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Kholina K, Brady J, Snelgrove-Clarke E, Rossiter MD, Whitfield KC. Dual modality feeders: a group of human milk feeders with unique practices and needs. Public Health Nutr 2023; 26:2882-2890. [PMID: 37927150 PMCID: PMC10755423 DOI: 10.1017/s1368980023002367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 10/09/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE Dual modality feeding (DMF) - feeding human milk interchangeably from the breast and from a bottle - comes with unique practical, emotional and relational challenges, as well as support needs. Yet, there is little research that explores the experiences of individuals who use DMF in the Canadian context. The aim of this study is to explore the practices, challenges, reasons and enablers of DMF. DESIGN Repeat, semi-structured one-on-one interviews were conducted at 8 weeks and 22 weeks postpartum. Interview transcripts were thematically analysed using a critical feminist lens. SETTING Nova Scotia, Canada. PARTICIPANTS Ten DMF mothers. RESULTS DMF practices were influenced by a mix of social and material circumstances, including breast-feeding challenges, the involvement of support persons, finances and access to lactation support. Individuals who predominantly fed at the breast expressed milk strategically to mitigate transitory breast-feeding challenges, for convenience under specific circumstances, and to share feeding responsibilities with other caregivers for personal and practical reasons. Individuals who mainly bottle-fed did so due to long-term breast-feeding challenges or a need to return to employment. Enablers of successful DMF were consistent between the two groups and included practical, personal and relational aspects. CONCLUSIONS DMF is a unique practice compared to feeding human milk solely from the breast or bottle. Despite the potential growing prevalence of DMF, it is currently understudied and inadequately addressed in existing support programmes in Nova Scotia. Tailored programming and public messaging are needed to support DMF families.
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Affiliation(s)
- Ksenia Kholina
- Department of Applied Human Nutrition, Mount Saint Vincent University, 166 Bedford Hwy, Halifax, Nova Scotia, B3M 2J6Canada
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, 5850 University Avenue, Halifax, Nova Scotia, Canada
| | - Jennifer Brady
- School of Nutrition and Dietetics, Acadia University, 15 University Ave, Wolfville, Nova Scotia, Canada
| | - Erna Snelgrove-Clarke
- School of Nursing, Faculty of Health Sciences, Queen’s University, 92 Barrie Street, Kingston, ON, Canada
| | - Melissa D Rossiter
- Department of Applied Human Sciences, University of Prince Edward Island, 550 University Ave, Charlottetown, Prince Edward Island, Canada
| | - Kyly C Whitfield
- Department of Applied Human Nutrition, Mount Saint Vincent University, 166 Bedford Hwy, Halifax, Nova Scotia, B3M 2J6Canada
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Quinn EA, Sobonya S, Palmquist AE. Maternal perceptions of human milk expression output: An experimental design using photographs of milk. Soc Sci Med 2023; 324:115871. [PMID: 37023658 DOI: 10.1016/j.socscimed.2023.115871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/20/2023] [Accepted: 03/26/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND The widespread use of breast pumps in the United States is a recent phenomenon that is reshaping how individuals understand and perceive lactation. In the 1990s, adequacy of milk supply was primarily measured indirectly by infant weight gain and/or diapers; now >95% of all lactating persons in the United States use breast pumps and are seeing their milk regularly. How seeing milk impacts the perception of lactation sufficiency is an important area of research. Research aim/question: To understand personal and intersubjective influences of seeing expressed human milk on perceptions of milk supply among participants who express milk for their infants. METHODS We surveyed 805 lactating participants from the United States about their pumping practices using an online survey. Participants described pumping practices, milk output, and beliefs. They were then randomized to view one of three photographs of expressed milk (<2 oz, 4 oz, >6oz) and asked to imagine they had just pumped that amount and provide a written response; this created 4 exposure groups (2 increase and 2 decrease) and a control group (no difference). RESULTS Participants randomized to a higher volume reported more positive feelings and used the terms "good", "great", and "accomplished" to describe emotional responses to output. Participants randomized to lower milk volumes reported more feelings of "bad" or "depressed." A subset of participants reported feeling "annoyed" about small volumes of milk. CONCLUSIONS Participants in this study were very conscious of the volume of milk pumped each session; both increases and decreases were associated with emotional responses that could contribute to decisions about pumping practices, perceived milk supply, and lactation duration.
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Fan HSL, Fong DYT, Lok KYW, Tarrant M. A Qualitative Exploration of the Reasons for Expressed Human Milk Feeding Informed by the Breastfeeding Self-Efficacy Theory. J Hum Lact 2023; 39:146-156. [PMID: 35414281 DOI: 10.1177/08903344221084629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is an increasing prevalence of expressed human milk feeding. The reasons for expressed human milk feeding of healthy term infants may differ from those for preterm infants. The process of adopting expressed human milk feeding for healthy full-term infants has not been well-described in the existing literature. RESEARCH AIM To describe the reasons for, and antecedents to, expressed human milk feeding among Chinese women who used a high proportion of expressed human milk for feeding. METHODS A descriptive, prospective cross-sectional qualitative design was used. Participants (N = 25) who used a high proportion of expressed human milk feeding were recruited from a larger perspective cohort study in two public hospitals in Hong Kong. Semi-structured, in-depth, one-to-one interviews were conducted 2017-2018. Data collection and thematic analysis were guided by the Breastfeeding Self-Efficacy Theory. RESULTS The authors conducted thematic analysis and identified six core themes: (1) perceived maternal roles; (2) breastfeeding role models; (3) negative feedback from social networks; (4) negative direct breastfeeding experiences; (5) expressed human milk feeding as a solution to a problem; and (6) advice from health care professionals to express human milk. These themes were consistent with the four antecedents of the Breastfeeding Self-Efficacy Theory (e.g., physiological and affective state, vicarious experiences, performance accomplishments, and verbal persuasion). CONCLUSIONS The main reason for participants to feed expressed human milk was experiencing difficulties with direct breastfeeding. Expressed human milk feeding was used as an immediate solution for breastfeeding problems. Strengthening breastfeeding support in the early postpartum period may decrease the perceived need for human milk expression.
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Affiliation(s)
- Heidi Sze Lok Fan
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR
| | - Marie Tarrant
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
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Waldby C, Noble‐Carr D, Carroll K. Mothers, milk and mourning: The meanings of breast milk after loss of an infant. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:109-127. [PMID: 36193004 PMCID: PMC10092727 DOI: 10.1111/1467-9566.13551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 08/15/2022] [Indexed: 06/16/2023]
Abstract
Breast milk is a highly valued substance, immunologically and nutritionally, which also signifies maternal care and love for the infant. This intersection of biological and cultural qualities confers breast milk with complex meanings, which necessarily shape the experience of breastfeeding. Our research, investigating the experience of lactation after the loss of an infant, casts a novel light on these meanings. This article analyses the experience of 17 Australian bereaved mothers and 114 health professionals charged with their care. We find that while all the mothers found post-loss lactation emotionally painful, many also found redemptive meaning in their milk-production, as a bond with the lost child, as confirmation of their maternal competence and as a life giving substance that they could donate to other needy infants. These complex meanings and positive connotations were at odds with hospital cultures that regard post-loss lactation as valueless and best dealt with through medical suppression, despite the more complex insights of individual health-care professions.
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Affiliation(s)
- Catherine Waldby
- Research School of Social SciencesCollege of Arts & Social SciencesThe Australian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Debbie Noble‐Carr
- Research School of Social SciencesCollege of Arts & Social SciencesThe Australian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Katherine Carroll
- Research School of Social SciencesCollege of Arts & Social SciencesThe Australian National UniversityCanberraAustralian Capital TerritoryAustralia
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Augusto A, Neves DM, Henriques V. Breastfeeding experiences and women's self-concept: Negotiations and dilemmas in the transition to motherhood. FRONTIERS IN SOCIOLOGY 2023; 8:1130808. [PMID: 37091724 PMCID: PMC10114285 DOI: 10.3389/fsoc.2023.1130808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/16/2023] [Indexed: 05/03/2023]
Abstract
Introduction Breastfeeding is much more than a biological event. It is a social construction, full of cultural meanings and framed by social structures. Being, simultaneously, a natural event and a social practice, breastfeeding poses challenges to feminist approaches in the sense it may be acknowledged as an empowering practice for women and/or as a setback in the process of women's social emancipation. Often focused on the product, i.e., the milk and its beneficial properties for the infant's health, the dominant discourse on breastfeeding makes it a trait of good mothering, withdrawing the understanding of the particular (but also structural) contexts in which this practice occurs. Methods Based on results from a focus group with five mothers of a first child, this paper addresses first-person testimonies about breastfeeding and transition to motherhood, aiming to capture eventual self-concept dilemmas, impacts of social judgments, difficulties related to the work-family balance, as well as negotiation processes taking place within couples and early-parents. Results and discussion Despite being subject to tensions and sometimes stressful adaptation processes, motherhood and breastfeeding tend to be ultimately described by women as experiences that enhance welcome changes in personal trajectories, life priorities and identities.
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Affiliation(s)
- Amélia Augusto
- ISCTE - Instituto Universitário de Lisboa (ISCTE-IUL), Centro de Investigação e Estudos de Sociologia, Lisboa, Portugal
- Departamento de Sociologia, Universidade da Beira Interior, Covilhã, Portugal
| | - Dulce Morgado Neves
- ISCTE - Instituto Universitário de Lisboa (ISCTE-IUL), Centro de Investigação e Estudos de Sociologia, Lisboa, Portugal
- *Correspondence: Dulce Morgado Neves
| | - Vera Henriques
- ISCTE - Instituto Universitário de Lisboa (ISCTE-IUL), Centro de Investigação e Estudos de Sociologia, Lisboa, Portugal
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Measuring Mothers' Viewpoints of Breast Pump Usage. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083883. [PMID: 33917169 PMCID: PMC8067810 DOI: 10.3390/ijerph18083883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/23/2021] [Accepted: 04/05/2021] [Indexed: 11/17/2022]
Abstract
Breastfeeding has short- and long-term positive influences on the health and wellbeing of the child. There are situations where breastfeeding does not occur and expressed or pumped mother's milk is used. Mothers and healthcare providers report problems or negative views on using pumps in studies across the globe. This systematic review and secondary analysis of 18 random control trials related to mothers' views of breast pumps examines the range of viewpoints gathered, the variety of measurement instruments used, how the outcomes are reported and the challenges that occur. It aims to inform critical reading of research as well as future research design. Devices which the mother views as comfortable and useful will facilitate more infants to receive human milk when direct breastfeeding does not occur, and they will have a positive influence on health and wellbeing.
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Taylor AM, Alexander J, van Teijlingen E, Ryan KM. Commercialisation and commodification of breastfeeding: video diaries by first-time mothers. Int Breastfeed J 2020; 15:33. [PMID: 32354372 PMCID: PMC7193407 DOI: 10.1186/s13006-020-00264-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 03/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many of aspects of our lives became increasingly commercialised in post-modern society. Although breastfeeding is perhaps a late comer to this process in recent years, it too has seen significant commercialisation facilitated by social media and our obsession with celebrity culture. This paper explores how the commercialisation and commodification of breastfeeding impacts mothers' experiences of breastfeeding. METHODS In a qualitative study, five mothers in the United Kingdom recorded their real-time breastfeeding experiences in video diaries. Using a multi-modal method of analysis, incorporating both visual and audio data, a thematic approach was applied. FINDINGS Women preparing for breastfeeding are exposed to increasing commercialisation. When things do not go to plan, women are even more exposed to commercial solutions. The impact of online marketing strategies fuelled their need for paraphernalia so that their dependence on such items became important aspects of their parenting and breastfeeding experiences. CONCLUSIONS The audio-visual data demonstrated the extent to which "essential" paraphernalia was used, offering new insights into how advertising influenced mothers' need for specialist equipment and services. Observing mothers in their video diaries, provided valuable insights into their parenting styles and how this affected their breastfeeding experience.
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Affiliation(s)
- Alison M Taylor
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health and Social Sciences, Bournemouth University, Royal London House, Christchurch Road, Bournemouth, Dorset, BH1 3LT, UK.
| | - Jo Alexander
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Edwin van Teijlingen
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health and Social Sciences, Bournemouth University, Royal London House, Christchurch Road, Bournemouth, Dorset, BH1 3LT, UK
| | - Kath M Ryan
- School of Pharmacy, University of Reading, Whiteknights Campus, Po Box 226, Reading, UK
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Palmér L. Previous breastfeeding difficulties: an existential breastfeeding trauma with two intertwined pathways for future breastfeeding-fear and longing. Int J Qual Stud Health Well-being 2019; 14:1588034. [PMID: 30893016 PMCID: PMC6442107 DOI: 10.1080/17482631.2019.1588034] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
PURPOSE Experiencing breastfeeding difficulties poses a risk for early cessation of breastfeeding and decreases the likelihood of breastfeeding a future child. To further understand breastfeeding outcomes, the aim of this study is to explain the phenomenon of breastfeeding difficulties in order to understand how women's previous experiences of breastfeeding difficulties relate to their decisions about future breastfeeding. METHODS A reflective lifeworld hermeneutical approach was adopted. The study consisted of 15 lifeworld interviews with eight women who had previously experienced difficulties with initial breastfeeding. RESULTS Previously experienced breastfeeding difficulties represent an existential breastfeeding trauma in an individual woman's life, from which there are two intertwined pathways for future breastfeeding: a fear of breastfeeding, which renders the idea of future breastfeeding unthinkable, and a longing for breastfeeding, which increases the likelihood of future breastfeeding. Fear and longing are intertwined in ambiguous ways in an individual woman's life. CONCLUSION Women with previous breastfeeding difficulties may bring negative breastfeeding experiences with them, which are etched into the woman's being as a mother as an embodied memory. A lifeworld-led caring science perspective as a foundation for care can contribute to the development of caring practices, which grasp the existential nature of the breastfeeding trauma.
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Affiliation(s)
- Lina Palmér
- a Faculty of Caring Science, Work Life and Social Welfare , University of Borås , Borås , Sweden
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9
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Cescutti-Butler L, Hemingway A, Hewitt-Taylor J. “His tummy's only tiny” – Scientific feeding advice versus women's knowledge. Women's experiences of feeding their late preterm babies. Midwifery 2019; 69:102-109. [DOI: 10.1016/j.midw.2018.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/10/2018] [Accepted: 11/04/2018] [Indexed: 10/27/2022]
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van Wijlen JE. Breastfeeding woman or lactating object? A critical philosophical discussion on the influence of Cartesian dualism on breastfeeding in the neonatal intensive care unit. J Clin Nurs 2018; 28:1022-1031. [PMID: 30302843 DOI: 10.1111/jocn.14686] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/22/2018] [Accepted: 09/30/2018] [Indexed: 11/29/2022]
Abstract
AIM This discursive paper aims to bring to the foreground the ongoing influence of Cartesian dualism and other important contextual complexities on breastfeeding in the neonatal intensive care unit (NICU). BACKGROUND Breastfeeding is widely supported as the optimal form of nutrition for the first 6 months of life and beyond. Amidst a myriad of contextual factors, current breastfeeding rates are below globally targeted goals. For premature and/or critically ill infants, the importance of receiving breast milk is often encouraged based on its immunological and nutritive benefits as opposed to the entirety of the breastfeeding interaction, underscoring the influence of dualism in the NICU. DESIGN The impact of Cartesian dualism and other sociocultural underpinnings of breastfeeding focused within the NICU environment are illustrated through a critical, philosophical discussion. METHODS Relevant historical context is provided followed by an overview of the realities of contemporary breastfeeding. These are presented as a frame of reference for the NICU breastfeeding experiences currently encountered by many mothers of preterm and critically ill neonates, further illustrated using a clinical exemplar as well as the author's own observations from neonatal nursing practice. RELEVANCE TO CLINICAL PRACTICE Shifting away from a dualistic approach requires rethinking breastfeeding support interactions between NICU nurses and mothers. To address the disembodied and often mechanistic approach to care inherent in the dominant Western medical model, a relational approach to breastfeeding support in the NICU is suggested and discussed. CONCLUSION Future research from a more critical lens is needed to examine the complex dynamics involved when nurses and mothers are negotiating decisions and processes related to infant feeding. In focusing on the relational dimensions of the breastfeeding experience, nurses can resist the dualistic influence and dominant discourses impacting infant feeding and motherhood in the 21st century.
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Affiliation(s)
- Jacqueline Elizabeth van Wijlen
- Rankin School of Nursing, St. Francis Xavier University, Antigonish, Nova Scotia, Canada.,Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
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Pinchevski-Kadir S, Shust-Barequet S, Zajicek M, Leibovich M, Strauss T, Leibovitch L, Morag I. Direct Feeding at the Breast Is Associated with Breast Milk Feeding Duration among Preterm Infants. Nutrients 2017; 9:E1202. [PMID: 29104257 PMCID: PMC5707674 DOI: 10.3390/nu9111202] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 10/18/2017] [Accepted: 10/29/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In spite of high rates of initiating breast milk feeding (BMF) among preterm infants, a significant rate of discontinuation occurs shortly after discharge. AIM To investigate the effect of mode (direct feeding at the breast vs. expressing) and exclusivity (breast milk combined with formula vs. breast milk only) as well as maternal perceptions on the duration of BMF among preterm infants. METHODS The study included mothers whose infants were born before 32 weeks gestation, between January 2012 and August 2015 at Sheba Medical Center (SMC). Perinatal data were collected retrospectively from infants' computerized charts. Mothers were approached >12 months postpartum and were asked to complete a questionnaire. Those who agreed to participate were asked (during their visit to the follow-up clinic or by phone or mail) to complete a questionnaire regarding mode and duration of BMF as well as reasons for its discontinuation. Mothers were also asked about their pre-partum intentions to feed directly at the breast. RESULTS Out of 162 eligible mothers, 131 (80.8%) initiated BMF during their intensive care unit (ICU) hospitalization. Of these, 66 (50.3%) discontinued BMF earlier than six months postpartum. BMF ≥ 6 months was significantly associated with direct feeding at the breast, duration of exclusive BMF, and singleton birth. Regression analysis revealed that direct feeding at the breast (any or only) and duration of BMF exclusivity were the only significant variables associated with BMF duration (Odds ratio (OR) 5.5 and 95% confidence interval (CI) 2.00-15.37; OR 1.5 and 95% CI 1.25-1.88, respectively). Milk supply (inadequate or nonexistent) was the most commonly reported cause for BMF discontinuation <6 months. Direct feeding at the breast was significantly associated with BMF duration and was more common among singletons. CONCLUSIONS Direct feeding at the breast and duration of exclusive BMF are associated with duration of BMF among infants born <32 weeks of gestational age (GA). These findings suggest that targeting these two factors may play a key role in prolonging BMF duration among preterm infants.
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Affiliation(s)
- Shiran Pinchevski-Kadir
- The Edmong and Lily Safra Children Hospital, Chaim Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Ramat Gan 5262000, Israel.
| | - Shir Shust-Barequet
- Rappoport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3525422, Israel.
| | - Michal Zajicek
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan 5262000, Israel.
| | - Mira Leibovich
- Newborn Neonatal Unit, Mayanei Hayeshua Medical Center, Bnei-Brak 5154475, Israel.
| | - Tzipi Strauss
- The Edmong and Lily Safra Children Hospital, Chaim Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Ramat Gan 5262000, Israel.
| | - Leah Leibovitch
- The Edmong and Lily Safra Children Hospital, Chaim Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Ramat Gan 5262000, Israel.
| | - Iris Morag
- The Edmong and Lily Safra Children Hospital, Chaim Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Ramat Gan 5262000, Israel.
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Felice JP, Geraghty SR, Quaglieri CW, Yamada R, Wong AJ, Rasmussen KM. "Breastfeeding" but not at the breast: Mothers' descriptions of providing pumped human milk to their infants via other containers and caregivers. MATERNAL & CHILD NUTRITION 2017; 13:e12425. [PMID: 28083933 PMCID: PMC5491362 DOI: 10.1111/mcn.12425] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 11/18/2016] [Accepted: 12/02/2016] [Indexed: 11/28/2022]
Abstract
As pumping has become more prevalent among American women, pumped human milk (HM) is on the rise in their infants' diets in place of some or all feeding at the breast. We aimed to fill a gap in knowledge about mothers' motivations, practices and perceptions related to pumping, and about mothers' and other caregivers' motivations, practices, and perceptions related to feeding pumped HM. Results related to providing pumped HM are reported here, and results related to pumping are reported elsewhere. We conducted in-depth, semi-structured interviews among a diverse sample of mothers whose infants were fed pumped HM (n = 20), following each up to 1 year postpartum. Data were analyzed using thematic analysis with Atlas.ti. Nearly all mothers felt bottles were necessary to meet infant HM-feeding goals. Nearly all pumped HM was fed by other caregivers because mothers typically preferred and prioritized feeding at the breast for convenience and maintaining their milk supply. Infants were bottle-fed HM for several reasons that changed over time, such as mother's absence, latch difficulty, or desire to share the burden and bonding of feeding. Feeding practices differed between feeds from bottles versus at the breast; some infants were bottle-fed on schedules but fed at the breast on demand. Mothers' methods for storing, transporting, and preparing HM varied substantially and included practices associated with loss of nutrients and microbial contamination. Mothers' reasons for bottle-feeding HM may affect how much their infants are bottle-fed. Consumption of pumped HM may not provide the same benefits to infants as feeding at the breast. These findings highlight important avenues for future research into the relationships between bottle-feeding HM and infant health, growth, and developmental outcomes.
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Affiliation(s)
- Julia P. Felice
- Division of Nutritional SciencesCornell UniversityIthacaNew YorkUSA
| | | | | | - Rei Yamada
- Division of Nutritional SciencesCornell UniversityIthacaNew YorkUSA
| | - Adriana J. Wong
- Division of Nutritional SciencesCornell UniversityIthacaNew YorkUSA
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Felice JP, Geraghty SR, Quaglieri CW, Yamada R, Wong AJ, Rasmussen KM. "Breastfeeding" without baby: A longitudinal, qualitative investigation of how mothers perceive, feel about, and practice human milk expression. MATERNAL & CHILD NUTRITION 2017; 13:e12426. [PMID: 28078789 PMCID: PMC5491350 DOI: 10.1111/mcn.12426] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 11/18/2016] [Accepted: 12/02/2016] [Indexed: 11/27/2022]
Abstract
Most American mothers who produce human milk (HM) now pump in place of some or all feeding at the breast, and most American infants are now fed pumped HM. We aimed to investigate mothers' perceptions of, attitudes toward, and practices for pumping and providing pumped HM. Results related to pumping are reported here. We conducted in-depth, semi-structured interviews among a diverse sample of 20 mothers who pumped, following each from pregnancy through infant HM-feeding cessation up to 1 year postpartum. Data were analyzed using thematic analysis with Atlas.ti. Mothers' reasons for pumping changed over time and reflected their needs and desires (e.g., latch difficulty, return to work, and increasing their milk supply). Mothers reported that pump type and quality were important to pumping success and that pumping was time-consuming, costly, and unpleasant compared to feeding at the breast. Regardless of how often mothers pumped, most felt pumping was necessary to meet their infant HM-feeding goals and was a welcome means of sharing with other caregivers the bonding opportunity and tasks they associated with feeding infants. Mothers interpreted output from pumping sessions to understand their ability to provide enough milk to meet their infants' needs. Mothers' reasons for pumping may signal constraints to infant HM feeding that may be addressed with policy changes. Mothers' attitudes and perceptions toward pumping indicate that, although pumping fills important and welcome roles for many mothers, the reality of its practice may make it an unacceptable or infeasible substitute for some.
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Affiliation(s)
- Julia P. Felice
- Division of Nutritional SciencesCornell UniversityIthacaNew YorkUSA
| | | | | | - Rei Yamada
- Division of Nutritional SciencesCornell UniversityIthacaNew YorkUSA
| | - Adriana J. Wong
- Division of Nutritional SciencesCornell UniversityIthacaNew YorkUSA
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Pang WW, Bernard JY, Thavamani G, Chan YH, Fok D, Soh SE, Chua MC, Lim SB, Shek LP, Yap F, Tan KH, Gluckman PD, Godfrey KM, van Dam RM, Kramer MS, Chong YS. Direct vs. Expressed Breast Milk Feeding: Relation to Duration of Breastfeeding. Nutrients 2017; 9:nu9060547. [PMID: 28554997 PMCID: PMC5490526 DOI: 10.3390/nu9060547] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 05/16/2017] [Accepted: 05/23/2017] [Indexed: 11/24/2022] Open
Abstract
Background: Studies examining direct vs. expressed breast milk feeding are scarce. We explored the predictors of mode of breastfeeding and its association with breastfeeding duration in a multi-ethnic Asian population. Methods: We included 541 breastfeeding mother—infant pairs from the Growing Up in Singapore Toward healthy Outcomes cohort. Mode of breastfeeding (feeding directly at the breast, expressed breast milk (EBM) feeding only, or mixed feeding (a combination of the former 2 modes)) was ascertained at three months postpartum. Ordinal logistic regression analyses identified predictors of breast milk expression. Cox regression models examined the association between mode of breastfeeding and duration of any and of full breastfeeding. Results: Maternal factors independently associated with a greater likelihood of breast milk expression instead of direct breastfeeding were Chinese (vs. Indian) ethnicity, (adjusted odds ratio, 95% CI; 3.41, 1.97–5.91), tertiary education (vs. secondary education or lower) (2.22, 1.22–4.04), primiparity (1.54, 1.04–2.26) and employment during pregnancy (2.53, 1.60–4.02). Relative to those who fed their infants directly at the breast, mothers who fed their infants EBM only had a higher likelihood of early weaning among all mothers who were breastfeeding (adjusted hazard ratio, 95% CI; 2.20, 1.61–3.02), and among those who were fully breastfeeding (2.39, 1.05–5.41). Mothers who practiced mixed feeding, however, were not at higher risk of earlier termination of any or of full breastfeeding. Conclusions: Mothers who fed their infants EBM exclusively, but not those who practiced mixed feeding, were at a higher risk of terminating breastfeeding earlier than those who fed their infants directly at the breast. More education and support are required for women who feed their infants EBM only.
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Affiliation(s)
- Wei Wei Pang
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore.
| | - Jonathan Y Bernard
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore 117609, Singapore.
| | - Geetha Thavamani
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore.
| | - Yiong Huak Chan
- Department of Biostatistics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore.
| | - Doris Fok
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore.
| | - Shu-E Soh
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore 117609, Singapore.
| | - Mei Chien Chua
- Department of Neonatology, KK Women's and Children's Hospital, Singapore 229899, Singapore.
| | - Sok Bee Lim
- Department of Child Development, KK Women's & Children's Hospital, Singapore 229899, Singapore.
| | - Lynette P Shek
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore 117609, Singapore.
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore.
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore 119228, Singapore.
| | - Fabian Yap
- Department of Paediatric Endocrinology, KK Women's and Children's Hospital, Singapore 229899, Singapore.
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore 229899, Singapore.
- Duke-NUS Medical School, Singapore 169857, Singapore.
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore 117609, Singapore.
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand.
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, Southampton SO16 6YD, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK.
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore.
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore.
| | - Michael S Kramer
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore.
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University Faculty of Medicine, Montreal, QC H3A 1A2, Canada.
| | - Yap-Seng Chong
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore.
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore 117609, Singapore.
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Sheehan A, Bowcher WL. Messages to new mothers: an analysis of breast pump advertisements. MATERNAL & CHILD NUTRITION 2017; 13:e12313. [PMID: 27103601 PMCID: PMC6866098 DOI: 10.1111/mcn.12313] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 02/08/2016] [Accepted: 02/11/2016] [Indexed: 11/28/2022]
Abstract
The mass media is replete with all kinds of advice, products and ideas about 'motherhood' with advertising being a major source of information on the latest products and consumer trends. Advertising is a key means of promoting ideas about infant feeding, and yet, there has been little in the way of critical analyses of breast pump advertisements in order to reveal the kinds of messages they convey about this method of feeding. This article makes an important step towards addressing this gap through analysing three advertisements for breast pumps from a popular Australian magazine for mothers. We utilize a social semiotic framework to investigate not just what choices are made in the design of the ads but also what those choices mean in terms of the overall message of the ads. Our analysis identifies three core messages: 'breastfeeding and breast pumping are the same with the purpose being to produce breast milk only', 'using breast pumps facilitates quality time with the baby' and 'mothers need outside expertise (including breast pumps) to ensure baby's development'. We believe it is important for those who provide information and support for breastfeeding women to be aware of the subtle, naturalized messages that ads convey so that they may better understand what may be underlying women's decisions regarding methods of infant feeding. © 2016 John Wiley & Sons Ltd.
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Affiliation(s)
- Athena Sheehan
- School of Nursing and MidwiferyWestern Sydney UniversityPenrithNew South WalesAustralia
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16
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Practices, predictors and consequences of expressed breast-milk feeding in healthy full-term infants. Public Health Nutr 2016; 20:492-503. [DOI: 10.1017/s136898001600241x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo investigate the prevalence and predictors of expressed breast-milk feeding in healthy full-term infants and its association with total duration of breast-milk feeding.DesignProspective cohort study.SettingIn-patient postnatal units of four public hospitals in Hong Kong.SubjectsA total of 2450 mother–infant pairs were recruited in 2006–2007 and 2011–2012 and followed up prospectively for 12 months or until breast-milk feeding had stopped.ResultsAcross the first 6 months postpartum, the rate of exclusive expressed breast-milk feeding ranged from 5·1 to 8·0 % in 2006–2007 and from 18·0 to 19·8 % in 2011–2012. Factors associated with higher rate of exclusive expressed breast-milk feeding included supplementation with infant formula, lack of previous breast-milk feeding experience, having a planned caesarean section delivery and returning to work postpartum. Exclusive expressed breast-milk feeding was associated with an increased risk of early breast-milk feeding cessation when compared with direct feeding at the breast. The hazard ratio (95 % CI) ranged from 1·25 (1·04, 1·51) to 1·91 (1·34, 2·73) across the first 6 months.ConclusionsMothers of healthy term infants should be encouraged and supported to feed directly at the breast. Exclusive expressed breast-milk feeding should be recommended only when medically necessary and not as a substitute for feeding directly at the breast. Further research is required to explore mothers’ reasons for exclusive expressed breast-milk feeding and to identify the health outcomes associated with this practice.
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17
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Crossland N, Thomson G, Morgan H, MacLennan G, Campbell M, Dykes F, Hoddinott P. Breast pumps as an incentive for breastfeeding: a mixed methods study of acceptability. MATERNAL AND CHILD NUTRITION 2016; 12:726-39. [PMID: 27502101 PMCID: PMC5096021 DOI: 10.1111/mcn.12346] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 05/27/2016] [Accepted: 05/30/2016] [Indexed: 11/30/2022]
Abstract
Increasing breastfeeding rates would improve maternal and child health, but multiple barriers to breastfeeding persist. Breast pump provision has been used as an incentive for breastfeeding, although effectiveness is unclear. Women's use of breast pumps is increasing and a high proportion of mothers express breastmilk. No research has yet reported women's and health professionals' perspectives on breast pumps as an incentive for breastfeeding. In the Benefits of Incentives for Breastfeeding and Smoking cessation in pregnancy (BIBS) study, mixed methods research explored women's and professionals' views of breast pumps as an incentive for breastfeeding. A survey of health professionals across Scotland and North West England measured agreement with ‘a breast pump costing around £40 provided for free on the NHS’ as an incentive strategy. Qualitative interviews and focus groups were conducted in two UK regions with a total of 68 participants (pregnant women, new mothers, and their significant others and health professionals) and thematic analysis undertaken. The survey of 497 health professionals found net agreement of 67.8% (337/497) with the breast pump incentive strategy, with no predictors of agreement shown by a multiple ordered logistic regression model. Qualitative research found interrelated themes of the ‘appeal and value of breast pumps’, ‘sharing the load’, ‘perceived benefits’, ‘perceived risks’ and issues related to ‘timing’. Qualitative participants expressed mixed views on the acceptability of breast pumps as an incentive for breastfeeding. Understanding the mechanisms of action for pump type, timing and additional support required for effectiveness is required to underpin trials of breast pump provision as an incentive for improving breastfeeding outcomes. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.
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Affiliation(s)
- Nicola Crossland
- Maternal and Infant Nutrition & Nurture Unit (MAINN), School of Community Health and Midwifery, University of Central Lancashire, Preston, United Kingdom.
| | - Gill Thomson
- Maternal and Infant Nutrition & Nurture Unit (MAINN), School of Community Health and Midwifery, University of Central Lancashire, Preston, United Kingdom
| | - Heather Morgan
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| | - Graeme MacLennan
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| | - Marion Campbell
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| | - Fiona Dykes
- Maternal and Infant Nutrition & Nurture Unit (MAINN), School of Community Health and Midwifery, University of Central Lancashire, Preston, United Kingdom
| | - Pat Hoddinott
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, United Kingdom
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18
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Morris C, Zaraté de la Fuente GA, Williams CET, Hirst C. UK Views toward Breastfeeding in Public: An Analysis of the Public's Response to the Claridge's Incident. J Hum Lact 2016; 32:472-80. [PMID: 27193432 DOI: 10.1177/0890334416648934] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 04/15/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND The embarrassment that UK mothers experience when breastfeeding in public has often been cited as a key factor in the decision of the mother to discontinue breastfeeding. There is convincing evidence that many UK residents are not comfortable with women breastfeeding in public; however, little is known about the underlying reasons for this discomfort. OBJECTIVE This study aimed to assess views on breastfeeding in public in the United Kingdom and to understand why some UK residents object to this practice. METHODS The comments sections of news media websites and parenting forums were systematically identified and reviewed for statements made in response to an incident widely reported in the British press: a woman was asked to cover up while breastfeeding in public at Claridge's, a London luxury hotel. Of these, 805 comments (73 108 words) met the inclusion criteria and were thematically analyzed. RESULTS The majority of commenters were supportive of "discreet" breastfeeding in public, but a significant portion felt that breastfeeding in public is always inappropriate. Sexualization of the breast was mainly evoked as something others may experience while viewing a breastfeeding mother, rather than to reflect the commenters' own views. Common justifications cited against breastfeeding in public were onlookers' embarrassment (not knowing where to look) and disgust (at bodily fluids and/or functions). CONCLUSION Campaigns portraying breastfeeding in public as normal and desirable with a focus on human milk as food rather than a bodily fluid may improve societal acceptance of breastfeeding in public.
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Affiliation(s)
- Cecile Morris
- Food and Nutrition Group, Sheffield Business School, Sheffield Hallam University, Sheffield, UK
| | | | - Claire E T Williams
- Food and Nutrition Group, Sheffield Business School, Sheffield Hallam University, Sheffield, UK
| | - Craig Hirst
- Food and Nutrition Group, Sheffield Business School, Sheffield Hallam University, Sheffield, UK
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19
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Frost N, Capdevila R, Johnson S. Special Issue of Women's Studies International Forum: Choosing mothering? The gendering of agency. WOMENS STUDIES INTERNATIONAL FORUM 2015. [DOI: 10.1016/j.wsif.2015.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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Infant feeding and maternal guilt: The application of a feminist phenomenological framework to guide clinician practices in breast feeding promotion. Midwifery 2015; 34:58-65. [PMID: 26612001 DOI: 10.1016/j.midw.2015.10.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 10/12/2015] [Accepted: 10/17/2015] [Indexed: 11/23/2022]
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21
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Leeming D, Williamson I, Johnson S, Lyttle S. Making use of expertise: a qualitative analysis of the experience of breastfeeding support for first-time mothers. MATERNAL & CHILD NUTRITION 2015; 11:687-702. [PMID: 23557351 PMCID: PMC6860267 DOI: 10.1111/mcn.12033] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
There is now a body of research evaluating breastfeeding interventions and exploring mothers' and health professionals' views on effective and ineffective breastfeeding support. However, this literature leaves relatively unexplored a number of questions about how breastfeeding women experience and make sense of their relationships with those trained to provide breastfeeding support. The present study collected qualitative data from 22 breastfeeding first-time mothers in the United Kingdom on their experiences of, and orientation towards, relationships with maternity care professionals and other breastfeeding advisors. The data were obtained from interviews and audio-diaries at two time points during the first 5 weeks post-partum. We discuss a key theme within the data of 'Making use of expertise' and three subthemes that capture the way in which the women's orientation towards those assumed to have breastfeeding expertise varied according to whether the women (1) adopted a position of consulting experts vs. one of deferring to feeding authorities; (2) experienced difficulty interpreting their own and their baby's bodies; and (3) experienced the expertise of health workers as empowering or disempowering. Although sometimes mothers felt empowered by aligning themselves with the scientific approach and 'normalising gaze' of health care professionals, at other times this gaze could be experienced as objectifying and diminishing. The merits and limitations of a person-centred approach to breastfeeding support are discussed in relation to using breastfeeding expertise in an empowering rather than disempowering way.
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Affiliation(s)
- Dawn Leeming
- Division of Psychology and CounsellingUniversity of HuddersfieldHuddersfieldUK
| | | | - Sally Johnson
- Division of PsychologySchool of Social and International StudiesUniversity of BradfordBradfordUK
| | - Steven Lyttle
- Psychology DepartmentDe Montfort UniversityLeicesterUK
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22
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McInnes RJ, Arbuckle A, Hoddinott P. How UK internet websites portray breast milk expression and breast pumps: a qualitative study of content. BMC Pregnancy Childbirth 2015; 15:81. [PMID: 25881251 PMCID: PMC4429834 DOI: 10.1186/s12884-015-0509-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/19/2015] [Indexed: 11/10/2022] Open
Abstract
Background Exclusive breastfeeding for six months is recommended but few parents achieve this; particularly younger and less well-educated mothers. Many parents introduce infant formula milk to manage feeding but describe a desire to express breastmilk alongside a lack of support or information. The Internet is highlighted as a key resource. This study aimed to examine UK websites on expressing breastmilk to identify key messages and how information is provided. Methods We used search terms in Google to identify websites with information rich content on expressing breastmilk and breast pumps. Ten sites were purposively selected at two time points in 2013 and 2014 to represent 3 categories: commercial, NHS or 3rd sector (voluntary or not for profit). Each site was reviewed by two researchers, data and reflective analytical notes were uploaded into NVivo and thematic data analysis undertaken. Results Sites varied considerably in their design, use of images, videos, audio files, product placement and marketing opportunities. Three key themes emerged: depiction of expressing; reasons to express; and recommendations about expressing. Inconsistent and conflicting information was common within and between sites. Expressing was portrayed as similar to, but easier than, breastfeeding although at the same time difficult and requiring to be learned. Expressed breastmilk is promoted by mainly commercial sites as immediately available, although pumps were also presented as needing to be concealed, not heard or seen. Health benefits were the overarching reason for expressing. Although predicated on separation from the baby, commercial sites identified this as a positive choice while other sites focused on separation due to circumstance. Commercial sites emphasised restrictions related to breastfeeding, lack of sleep and bonding with the father and wider family. Non-commercial sites emphasised hand expression, with some not mentioning breast pumps. Practical information about starting expressing in relation to infant age or duration of breastfeeding was conflicting. Conclusions Internet information about expressing breastmilk is inconsistent, incomplete and not evidence informed. The lack of research evidence on the relationship between expressing and feeding outcomes has provided opportunities for commercial companies, which have the potential to further exacerbate observed health inequalities. Access to good quality information based on robust evidence is urgently required.
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Affiliation(s)
- Rhona J McInnes
- School of Health Sciences, University of Stirling, Stirling, FK9 4LA, UK.
| | - Alix Arbuckle
- Master of Health Research (MRes) programme, School of Health Sciences, University of Stirling, Stirling, FK9 4LA, UK.
| | - Pat Hoddinott
- Nursing Midwifery and Allied Health Professions Research Unit, School of Health Sciences, University of Stirling, Stirling, FK9 4LA, UK.
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23
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Boyer K. ‘Neoliberal motherhood’: Workplace lactation and changing conceptions of working motherhood in the contemporary US. FEMINIST THEORY 2014. [DOI: 10.1177/1464700114545321] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Through an analysis of policy texts, population statistics, and the popular press, this article advances knowledge about working motherhood in the contemporary US and proposes a refinement to how wage-work/care-work relations are conceptualised. I focus on the Patient Protection and Affordable Care Act of 2011 which grants certain rights and protections to women seeking to combine lactation with wage-work. I argue that this policy represents a form of work–life integration that is particularly burdensome for working mothers, and that expectations relating to working motherhood in the contemporary US are being reshaped around the demands of neoliberalism, producing what I term ‘neoliberal motherhood’. I assert that this policy represents a way of combining wage-work and care-work that is not captured within existing conceptualisations, and suggest that a re-working of theory in this area is needed to address cases in which embodied care-work is enfolded within the time and space of wage-work.
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24
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Ryan K, Team V, Alexander J. Expressionists of the twenty-first century: the commodification and commercialization of expressed breast milk. Med Anthropol 2014; 32:467-86. [PMID: 23944247 DOI: 10.1080/01459740.2013.768620] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Breast milk expression has been promoted as liberating for women and as offering them more choices, but there has been little research on women's experiences of it and even less critical commentary on the consequences of its incorporation into mainstream behavior. Drawing on narratives of women in the United Kingdom about breastfeeding, we explore the increasingly popular practice of expressing and feeding expressed breast milk. We argue that breast milk has become commodified, breastfeeding commercialized and technologized, and the mother-infant relationship disrupted. We suggest that breastfeeding as a process is being undermined by vested interests that portray it as unreliable and reconstruct it in artificial feeding terms, so playing on women's insecurities. The major beneficiaries of expression are fathers who want increased involvement in infant care and commercial enterprises that aim to maximize profits for shareholders.
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Affiliation(s)
- Kath Ryan
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.
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25
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Abstract
Prematurity is a complication of pregnancy for 1 in 8 families in the United States. The focus of care after preterm birth shifts to the fragile newborn, while the needs of the woman and her family may be overlooked. There are many challenges for parents, including impaired parent-newborn attachment, difficulties with breastfeeding, postpartum mental health, and family disruption. Premature birth may even risk the developing relationship between parents and their child. Comprehensive care is recommended for parents who have experienced a preterm birth, including support of effective lactation, promotion of skin-to-skin care, reflection on the birth experience, support and evaluation of postpartum mental health, and provision of family-centered care. Preconception care after preterm birth needs to include guidance about the recurrence risk for preterm birth as well as recommendations for risk reduction.
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26
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Johns HM, Forster DA, Amir LH, McLachlan HL. Prevalence and outcomes of breast milk expressing in women with healthy term infants: a systematic review. BMC Pregnancy Childbirth 2013; 13:212. [PMID: 24246046 PMCID: PMC4225568 DOI: 10.1186/1471-2393-13-212] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 11/13/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Expressing breast milk has become increasingly prevalent, particularly in some developed countries. Concurrently, breast pumps have evolved to be more sophisticated and aesthetically appealing, adapted for domestic use, and have become more readily available. In the past, expressed breast milk feeding was predominantly for those infants who were premature, small or unwell; however it has become increasingly common for healthy term infants. The aim of this paper is to systematically explore the literature related to breast milk expressing by women who have healthy term infants, including the prevalence of breast milk expressing, reported reasons for, methods of, and outcomes related to, expressing. METHODS Databases (Medline, CINAHL, JSTOR, ProQuest Central, PsycINFO, PubMed and the Cochrane library) were searched using the keywords milk expression, breast milk expression, breast milk pumping, prevalence, outcomes, statistics and data, with no limit on year of publication. Reference lists of identified papers were also examined. A hand-search was conducted at the Australian Breastfeeding Association Lactation Resource Centre. Only English language papers were included. All papers about expressing breast milk for healthy term infants were considered for inclusion, with a focus on the prevalence, methods, reasons for and outcomes of breast milk expression. RESULTS A total of twenty two papers were relevant to breast milk expression, but only seven papers reported the prevalence and/or outcomes of expressing amongst mothers of well term infants; all of the identified papers were published between 1999 and 2012. Many were descriptive rather than analytical and some were commentaries which included calls for more research, more dialogue and clearer definitions of breastfeeding. While some studies found an association between expressing and the success and duration of breastfeeding, others found the opposite. In some cases these inconsistencies were compounded by imprecise definitions of breastfeeding and breast milk feeding. CONCLUSIONS There is limited evidence about the prevalence and outcomes of expressing breast milk amongst mothers of healthy term infants. The practice of expressing breast milk has increased along with the commercial availability of a range of infant feeding equipment. The reasons for expressing have become more complex while the outcomes, when they have been examined, are contradictory.
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Affiliation(s)
- Helene M Johns
- Mother & Child Health Research, La Trobe University, Melbourne, Victoria, Australia.
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27
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Leeming D, Williamson I, Lyttle S, Johnson S. Socially sensitive lactation: Exploring the social context of breastfeeding. Psychol Health 2013; 28:450-68. [DOI: 10.1080/08870446.2012.737465] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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28
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Lööf-Johanson M, Foldevi M, Rudebeck CE. Breastfeeding as a specific value in women's lives: the experiences and decisions of breastfeeding women. Breastfeed Med 2013; 8:38-44. [PMID: 23131095 DOI: 10.1089/bfm.2012.0008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Worldwide, breastfeeding is recommended for every woman who gives birth to a child. The propensity to breastfeed varies. There is considerable knowledge about the experiences and circumstances that affect the decision to breastfeed, but knowledge about what actually generates the decision's force still needs to be increased. The aim of this study was to gain knowledge of how the decision to breastfeed is initiated and upheld. SUBJECTS AND METHODS Eighteen women from three generations were interviewed, and the data were analyzed by qualitative content analysis. RESULTS Six categories were revealed: "Task," "Instinct," "Silent Impact," "Conflicts," "Job," and "Joy." The women took on the Task of breastfeeding during pregnancy. The will to breastfeed was also recognized as an Instinct. The older women remained more in the background, exerting a Silent Impact. Parents' agreement that mothers remain at home and breastfeed for the first 6 months could be considered disturbing from a gender equality perspective. Competition arose between spouses, which could lead to Conflicts at weaning. The mothers in the study chose to stay home to do the Job and experience the Joy of breastfeeding. CONCLUSIONS A summarizing theme was the specific life value of breastfeeding, encompassing feelings of coherence, pleasure, and pride, regardless of generation affiliation. As the favorable interplay of biological, sensual, relational, and social elements this value upheld the decision to breastfeed. It compensated for the effort and negative experiences, and as a finding, it appears to be transferable among breastfeeding mothers in other developed countries.
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Callaghan JE, Lazard L. ‘Please don’t put the whole dang thing out there!’: A discursive analysis of internet discussions around infant feeding. Psychol Health 2012; 27:938-55. [DOI: 10.1080/08870446.2011.634294] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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30
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Geraghty SR, Sucharew H, Rasmussen KM. Trends in breastfeeding: it is not only at the breast anymore. MATERNAL AND CHILD NUTRITION 2012; 9:180-7. [PMID: 22625407 DOI: 10.1111/j.1740-8709.2012.00416.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The past characterisations of breastfeeding as being only at the breast of the mother may no longer be applicable in the United States as mothers now frequently express their milk. We conducted a retrospective cohort study with women who visited the Cincinnati Children's Breastfeeding Medicine Clinic to understand breast milk feeding behaviours of healthy mothers and infants, which included questions specifically about breast milk expression. All 40 mothers in the cohort expressed their milk and all 40 infants were fed expressed milk. One infant was fed another mother's milk for 30 days. Two-thirds (13/40) of infants received their mother's expressed milk at least a week after it was first expressed and 25% (10/40) of infants continued to be fed expressed breast milk after mothers had stopped expressing milk. There were 14 sequences of breast milk production by the mothers and 16 sequences of consumption by the infants. Early in the post-partum period, mothers started expressing milk even though their infants were consuming all of the breast milk that they needed at the breast. As a result of breast milk expression by all mothers in this cohort, we observed highly variable patterns of maternal breast milk production and infant breast milk consumption, which were not necessarily synchronous within a dyad. It is now time to develop appropriate ways to characterise the production and consumption of breast milk more accurately and investigate whether these behaviours have consequences for the health of mothers and infants.
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Affiliation(s)
- Sheela R Geraghty
- Center for Breastfeeding Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
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Johnson S, Leeming D, Williamson I, Lyttle S. Maintaining the 'good maternal body': expressing milk as a way of negotiating the demands and dilemmas of early infant feeding. J Adv Nurs 2012; 69:590-9. [PMID: 22607057 DOI: 10.1111/j.1365-2648.2012.06035.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To report a descriptive study of early infant feeding experiences focusing on ACCOUNTS OF WOMEN WHO EXPRESSED MILK EXTENSIVELY IN THE FIRST FEW WEEKS POSTPARTUM. BACKGROUND Relatively little is known about the reasons for expressing milk following healthy term births. Evidence indicates it is an increasingly common practice during early infant feeding in Westernized countries. A more comprehensive understanding of this practice will help midwives and nurses assist mothers negotiate early feeding challenges. DESIGN Qualitative data were collected in two phases in the first few weeks postpartum. METHOD Audio-diary and semi-structured interview data from seven British women who extensively expressed milk in the first month postpartum were analysed. These data were drawn from a larger qualitative longitudinal study which took place in 2006-2007. Themes, discursive constructions and discourses are identified through the use of a feminist informed analysis. FINDINGS The practice of expressing was employed as a solution to managing the competing demands and dilemmas of early breastfeeding and ensuring the continued provision of breast milk, thereby deflecting potential accusations of poor mothering. In addition, the practice may afford a degree of freedom to new mothers. CONCLUSIONS The need to maintain the 'good maternal body' can account for the motivation to express milk, although there may be reasons to be cautious about promoting expression as a solution to breastfeeding difficulties. Education for health professionals, which emphasizes the complexities and contradictions of mothering and which challenges prescriptive notions of 'good mothering' could better support new mothers in their feeding 'choices'.
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Ryan K, Todres L, Alexander J. Calling, permission, and fulfillment: the interembodied experience of breastfeeding. QUALITATIVE HEALTH RESEARCH 2011; 21:731-742. [PMID: 21139042 DOI: 10.1177/1049732310392591] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Drawing on examples from in-depth interviews with 49 women, in this article we aim to open up a discursive space for women and health professionals to begin to explore the phenomenon of the interembodied experience of breastfeeding. Although acknowledging that social dimensions partially constitute the lived body, we further the view that the lived body's understanding is embedded in contexts far more complex than those that can be represented by language. We argue that women's narratives of their breastfeeding experience contained instances of the body "understanding" its emotional task at a prelogical, preverbal level. We identified three central, iterative dimensions of the phenomenon—calling, permission, and fulfillment—that occurred prereflexively in the protected space provided by the mother, a space that was easily disrupted by unsupportive postnatal practices. We offer this eidetic understanding and conceptual framework and suggest that it provides new (less damaging) subject positions and ways of behaving.
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Affiliation(s)
- Kath Ryan
- La Trobe University, Melbourne, Victoria, Australia.
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