Successfully breastfeeding term infants at 10 days was also associated with being given advice to recognise if the infant was receiving enough milk, awareness of the national breastfeeding helpline and using community support groups. Strengths of this study include the use of a national, population-based survey. The analysis employed survey weights which allowed for non-response and oversampling of mothers from the lowest quintile of the IMD ensuring adequate representation of this group. Using IFS data enabled simultaneous evaluation of a wide range of breastfeeding support among late preterm and term infants. As such, this study is one of the first to compare effectiveness of support between these two groups thereby addressing a gap in current literature. However, it is of note that the original survey findings are now 5 years old. A further strength is measuring outcomes at both 10 days and 6 weeks to identify support factors impacting on clinically important postnatal time points. The most rapid decline in breastfeeding rates occurs in the first 10 days after birth,17 indicating that breastfeeding support could have the most to offer mothers during that time. The risk of recall bias was limited as the questionnaire was intended for when the infant was 6 weeks old. However, given the sensitive and emotive nature of breastfeeding duration, responses may have been influenced by a socially desirable response bias with mothers perhaps overestimating the length of time they achieved breastfeeding, or underplaying the support received. The IFS questionnaire is long (150 questions) potentially presenting a challenge for a parent with a newborn infant. This may have introduced a bias in those who may have been more likely to Table 4 Adjusted ORs† for breastfeeding support in term infants Variable Breastfeeding at 10 days Breastfeeding at 6 weeks Responsibility for Development The Registered Nurses Association of Ontario (RNAO), with funding from the Ontario Ministry of Health and Long-Term Care, has embarked on a multi-year project of nursing best practice guideline development, pilot implementation, evaluation and dissemination. In this third cycle of the project, one of the areas of emphasis is on breastfeeding. This guideline was developed by a panel of nurses and other health care professionals convened by the RNAO, conducting its work independent of any bias or influence from the Ministry of Health and Long-Term Care. Purpose and Scope The purpose of this guideline is to improve breastfeeding outcomes for mothers and infants, to assist practitioners to apply the best available research evidence to clinical decisions, and to promote the responsible use of health care resources. Additionally, gaps in the availability of evidence-based practice will be highlighted. Nurses working in specialty areas or with special needs infants/families (i.e., pre-term infants) will require further practice direction from clinical practice guidelines in their unique area of focus. Best practice guidelines are systematically developed statements to assist practitioners’ and clients’ decisions about appropriate health care (Field & Lohr, 1990). This best practice guideline is intended to provide direction to practicing nurses in all care settings (institutional and community) in promoting successful and enjoyable breastfeeding experiences. The promotion of breastfeeding within the context of this document includes the concepts of promotion, protection and support of breastfeeding. This guideline focuses its recommendations on three areas: (1) Practice recommendations directed at the nurse; (2) Education recommendations directed at the competencies required for practice; (3) Organizational and policy recommendations addressing the importance of a supportive practice environment as an enabling factor for providing high quality nursing care, which includes ongoing evaluation of guideline implementation. This guideline contains recommendations for Registered Nurses (RNs) and Registered Practical Nurses (RPNs). Although these guidelines are written for the nurse, breastfeeding support is an interdisciplinary and community wide endeavour. Many settings have formalized interdisciplinary teams and the panel strongly supports this structure. Collaborative assessment and planning with the client is essential. The recommendations made are guidelines for nurses and should assist in informed decision-making for clients and their families. It is the consensus of the development panel that the baby at the breast is considered best practice, and it is the intention of this document to identify best nursing practices in breastfeeding support. It is acknowledged that individual competencies of nurses vary between nurses and across categories of nursing professionals and are based on knowledge, skills, attitudes and judgment enhanced over time by experience and education. It is expected that individual nurses will perform only those aspects of breastfeeding support for which they have appropriate education and experience. Further, it is expected that nurses will seek consultation in instances where the client’s care needs surpass the individual nurse’s ability to act independently. It is acknowledged that effective care depends on a coordinated interdisciplinary approach incorporating ongoing communication between health