Nurse-Midwifery M.S.

Number of Pages


Year Approved


First Advisor

Hardy, Paige

Second Reader

Julie Ann Vingers


Introduction: Current professional position statements support the optimal method of feeding for the first six months of life is breastfeeding. Despite current recommendations, exclusive breastfeeding rates remain below 50% in the United States at three months postpartum. The aim of this integrative review is to find evidence to support how obstetric practitioners can encourage primiparous patients personally, interpersonally, and socially in their shared goal of exclusive breastfeeding. Methods: Following a rigorous search method, a keyword search was conducted using CINAHL, PubMed, and SCOPUS. Studies were then screened using Covidence software and PRISMA methodology, yielding 21 studies to be included in the final review. Findings were then organized using King’s Theory of Goal Attainment as a theoretical framework. Results: Findings provided evidence from 5,728 participants ranging between the ages of 18 and 35, with over half of the studies exclusively having collected data from primiparous participants. Studies were obtained from developed or developing countries around the world with eight included studies from the United States. The data supports common barriers to breastfeeding for primiparas patients including difficulty latching, perception of inadequate milk supply, fatigue, pain, worry surrounding infant weight gain, lack of support, long labor, and misinformation or unrealistic expectations. Positive associations with exclusive breastfeeding duration for primiparous parents include the promotion of breastfeeding self-efficacy through education, interpersonal support, and supportive systemic policies. Conclusion: Standard obstetric practice needs to include more resources and support for primiparas. New birthing families are looking to practitioners for more preparation and support for exclusive breastfeeding during the immediate postpartum period.

Degree Name

M.S. Nurse-Midwifery

Document Type

Masterʼs thesis