Breastfeeding Counselling can be a Matter of Interprofessional Communication

Abstract

The need of breastfeeding mothers often remains unmet. Breastfeeding has both biological and emotional impacts on the mother’s and the child’s health. Breastfeeding is a “negotiation process” triggered by interactive initiatives of the infant and the caregiver’s interpretations and responses thereto. A parallel negotiation process is evident between a mother and her midwife. The Swedish Act on Patient Safety decrees that planned care should include maternal consultation. The aim of this study was to describe health care professionals’ own reflections on given formula of infants after birth and differences in how midwives perceived their responsibilities, and how they valued patient participation, in caring situations regarding breastfeeding. A total of 39 midwives wrote reflections on the degree of care they used when promoting breastfeeding; the data were analysed hermeneutically. The hospital hierarchy influenced midwives’ work and how midwives co-operated with other professionals. It also influenced what participation and responsibility can mean for a midwife, and three themes emerged as evident: asymmetrical responsibility, symmetrical responsibility, and abdication of responsibility. Midwives focused principally on how their actions were viewed by medical professionals; this was paralleled by the treatment of mothers and newborns. It is important to realise that breastfeeding poses a challenge to interprofessional co-operation and a good communication between doctors and midwives; otherwise they will be losing the holistic view.