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Waiting to be weighed : a pilot project comparing two different infant weighing practices of community health nurses and their effect on breastfeeding outcomes Thomson, Trisha Suzanne


Breastfeeding initiation rates are rising in Canada; however, the duration rates remain far below what is recommended internationally. Maternal breastfeeding confidence has been supported in the literature as a key variable influencing breastfeeding initiation and duration; community health nurses (CHNs) have been identified as positive influences on breastfeeding outcomes. Because breastfeeding has positive effects for mothers and infants, examining specific CHN practices and their effects on breastfeeding outcomes is imperative. A practice that is potentially important for breastfeeding outcomes is newborn weighing at home following discharge from hospital. The literature offers limited research examining the effects of newborn weighing practices on maternal confidence levels, breastfeeding attrition or formula supplementation volumes. This purpose of this experimental, pretest - posttest feasibility study was to compare breastfeeding self-efficacy, intended duration of breastfeeding and formula supplementation volumes between two groups of mothers and newborns exposed to different weighing protocols in Vancouver, BC. Newborns randomized to a control group were weighed 24 hours following hospital discharge (day two or three postpartum), and subsequent days following until there was a demonstrated weight gain, while those in the experimental group were not weighed until day five postpartum when a gain in weight was anticipated following maternal breast milk establishment. Variables were measured during the initial CHN visit 24 hours post discharge and two weeks later. Fifty-five women were recruited and randomly assigned to groups. Hypothesis three was partially supported. Although there was no significant difference in volumes of formula supplementation between groups, the group weighed 24 hours post discharge had significantly higher increases in volumes of formula supplementation from two or three days to two weeks than the five day weight group. Hypotheses one and two were not supported, that is there were no significant differences between groups on breastfeeding confidence and intended breastfeeding duration. There was a trend in the data supporting hypothesis one, which indicated that weighing infants prior to day five would have a negative effect on maternal confidence. Specifically, there was a small decrease in control group confidence and an increase in experimental group confidence over time. The findings from this small sample size provide support for conducting a larger study to investigate the potential influence of CHN weighing practices on breastfeeding confidence, intended breastfeeding duration and formula supplementation volumes. Implications for nursing practice, education, health policy and future research are discussed.

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