Working mothers' breastfeeding experience: a phenomenology qualitative approach

Prevalence, patterns, and determinants of breastfeeding cessation among mothers of children under 24 months in Uganda

BACKGROUND

Breastfeeding duration is a critical component of infant and child nutrition, providing immediate and long-term benefits to both children and their mothers. This study uses data from the lot quality assurance sampling (LQAS) survey to examine the prevalence, patterns, and determinants of breastfeeding cessation in Uganda.

METHODS

This study was a secondary analysis of data collected by the cross-sectional LQAS surveys in 2021 and 2022 covering 77 districts in Uganda. The LQAS survey methodology employs a systematic sampling approach to assess whether predefined quality standards are met within specific subgroups of a population. The study employed spatial analysis, bivariate analysis and logistic regression, both with and without clustering, to explore associations between independent variables and breastfeeding cessation. Unadjusted and adjusted odds ratios with 95% confidence intervals were calculated. Statistical significance was set at 5%.

RESULTS

Overall, the study analysed 26,377 records of mothers with children under 24 months old. The mothers' mean age was 27.9 years while that of their children was 11.0 months. While the general breastfeeding cessation rate was 17.7%, cessation was highest (49.7%) among mothers of children 18-23 months. Factors associated with increased odds of breastfeeding cessation included older child's age, older mother's age, using modern family planning, being pregnant and having an unknown pregnancy status. Lower odds of breastfeeding cessation were observed among mothers who; were married, lived in larger households, lived in rural residences, whose children received vitamin A supplementation and among all other regions compared to Kampala.

CONCLUSION

One in five mothers cessed breastfeeding before their child reached 2 years, with a significant increase in cessation odds among mothers of older children. These findings underscore the importance of interventions to promote breastfeeding continuation and adequate nutrition for non-breastfed infants, particularly in regions with high cessation rates.

Investigation of maternal breastfeeding guarantee policy needs and influencing factors: a cross-sectional study in China

Background

The promotion of breastfeeding is an important strategy to prevent neonatal death and improve maternal and infant health. But Chinese efforts to improve breastfeeding practices have not been particularly effective. There is still a long way to go to achieve the national health development goals. We aimed to explore the maternal demand for breastfeeding guarantee policy in China and to determine the impact of a range of socio-demographic and neonatal-related variables on breastfeeding guarantee policy demand.

Methods

The study was carried out in the Obstetrics and Gynecology hospital of Shanghai, one of China's earliest provincial and municipal maternal and child health care institutions. From June to November 2021, 1,292 women were recruited for the cross-sectional study in child health clinic. We collected relevant socio- demographic and neonatal-related data. Maternal breastfeeding needs were measured through a self-designed questionnaire on breastfeeding guarantee policy demands of mothers.

Results

The mean score of breastfeeding guarantee policy demand was 4.42 ± 0.51. There were statistically significant differences in the effects of maternal age, education level, family income per capita (Yuan), medical payment type, baby age, work status, and current feeding methods on the demand for breastfeeding guarantee policies (P < 0.05). Multiple linear regression analyses showed that higher education level (B = 4.437, P < 0.001), baby age (B = 2.150, P = 0.002), and current feeding methods (B = 2.754, P = 0.005) were significantly associated with a higher demand for a breastfeeding guarantee policy, the effect of medical payment type is the most influencing factor (B = -7.369, P < 0.001).

Conclusions

The maternal needs for breastfeeding guarantee policy are multi-faceted and urgent. In the process of improving and implementing policies, the government and relevant departments should take into account the actual needs of women who have different education levels, baby ages, family economics, and feeding methods.

Effect of Nurse Support in the Immediate Postpartum Period on Mothers' Breastfeeding Self-Efficacy Levels in Turkey: A Quasi-Experimental Study

OBJECTIVES

This study aimed to determine the effect of nurse-based breastfeeding support during the immediate postpartum period on mothers' breastfeeding self-efficacy levels.

METHODS

A quasi-experimental study was conducted with 256 mothers in the immediate postpartum period (128 in the intervention group who received nurse-based breastfeeding support and routine care and 128 in the control group who received routine care) during February-June 2018. Data were collected using the Mother-Infant Data Sheet, the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), and the Nurse-Parent Support Tool (NPST).

RESULTS

BSES-SF and NPST mean scores of mothers in the intervention group were higher than those of mothers in the control group (p < 0.01). While the association between breastfeeding self-efficacy and nurse support was low in the control group (0.271), it was rather high in the intervention group (0.693) (p < 0.05). It was found that nurse support explained 48% of the variance in breastfeeding self-efficacy in the intervention group, but only 7.3% of the variance in breastfeeding self-efficacy in the control group.

CONCLUSIONS FOR PRACTICE

The results of the study indicate that nurse support for mothers in the immediate postpartum period based on breastfeeding training has a positive impact on breastfeeding self-efficacy.

Barriers to promoting breastfeeding in primary health care in Mexico: a qualitative perspective

Objective

This article aimed to identify the main barriers related to promoting and counseling breastfeeding (BF) at the Primary Health Care (PHC) in Mexico.

Methodology

A qualitative study with a phenomenological approach was carried out in 88 health centers of the Ministry of Health in the states of Chihuahua, Oaxaca, Chiapas, Veracruz, Mexico, and Yucatan. From September to November 2021, we interviewed 88 key health professionals (HPs) (physicians, nurses, nutritionists, and others) from the PHC of the Ministry of Health in Mexico and 80 parents of children under 5 years old. In addition, nine focus groups were conducted with parents and caregivers. The data obtained were triangulated with information from focus groups and semi-structured interviews.

Results

Of the total interviews, 43.2% (n = 38) were nurses, 29.5% (n = 26) were physicians, 19.3% (n = 17) were nutritionists, and the rest were other health professionals. In the group of users, 97.6% (n = 121) were women. We identified contextual barriers, such as the lack of well-trained health professionals and the scarcest nutrition professionals, as material resources in the health units, without mentioning the low user attendance at their control consultations. Furthermore, we identified barriers related to the orientation and promotion of breastfeeding in health units, including a lack of specific strategies, ineffective communication, and the recommendations of commercial milk formulas.

Conclusion

The results presented reflect the reality of Mexico in relation to BF, making it urgent to take immediate action to improve the quality of nutritional care related to the promotion and orientation of BF at the PHC.

Influence of the Quality of Antenatal Care on Early Breastfeeding Initiation and Exclusive Breastfeeding Among Haitian Women

OBJECTIVE

To assess the influence of the quality of antenatal care on early breastfeeding initiation and exclusive breastfeeding among Haitian women.

DESIGN

Secondary analysis of a cross-sectional household survey.

SETTING

Haiti Demographic and Health Survey, 2016 to 2017.

PARTICIPANTS

Women (N = 2,489) who were 15 to 49 years of age with children younger than 24 months of age.

METHODS

We used multivariable adjusted logistic regression analysis to examine the independent associations between quality of antenatal care and early breastfeeding initiation and exclusive breastfeeding.

RESULTS

The prevalence of early breastfeeding initiation and exclusive breastfeeding were 47.7% and 39.9%, respectively. Approximately 76.0% of the participants received intermediate antenatal care. The odds of early breastfeeding initiation were greater among participants who received antenatal care of intermediate quality than among those who did not receive antenatal care, adjusted OR (AOR) = 1.58, 95% confidence interval (CI) [1.13, 2.20]. Additionally, maternal age of 35 to 49 years (AOR = 1.53, 95% CI [1.10, 2.12]) was positively associated with early breastfeeding initiation. Factors negatively associated with early breastfeeding initiation were cesarean birth (AOR = 0.23, 95% CI [0.12, 0.42]), birth at home (AOR = 0.75, 95% CI [0.34, 0.96]), and birth in a private facility (AOR = 0.57, 95% CI [0.34, 0.96]). Factors negatively associated with exclusive breastfeeding were employment (AOR = 0.57, 95% CI [0.36, 0.90]) and birth in a private facility (AOR = 0.21, 95% CI [0.08, 0.52]).

CONCLUSION

Antenatal care of intermediate quality was positively associated with early breastfeeding initiation among women in Haiti, which highlights the influence that care during pregnancy can have on breastfeeding outcomes.

Continued breastfeeding and work: scenario of maternal persistence and resilience

OBJECTIVES

to understand the challenges in mothers' daily life and strategies adopted to reconcile activities outside the home and continued breastfeeding.

METHODS

a cross-sectional, qualitative study. Theoretical-methodological assumptions were discursive practices and production of meanings in everyday life. Participants were 22 women from a specific social media group who had breastfed at least one child for >7 months. Data were collected between November 2020 and March 2021.

RESULTS

themes: Around the world of activities outside the home; Work environment: routines, opportunities and difficulties to maintain breastfeeding.

FINAL CONSIDERATIONS

women's experiences reveal a daily life with difficulties in reconciling the desire to breastfeed and the work scenario. Support network and adaptation to children's food routine were strategies adopted to minimize risks of weaning. The results show the need to consolidate policies to encourage continued breastfeeding in the labor market.

Exploring the reasons why mothers do not breastfeed, to inform and enable better support

Introduction

Infant and maternal breastfeeding benefits are well documented, globally. Despite efforts to increase global breastfeeding rates, the majority of high-income settings fall short of recommended targets. Breastfeeding rates in the UK are especially poor, and physiological difficulties (e.g., inverted nipples), fail to account for the observed breastfeeding intention-behaviour gap.

Method

The current online study sought to investigate the infant feeding experiences of 624 UK formula feeding mothers, through open text survey responses.

Results

A content analysis identified the following clusters of reasons for formula feeding: Feeding Attitudes, Feeding Problems, Mental Health, and Sharing the Load.

Discussion

Feeding Attitudes explained a large percentage of reasons given for formula feeding. Recommendations are made to improve antenatal breastfeeding education and to develop an intervention with an aim to improve maternal breastfeeding attitudes and subsequent practice. Feeding Problems also explained a large portion of combination feeding and started but stopped infant feeding accounts. The current paper calls for more comprehensive and tailored antenatal breastfeeding education to refine practical breastfeeding skills necessary for successful breastfeeding establishment and maintenance. Mental Health explained relatively small coverage. Suggestions are therefore made to train mental health practitioners on infant feeding with an aim to provide more extensive support, which may serve to disrupt the bidirectional relationship between poor mental health and poor breastfeeding outcomes. Finally, Sharing the Load explained moderate coverage across never breastfed, combination fed, and started but stopped feeding groups. Recommendations are made, in light of these findings, to tighten workplace legislation to protect breastfeeding women.

Amamentação continuada e trabalho: cenário de persistência e resiliência materna

RESUMO Objetivos: compreender os desafios do cotidiano materno e as estratégias adotadas para conciliação entre as atividades fora do lar e a amamentação continuada. Métodos: estudo transversal, qualitativo. Pressupostos teórico-metodológicos foram: práticas discursivas e produção de sentidos no cotidiano. Participaram 22 mulheres, de um grupo de mídia social específico, que amamentaram pelo menos um filho por > sete meses. Dados foram coletados entre novembro de 2020 e março de 2021. Resultados: temas: A volta ao mundo das atividades fora do lar; Ambiente no trabalho: rotinas, oportunidades e dificuldades para manter a amamentação. Considerações Finais: a vivência das mulheres revela um cotidiano com dificuldades de conciliar o desejo de amamentar e o cenário laboral. Rede de apoio e a adaptação na rotina alimentar da criança foram estratégias adotadas para minimizar os riscos de desmame. Os resultados mostram a necessidade de consolidação das políticas de incentivo ao aleitamento continuado no mercado de trabalho.

Postnatal women's breastfeeding beliefs, practices, and support during the COVID-19 pandemic: a cross-sectional comparative study across five countries

Background

Women with COVID-19 experienced numerous concerns and doubts about the safety of breastfeeding their babies, and lack of support may have impacted breastfeeding practices. This study aims to compare breastfeeding beliefs, practices, and contact with healthcare professionals regarding the level of postnatal feeding support provided during the COVID-19 pandemic in Brazil, South Korea, Taiwan, Thailand, and the United Kingdom.

Methods

A multi-country cross-sectional study was conducted with postnatal women in five countries. Women up to six months postpartum were invited to complete an online survey concerning the transmission of preventative measures, beliefs toward breastfeeding, infant feeding practices in the last 24 hours and experiences of postnatal infant feeding support between July to November 2021. Bivariate and multivariate analyses were performed to identify the association.

Results

Of the 3,253 eligible responses received, 39.5% of children were aged between one and two months, but in Taiwan (36%) and South Korea (42.8%) they were between three and four months. The mean of the belief score was significantly different among countries (p < 0.0001). Women in Brazil and the UK had a higher rate of breastfeeding at the breast (90.7% and 85.4%, respectively) compared to the three Asian countries (p < 0.0001) while feeding with expressed breastmilk in Thailand (59.9%), Taiwan (52.6%), and South Korea (50.4%) was higher than the others (p < 0.0001). Brazil and UK mothers (mean = 16.0 and 14.5 respectively) had a higher mean score for belief toward breastfeeding during the COVID-19 than the others. These results are inversely associated with breastfeeding but positively related to formula feeding practice. Postnatal feeding support during the COVID-19 pandemic was mainly provided by healthcare professionals (67.1%) and peers / family through face-to-face personal contact (51.6%) in all countries.

Conclusion

Some differences were found in breastfeeding beliefs during the COVID-19 pandemic in Asian countries. A positive breastfeeding belief was associated with the practice of breastfeeding at the breast. Women from all countries received postpartum infant feeding support from health professionals and peers / family through personal contacts. Governments need to emphasize and disseminate the importance of breastfeeding safety, especially in Asian countries.

Breastfeeding Experience among Mothers during the COVID-19 Pandemic

When health experts declared COVID-19 to be a global pandemic, they recognized the virus as a major environmental factor that could affect the practice of breastfeeding. A few studies focused on the effect of COVID-19 on mothers who gave birth during the pandemic. The purpose of this study is to explore the experience of Saudi Arabian breastfeeding mothers during the COVID-19 pandemic. This study used a descriptive phenomenology qualitative design and a convenience sample of 18 mothers who breastfed their children beginning in March 2020. Data were collected through semi-structured, open-ended phone interviews and analyzed using thematic analysis. The mothers were between 27 and 36 years old, and most of them had previous breastfeeding experience. Four main themes emerged regarding breastfeeding experiences during the COVID-19 pandemic: breastfeeding experience (positive and negative), support, facilitators, and challenges. Most mothers felt their experience with breastfeeding during the pandemic encouraged them to continue. It is important to reassure and educate breastfeeding mothers about the nature of COVID-19 and its mode of transmission. The findings from this study lay the foundation for future research to support the practice of breastfeeding and overcome the challenges that arose during the pandemic.