Usefulness of a non-experimental study design in the evaluation of service developments for infant feeding in a general hospital

Contemporary breast-feeding policy and practice: implications for midwives

In this paper, the authors draw upon recent Australian research to provide a critical commentary on the current policies and professional practices surrounding breast feeding. These studies, conducted by the first and second authors, explored aspects of the breast-feeding experience, with the findings highlighting areas for concern in relation to the promotion and support of breast feeding in western societies. Of particular concern to the authors was the number of women in these studies who equated breastfeeding with being a 'good' mother. This perception meant that some women maintained a strong commitment to breast feeding despite enormous difficulties. In this paper we firstly, overview the findings of these studies and use women's stories to illustrate their perseverance and their intense commitment to breast feeding. In the second part of the paper, we consider the consequences of the strong public rhetoric surrounding breast feeding in Australia and challenge some of the assumptions underlying policies and professional practices related to breast feeding. We examine the consequences of 'professionalising' breast feeding, and make suggestions for a way forward in the promotion of breast feeding that encompasses the range of perspectives held by women. In conclusion, the authors highlight the complexity of establishing appropriate breast-feeding policies that guide professional practices in a flexible manner, allowing for diversity in individual breast-feeding experiences.

Does breastfeeding education affect nursing staff beliefs, exclusive breastfeeding rates, and Baby-Friendly Hospital Initiative compliance? The experience of a small, rural Canadian hospital

The effectiveness of a breastfeeding education intervention consisting of a 1 1/2-hour mandated session for all nursing staff, with an optional self-paced tutorial, was evaluated in a small rural Canadian hospital. The intervention was designed to increase exclusive breastfeeding rates, create positive beliefs and attitudes among staff members, and increase compliance with the World Health Organization/UNICEF Baby-Friendly Hospital Initiative (BFHI). Staff surveys and chart audits were conducted at both the intervention and control site hospitals prior to the intervention and 7 months after the intervention. Over a 7-month period, the intervention hospital experienced an increase in BFHI compliance (24.4 vs. 31.9, P < .01), breastfeeding beliefs (55.0 vs. 58.8, P < .05), and exclusive breastfeeding rates (31% vs. 54% of breastfed babies, P < .05) but no change in breastfeeding attitudes (44.0 vs. 44.9, P = .80). The control site experienced no change in BFHI compliance, beliefs, or attitudes but a significant decrease in exclusive breastfeeding rates (43% vs. 0%, P < .05).

Connection and pleasure, disruption and distress: women's experience of breastfeeding

Interview data collected in a recent study of first time motherhood were used to explore the experience of breastfeeding. Twenty-five Australian women participated in a series of semistructured interviews begun during late pregnancy and continuing until 6 months postpartum. Discourse analysis was used to examine the transcribed data. The analysis revealed that breastfeeding was central to these women's experience of motherhood. The majority of women were strongly committed to breastfeeding. Their decision to breastfeed was influenced by a range of public and professional discourses. Breastfeeding was also an embodied experience that was difficult to articulate. For some, this embodied experience was connected, harmonious and pleasurable and for others, disruptive, unpleasant, and violent. This paper describes the embodied experience of breastfeeding and highlights the complexity of the relationship between embodied experience and contemporary meanings and context of breastfeeding.

Prenatal breastfeeding education: its effect on breastfeeding among WIC participants

The effect of prenatal breastfeeding education on breastfeeding incidence and duration was determined among 31 prenatal WIC participants. The subjects, assigned to a control group (n = 17) or experimental group (n = 14), received prenatal nutrition education through the WIC program. The experimental group received at least one breastfeeding education class. There was no significant difference in breastfeeding incidence between the groups, however, there was a significant difference in breastfeeding incidence by parity (p < 0.05). There was a significantly higher percentage of women still breastfeeding at 3 and 4 months postpartum in the experimental versus the control group (p < 0.05). The control group breastfed for 29.5 +/- 43.6 days, while the experimental group breastfed for 76 days +/- 104.3 (p = .05). Multiparous women who had bottle-fed previous children breastfed for a shorter duration (18 +/- 22 days) than primiparous women (60 +/- 87 days) (p < .07).