by Mary Ryngaert
January 13, 2009

A 158 page paperback volume, Continuity of Care in Breastfeeding: Best Practices in the Maternity Setting is designed to educate health care professionals to provide optimal support for best feeding practices in the perinatal period. Cleverly laid out in chapters that parallel the joint WHO/UNICEF statement, Ten Steps to Successful Breastfeeding, the book is a compilation of the authors’ 60-plus years of experience. Authors, Karin Cadwell and Cindy Turner-Maffei are well-known educators and champions of breastfeeding. Their lofty ideals and practical get-the-job-done approach combine to make this a great read for those who wish to promote breastfeeding in their communities.

Early chapters focus on policy development, staff and patient education, and competencies for optimal breastfeeding support. Subsequent chapters offer practical tactics for the promotion and support of breastfeeding from the birth of the infant through first week of life. The authors address the value of early skin-to-skin contact, rooming-in and measures that promote exclusive breastfeeding. Cadwell and Turner-Maffei also address the challenges of “mixed messages” and related issues of long-standing policies and beliefs that do not promote breastfeeding.

Chapter 10 is devoted to “Bridging Gaps Into the Community,” providing important information for the development of referral plans to help families persist with breastfeeding. The authors also discuss the “Baby Friendly Hospital” initiative and Woman-Centered care, offering insights for health care professionals to bring these models to their own communities successfully.

The authors have a wealth of knowledge and this epistle is packed with their pearls of wisdom. Throughout the text, Cadwell and Turner-Maffei cite studies that provide insight and rationale for their recommendations. Boxes are interspersed in the text offering anecdotes as well as competencies and bulleted lists for problem solving. There are drawings that illustrate breastfeeding positions and latch.

Turner-Maffei and Cadwell are great listeners and insightful. They report in the book’s foreword that the book is the result of many years of experience, conversations, and observations. It is very clear that there is a great commonality of frustration amongst those of us who hope our families will be supported in their desire to breastfeed. The problems they describe are the same we hear our friends, family, and patients reporting to us. Beyond the frank discussion of the challenges and roadblocks, there are effective strategies and suggestions offered. Turner-Maffei and Cadwell demonstrate an intuitive sense of bringing change to institutions through education as well as simple strategies like process audits. They argue the importance of promoting continuity of care as both a horizontal (across time) and vertical (across disciplines) process.

The text is well-written and concise, but pitched to a sophisticated reader. It is not a textbook for training all of the nurses on a unit, but should be required reading for that unit’s nurse educator, nurse manager, and medical director. It is a helpful asset to the hospital or community that is serious about moving toward a Baby Friendly designation.