Document Type

Dissertation - Open Access

Award Date


Degree Name

Doctor of Philosophy (PhD)


Graduate Nursing

First Advisor

Cynthia Elverson


breastfeeding, education, intervention, lactation, randomized controlled tria, social support


Breastmilk is the ideal food source for infants providing health immediate and lifelong health benefits for the woman and infant. Current recommendations from the American Academy of Pediatrics state that infants should be breastfed exclusively for the first six months of life and continued breastfeeding in combination with solid foods through one year of age. Despite these recommendations, the United States continues to have suboptimal breastfeeding rates for any and exclusive breastfeeding in the first year. This topic has been extensively studied with many interventions developed and implemented; however, many have lacked effectiveness. Gaps in the science related to effective breastfeeding interventions persist. This dissertation addresses the current state of the science concerning breastfeeding in three phases. First, a thorough review of the literature is presented in an integrative review of breastfeeding interventions targeted at improving breastfeeding outcomes from 6-weeks to 6-months in Chapter 2. Using the strengths of previous interventions, this review of existing breastfeeding interventions provided recommendations to guide the development of an innovative breastfeeding intervention. Detailed development of a theory-based intervention is described in Chapter 3. A pilot trial of the developed breastfeeding intervention is described in Chapter 4. Together the findings of this dissertation: (a) provide recommendations for future breastfeeding intervention development and implementation, (b) present an in-depth guide to the development and implementation of an innovative breastfeeding intervention, and (c) demonstrate the feasibility of a fully-powered trial to evaluate the effectiveness of this educational intervention for women and their support persons on breastfeeding outcomes.

Library of Congress Subject Headings

Breastfeeding promotion.
Breastfeeding -- Health aspects.



Number of Pages



South Dakota State University


In Copyright - Educational Use Permitted

Available for download on Friday, August 18, 2023