Abstract
Mothers with learning disabilities face many challenges during the perinatal period including preparing for and establishing infant feeding. Evidence shows that women with learning disabilities are less likely to breastfeed than other mothers. A scoping review was undertaken using Arksey and O'Malley's methodology to understand what is known about how women with learning disabilities can be supported to make infant feeding decisions, particularly in relation to the use of appropriate and accessible images. An additional aim was to understand what further research is needed to achieve sustainable improvements to policy and practice in this area. A comprehensive search of fourteen electronic databases was undertaken to look for both published and grey literature. Initial searches, after removal of duplicates, resulted in 467 primary research articles plus 22 items of grey literature. Following a systematic process, three published papers and six items of grey literature were identified which met inclusion and exclusion criteria, five of which were resources. Little is known about the acceptability of existing resources, specifically in relation to the use of visual images. A synthesis of the grey literature and a thematic analysis of published literature was conducted and confirmed that women with learning disabilities need tailored support with infant feeding, including accessible resources and that there is a need for more in‐depth research in this area. There is a high level of agreement about the importance of using easily read visual images within these resources, but little evaluation of the types of imagery used or their aesthetic histories.
Highlights
Learning disability includes a ‘significant reduced ability to understand new or complex information and to learn new skills, with a reduced ability to cope independently’ (Department of Health, 2001, p. 4)
A study by Porter et al (2012) identified a paucity of antenatal resources for pregnant women who have learning disabilities, and a systematic review of antenatal care provision for women with learning disabilities (Homeyard et al, 2016) identified that this population often struggle to understand antenatal communication and information, with findings suggesting that midwives lack knowledge in this area and would welcome additional guidance
It is important that mothers with a learning disability are supported to make informed decisions about infant feeding, to understand the benefits of breastfeeding for the health of women and children (Victora et al, 2016), and to understand that they have choices about how they feed their babies, including safe formula feeding
Summary
Learning disability includes a ‘significant reduced ability to understand new or complex information and to learn new skills, with a reduced ability to cope independently’ (Department of Health, 2001, p. 4). This document argues that as a central tenet of good practice, better accessibility to quality resources and information can lead to enhanced outcomes for children whose mothers have a learning disability This includes the fostering of close maternal/ infant bonds, which can be achieved through a range of experiences including infant feeding. It is important that mothers with a learning disability are supported to make informed decisions about infant feeding, to understand the benefits of breastfeeding for the health of women and children (Victora et al, 2016), and to understand that they have choices about how they feed their babies, including safe formula feeding This scoping review aims to discover what is currently understood about infant feeding choices for women with learning disabilities, paying attention to the use of visual images and where further research is needed to achieve effective and sustainable improvements to policy and practice in this area. A final report synthesising findings from all three phases to make recommendations for practice and/or future research
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