Abstract
There is extensive evidence to suggest that social support improves breastfeeding outcomes. Building on this evidence-base, public health services and interventions aiming to improve breastfeeding rates have primarily targeted informational and emotional support to mothers, reflecting an individual behaviour-change approach. However, mothers exist within a wider social network, and the characteristics of their broader support networks may be an important predictor of breastfeeding outcomes. Here we explore the typologies of postnatal support for mothers in the UK; a population with one of the lowest breastfeeding rates in Europe. Using retrospective data from an online survey (data collection period December 2017 - February 2018), we carry out a latent class regression (n = 432) to identify “clusters” of postnatal support in our data. Mothers in our sample were most likely to report receiving practical and emotional support from partners and maternal grandmothers, and breastfeeding information from health professionals. We identify three distinct typologies of postnatal support: 1) Extensive support, where mothers received support from a wide range of supporters including partners, maternal grandmothers, friends and health professionals, but mothers were the only ones to feed the infant; 2) Family support, where mothers received support from partners and maternal grandmothers, including with infant feeding, but less likely to receive support from health professionals; and 3) Low support, where mothers primarily received support from partners. 94% of women with extensive support were predicted to be breastfeeding at two months, followed by 48% of mothers in the low support group, and 13% in the family support group. Our findings highlight the complexities of family support and its potential impact on breastfeeding, as well as the significance of professional support. Overall, our results hint at the potential value for health professionals to engage with wider family in order to achieve extensive support for mothers.
Highlights
Breastfeeding has been associated with numerous physical health benefits for both mother and baby[1,2,3], and the World Health Organisation currently recommends exclusive breastfeeding for 6 months[2, 3]
We find evidence of three distinct typologies of postnatal support: 1) mothers with extensive support were likely to report support from all supporters and across support types, bar infant feeding; 2) mothers with family support were likely to report support from family, including infant feeding, but were less likely to receive support from health professionals compared to mothers with extensive support; and 3) mothers with low support were less likely to report support across all supporters and support types
We found that mothers in the low support group were less likely to breastfeed for 2m or longer compared to the extensive support group, but more likely to breastfeed compared to the family support group
Summary
Breastfeeding has been associated with numerous physical health benefits for both mother and baby[1,2,3], and the World Health Organisation currently recommends exclusive breastfeeding for 6 months[2, 3]. Despite continued efforts from the public health community[4, 5], breastfeeding rates remain low in many developed countries[4]. Breastfeeding rates in the UK are one of the lowest in Europe[4, 6]: A 2010 government survey estimated that 1% of UK women breastfeed exclusively at 6 months[4, 7], which is notably low compared to, for example, 18% in Netherlands and 28.5% in Spain[4]. In the aforementioned 2010 survey, around 80% of UK women who stopped breastfeeding within the first 6 weeks said they would have liked to breastfeed for longer[7], highlighting high levels of “unmet feeding goals.”. In the aforementioned 2010 survey, around 80% of UK women who stopped breastfeeding within the first 6 weeks said they would have liked to breastfeed for longer[7], highlighting high levels of “unmet feeding goals.” Studies have repeatedly shown that such unmet feeding goals are often accompanied by a sense of guilt and failure[9], and problems associated with breastfeeding have been associated with postnatal depression[10]
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