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The purpose of this study was to determine associations between missed nursing care and nurse staffing during labor and birth, and exclusive breast milk feeding at hospital discharge. Labor and birth nurses in three states were surveyed about missed nursing care and their maternity units' adherence to the Association of Women’s Health, Obstetric and Neonatal Nurses (2010) nurse staffing guidelines for care during labor and birth, using the Perinatal Misscare Survey.

Nursing responses were aggregated to the hospital level and estimated associations between missed nursing care, nurse staffing, and hospitals' exclusive breast milk feeding rates were measured using The Joint Commission's Perinatal Care Measure (PC-05). Exclusive breast milk feeding is a national quality indicator of inpatient maternity care. Nurses have substantial responsibility for direct support of infant feeding during the childbirth hospitalization. These results support exclusive breast milk feeding (PC-05) as a nurse-sensitive quality indicator.