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Henshaw EJ, Mayer M, Balraj S, Parmar E, Durkin K, Snell R. Couples talk about breastfeeding: Interviews with parents about decision-making, challenges, and the role of fathers and professional support. Health Psychol Open 2021; 8:20551029211029158. [PMID: 34367651 PMCID: PMC8312175 DOI: 10.1177/20551029211029158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Despite health benefits, sustained breastfeeding rates remain low in the United States, and the role of partners in breastfeeding is not well understood. Using a grounded theory approach, the current qualitative study explored how couples communicate regarding breastfeeding decisions and challenges. Mother-father dyads (n = 16) completed individual semi-structured interviews 1 year after the birth of their first child. Following iterative qualitative analysis, three phases of breastfeeding communication emerged: Should we try this? ( Mother's opinion counts) How do we make this work? (adjusting and problem-solving) and How do we settle into a routine? (gaining confidence, resolving issues) Findings underscore the complexity of defining the partner role in breastfeeding.
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Catala P, Peñacoba C, Carmona J, Marin D. Maternal Personality and Psychosocial Variables Associated with Initiation Compared to Maintenance of Breastfeeding: A Study in Low Obstetric Risk Women. Breastfeed Med 2018; 13:680-686. [PMID: 30403497 DOI: 10.1089/bfm.2018.0034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
INTRODUCTION The benefits of breastfeeding are well known for mother and child. Research about the predictive factors related to the initiation and maintenance of breastfeeding is of great interest to public health. AIM To analyze the factors associated with the timely initiation of breastfeeding at immediate postpartum and the variables that facilitate their maintenance 4 months after birth. MATERIALS AND METHODS A longitudinal prospective design was used, including four stages: first trimester of pregnancy (personality), third trimester (childbirth expectations, breastfeeding intention, pregnancy worries, and coping strategies), immediately after childbirth (initiation of breastfeeding and childbirth satisfaction), and 4 months after birth (continuation of breastfeeding). RESULTS A sample of 116 women took part in the study from the first trimester to 4 months after birth. Timely initiation of breastfeeding is associated with vaginal birth (p < 0.000) and with variables related to the absence of stress factors: fewer worries regarding childbirth (p = 0.009), higher satisfaction during birth in relation to holding the baby (p > 0.000), and the meeting of expectations (p = 0.017). These associations disappear when the type of birth is introduced. Maintenance of breastfeeding is associated with maternal personality and psychosocial variables: openness to experience (p = 0.007), increased worries about coping with the baby (p = 0.046), relationship with partner (p = 0.047), and overt emotional expression (p = 0.040). CONCLUSION Different factors are associated with initiation and maintenance of breastfeeding. Specific prevention strategies are needed, aimed toward health care staff for improving breastfeeding initiation and to empower women during the entire pregnancy for breastfeeding maintenance.
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Affiliation(s)
- Patricia Catala
- 1 Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Cecilia Peñacoba
- 1 Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Javier Carmona
- 2 Critical Care Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - Dolores Marin
- 1 Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.,3 Obstetrics Department, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
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Abstract
OBJECTIVE In this paper, we apply psychological agency theory to women's interviews of their breastfeeding experiences to understand the role of agency in relation to breastfeeding initiation, maintenance and duration. DESIGN Qualitative, video interviews were collected from 49 women in the UK from a wide range of ethnic, religious, educational and employment backgrounds about their breastfeeding experiences. We undertook secondary analysis of the data focusing on their accounts of vulnerability and agency. FINDINGS Women's agency was impacted by a variety of factors including their own vulnerability, knowledge, expectations and experience, the feeding environment and the support of health professionals in sharing decision-making and dealing with uncertainty. CONCLUSION Health professionals as co-agents with women are well positioned to maintain, enhance or restore women's sense of agency. Breastfeeding goals should be included in women's birth plans. Training related to agency, continuity of care, and staffing and workload management supported by national breastfeeding policies could improve breastfeeding rates and experiences.
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Affiliation(s)
- Kath Ryan
- a School of Pharmacy , University of Reading , Reading , UK
| | - Victoria Team
- b School of Social Sciences , Monash University , Melbourne , Australia
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Briere CE, McGrath JM, Cong X, Brownell E, Cusson R. Direct-Breastfeeding Premature Infants in the Neonatal Intensive Care Unit. J Hum Lact 2015; 31:386-92. [PMID: 25900843 DOI: 10.1177/0890334415581798] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 03/20/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND The neonatal intensive care unit (NICU) presents challenges for breastfeeding, especially with feeding directly at the breast (direct-breastfeeding). OBJECTIVES The objectives of this study were to describe the characteristics of direct-breastfeeding and identify factors that are associated with direct-breastfeeding in the NICU. METHODS A retrospective chart review of 88 infants born < 34 weeks gestational age whose mothers provided human milk was conducted. Analyses included chi-square and logistic regression models. RESULTS Of infants who received human milk at the time of their first oral feeding, 59% received their first oral feeding at breast and 33% of mothers had a specific breastfeeding goal. Mothers who breastfed ≥ 1 direct-breastfeed per day were more likely to have a breastfeeding goal (odds ratio [OR] = 11.13; 95% confidence interval [CI], 1.43-86.88) and be older (OR = 1.33; 95% CI, 1.03-1.72). Their infants had more days between the first breastfeed and introduction of a bottle (OR = 1.56; 95% CI, 1.11-2.17) and had shorter lengths of stay (OR = 0.9; 95% CI, 0.9-0.97). Mothers were more likely to provide direct-breastfeeding at discharge if they were non-Hispanic (OR = 0.05; 95% CI, < 0.01-0.60), were primiparous (OR = 0.06; 95% CI, 0.01-0.45), had a specific breastfeeding goal (OR = 13.79; 95% CI, 1.99-95.80), and their infant had a shorter length of stay (OR = 0.94; 95% CI, 0.90-0.98). CONCLUSION Mothers should be supported to breastfeed before using bottles in the NICU. In addition, goal setting is important for prenatal care providers to discuss with all mothers early in pregnancy, especially those at high risk for premature delivery.
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Affiliation(s)
- Carrie-Ellen Briere
- School of Nursing, University of Connecticut, Storrs, CT, USA Institute for Nursing Research and Evidence Based Practice, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Jacqueline M McGrath
- School of Nursing, University of Connecticut, Storrs, CT, USA Institute for Nursing Research and Evidence Based Practice, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Xiaomei Cong
- School of Nursing, University of Connecticut, Storrs, CT, USA
| | - Elizabeth Brownell
- Division of Neonatology, Connecticut Children's Medical Center, Hartford, CT, USA University of Connecticut School of Medicine, Storrs, CT, USA
| | - Regina Cusson
- School of Nursing, University of Connecticut, Storrs, CT, USA
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Elliott-Rudder M, Pilotto L, McIntyre E, Ramanathan S. Motivational interviewing improves exclusive breastfeeding in an Australian randomised controlled trial. Acta Paediatr 2014; 103:e11-6. [PMID: 24117857 DOI: 10.1111/apa.12434] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 09/11/2013] [Accepted: 09/25/2013] [Indexed: 11/27/2022]
Abstract
AIM To increase maintenance of breastfeeding through improved primary care support. METHOD A cluster randomised controlled trial recruited 15 rural family doctor's offices and 330 women who were currently breastfeeding took part. Eight practices formed the intervention group (154 women) and seven formed the control group (176 women). The practice nurses who provided the intervention used a specially designed motivational flowchart to speak to the mothers when they brought their child for immunisation at 2, 4 and 6 months. The nurses also attended preparatory workshops on breastfeeding management, counselling skills, motivational interviewing and reflective practice and were given resources and support. Breastfeeding rates were measured at 4 and 6 months. RESULTS Randomisation equally distributed all measured variables except prenatal intentions to rejoin employment within 12 months (70% intervention, 56% control, p < 0.05). After adjustment, the 4-month figures showed significantly higher rates of exclusive breastfeeding (OR 1.88; 95%CI 1.01-3.50; p = 0.047) and full breastfeeding (water/juice allowed) (OR 1.95; 95%CI 1.03-3.69; p = 0.04) in the intervention group. There were no differences at 6 months. CONCLUSION A motivational interviewing intervention by primary care health professionals who have undertaken a replicable training programme is feasible and effective in increasing exclusive breastfeeding and full/predominant breastfeeding at 4 months.
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Affiliation(s)
- M Elliott-Rudder
- Rural Clinical School; Faculty of Medicine; The University of New South Wales; Wagga Wagga NSW Australia
- Rural Clinical School; School of Medicine Sydney; University of Notre Dame Australia; Wagga Wagga NSW Australia
| | - L Pilotto
- Rural Clinical School; Faculty of Medicine; The University of New South Wales; Wagga Wagga NSW Australia
| | - E McIntyre
- Primary Health Care Research & Information Service; Discipline of General Practice; Flinders University; Adelaide SA Australia
| | - S Ramanathan
- Hunter Valley Research Foundation; Newcastle NSW Australia
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Tully KP, Ball HL. Maternal accounts of their breast-feeding intent and early challenges after caesarean childbirth. Midwifery 2013; 30:712-9. [PMID: 24252711 DOI: 10.1016/j.midw.2013.10.014] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Revised: 10/08/2013] [Accepted: 10/13/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND breast-feeding outcomes are often worse after caesarean section compared to vaginal childbirth. OBJECTIVES this study characterises mothers' breast-feeding intentions and their infant feeding experiences after caesarean childbirth. METHODS data are from 115 mothers on a postnatal unit in Northeast England during February 2006-March 2009. Interviews were conducted an average of 1.5 days (range 1-6 days) after the women underwent unscheduled or scheduled caesarean. RESULTS thematic analysis of the data suggested was mostly considered the 'right thing to do,' preferable, natural, and 'supposedly healthier,' but tiring and painful. Advantages of supplementation involved more satiated infants, feeding ease, and longer sleep bouts. The need for 'thinking about yourself' was part of caesarean recovery. Infrequent feeding was concerning but also enabled maternal rest. Other breast-feeding obstacles were maternal mobility limitations, positioning difficulties, and frustration at the need for assistance. Participants were confused about nocturnal infant wakings, leading many to determine that they had insufficient milk. Mothers were surprised that sub-clinically poor infant condition was common following caesarean section. Some breast-feeding difficulty stemmed from 'mucus' expulsion that had to occur before the infants could be 'interested' in feeding. Women who cited motivations for breast feeding that included benefit to themselves were more likely to exclusively breast feed on the postnatal unit after their caesareans than those who reported infant-only motivations. CONCLUSIONS for the majority of mothers, breast feeding after a caesarean is affected by interrelated and compounding difficulties. Provision of more relational breast-feeding information may enable families to better anticipate early feeding experiences after caesarean section childbirth.
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Affiliation(s)
- Kristin P Tully
- Center for Developmental Science, Carolina Global Breastfeeding Institute, University of North Carolina at Chapel Hill, 100 East Franklin Street, Suite 200, Campus Box 8115, Chapel Hill, NC 27599, United States.
| | - Helen L Ball
- Department of Anthropology, Wolfson Research Institute for Health and Wellbeing, Durham University, Durham, United Kingdom
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Mauri PA, Zobbi VF, Zannini L. Exploring the mother's perception of latching difficulty in the first days after birth: An interview study in an Italian hospital. Midwifery 2012; 28:816-23. [DOI: 10.1016/j.midw.2011.09.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Revised: 09/10/2011] [Accepted: 09/24/2011] [Indexed: 11/28/2022]
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Abstract
BACKGROUND Mothers need to be given support, confidence and encouragement to successful breastfeeding. The importance of breastfeeding support has been addressed in numerous studies. However, reviews to explore strategies to support breastfeeding are sparse. AIM The study aims to explore strategies to support breastfeeding. It was also aimed to reveal how the international papers compare with the Turkish situation. METHODS Searches of CINAHL, PubMed, ScienceDirect, Scopus, Web of Science databases, Cochrane databases, Turkish health databases were conducted for data collection. The search was limited to articles published between the years 1995 and 2011, focusing on the strategies related to the support received by mothers. Two experts independently read and analysed 38 articles. FINDINGS Thirty-eight papers were included in this review. The findings identified strategies to support breastfeeding. These include collaboration with community and family members; confidence building; appropriate ratio of staffing levels; development of communication skills; and 'closing the gap' in inequalities in health. CONCLUSION Mothers benefit from strategies that encourage breastfeeding, with guidance that supports their self-efficacy and feelings of being capable and empowered, and is tailored to their individual needs.
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Affiliation(s)
- B Demirtas
- Nursing Department, Ankara University Faculty of Health Sciences, Ankara, Turkey.
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Harvey N, Holmes CA. Nominal group technique: An effective method for obtaining group consensus. Int J Nurs Pract 2012; 18:188-94. [DOI: 10.1111/j.1440-172x.2012.02017.x] [Citation(s) in RCA: 303] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ngai FW, Chan SWC, Holroyd E. Maternal Coping during Early Motherhood among First-time Chinese Mothers. J Health Psychol 2011; 17:189-96. [DOI: 10.1177/1359105311415728] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This qualitative study explored the coping strategies used by first-time Hong Kong Chinese mothers in adjusting to the demands of early motherhood. A purposive sample of 26 first-time Chinese mothers who had participated in a childbirth psycho-education program was interviewed in-depth at six weeks postpartum in respect to their coping strategies. Two main categories emerged: making personalized and achievable decisions and seeking emotional and spiritual solace. Implications for health professionals are discussed, including the need to support individual women’s personal resources and foster social networks to optimize maternal and infant health.
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