge and skills to teach parents, described “The Roadmap” as a helpful tool, and noted improved exclusive breastfeeding duration.  (Research details are pending publication.)

BSN research includes HUG Your Baby in Childbirth Education

Molly Rippe, BSN, from Durham NC shares her research using HUG Your Baby.

I really enjoyed teaching breastfeeding using the HUG curriculum and resources. The couples in the class came up to me afterwards and were so excited to start their breastfeeding journeys! All were expecting their first baby, and took the HUG DVD home with them. The partners were also eager to help and support them in the breastfeeding journey. Because I collected data on this class, through my pilot study, I know that the participatns increased their knowledge and self-efficacy about breastfeeding during this course, and I truly feel they will be more prepared to continue through any challenges that they may face. The video content was a great way to engage the class as well. 

I taught a 30-minute segment of a longer childbirth preparation course that focused on breastfeeding. I used HUG curriculum to support this teaching in a pilot study to test whether the curriculum could increase prenatal breastfeeding self-efficacy, breastfeeding knowledge, and intention to breastfeed. I specifically used the Roadmap to Breastfeeding Success, and teaching about newborn behavior to create a more well-rounded understanding of breastfeeding.

The outline of my class was as follows:

• Start with a discussion about the myths and challenges that participants have heard about breastfeeding. I led the discussion and guided it so that it covered several key topics
  • Pain: what a proper latch looks and feels like, and who to call if you are experiencing pain, as this is not normal. Demonstration using breast and video was used to understand latch
  • Lack of milk supply: understanding when a woman’s milk supply comes in, the size of the newborn’s stomach, colostrum, counting diapers for numbers of pees and poos
  • Challenges with breastfeeding and going back to work: overall babies who are breastfed are healthier, have stronger immune systems, and cause moms to miss less days of work because they are not sick as often as formula fed babies.
• Introducing the baby-friendly concept and how giving birth at UNC is different in the support received for breastfeeding by this hospital designation
• Watching first HUG video clip about newborn behaviors and signs that your baby is hungry
  • After video, we discussed the common signals a newborn uses to communicate with us and let us know they are hungry: wiggle and squirm, lip smacking, bringing hands to mouth, and the last one is crying
• Watched second HUG video
• Practiced breastfeeding holding positions with baby-dolls
  • Emphasize that they need to be comfortable to have success
  • Ways partner can help
  • Positions to practice: cross cradle, football hold, side lying and reclining
• Close with the health benefits to both mom and baby when breastfeeding
  • Ask yourself—who are your friends and family members who are going to be supportive of your breastfeeding journey, and similarly, who do youknow that is not going to be supportive?
  • Surround yourself with support!
  • Provide lactation hotline number at UNC- available for help for first 12 months postpartum

NICU Fathers Benefit from HUGYour Baby Teaching

Using HUG Your Baby in a NICU increases fathers’ knowledge of their infants. [Kadivar, M., Mozafarinia, M. (2013). Supporting fathers in a NICU: Effects of the HUG Your Baby program on father’s understanding of preterm infant behavior. Journal of Perinatal Education. 22(2), 113-119.]

• MSN project for Iranian student in a tertiary level NICU in Tehran.
• Student professionally translated HUG Your Baby parent education resources into Farsi and completed Certified HUG Teacher training.
• Hospital layout and protocols made it difficult for mothers to visit their babies for several days.
• Student used translated HUG Your Baby materials to teach a one-hour class to fathers whose babies were in the NICU and spent one-on-one time reviewing each baby’s behavior with his father.
• 23 fathers in both control and intervention group.
• Research tool: The Knowledge of Preterm Infant Behavior (KPIB) scale.
• Results: Fathers in intervention group had increased knowledge of infant behavior.

More details here.

Study confirms value of HUG in Special Care Nursery

Implementing a parent education program in the Special Care Nursery. 

Hunter, L., Blake, S., Simmons, C., Thompson, J. & Derouin, A. (2018). Journal of Pediatric Health Care, Aug 23, 1-7.

• Parents with babies in a NICU or SCN typically find this environment to be stressful and intimidating.
• DNP project to explore impact of HUG Your Baby teaching on SCN parents.
• 22 mothers with babies in the SCN watched the HUG Your Baby parent education video and met with a DNP student trained in HUG Your Baby.
• Research tools included PSS:NICU (evaluates stress experienced by parents) and PMP SE (evaluates maternal-infant interactions).
• Results: Significant decrease in maternal stress and increase in maternal confidence.

Click here to access article.

Developing the Japanese HUG

Developing the Japanese HUG (Help-Understanding-Guidance) Your Baby Program.

Iida, M., Shimpuku, Y., Tanimoto, K., Matsunaga, M. & Horiuchi, S.(2017). Journal of Japanese Academic Midwifery.31(2), 187-194.]

·       Researchers collaborated with Jan Tedder, creator of HUG Your Baby, to translate professional and parent education resources.

·       Introduces the medical literature used to develop HUG Your Baby and components of the Japanese version of this program.

·       Describes researchers’ experiences using HUG Your Baby resources with parents.

·       Currently analyzing data on parents’ responses to HUG Your Baby.