Breastfeeding Efforts Research Articles

Resisting stigma: the role of online communities in young mothers’ successful breastfeeding

BackgroundBreastfeeding initiation and continuation rates are shaped by complex and interrelated determinants across individual, interpersonal, community, organisational, and policy spheres. Young mothers, however, face a double burden of stigma, being perceived as immature and incompetent in their mothering and breastfeeding abilities. In this study, we aimed to understand the experiences of young mothers who exclusively breastfed for six months and beyond and explore their experiences of stigma and active resistance through social media.MethodsIn 2020, in-depth telephone interviews about breastfeeding experiences were conducted with 44 young mothers under age 25 in Aotearoa New Zealand who breastfed for six months or longer. Participants were recruited via social media. Interviews were audio-recorded, transcribed and analysed thematically.ResultsAnalysis yielded four themes on young mothers’ negotiation of breastfeeding and support. The first three themes revealed young mothers’ encounters with socio-cultural contexts. They faced negative judgments about maturity and competence, adverse guidance to supplement or cease breastfeeding, and an undermining of their breastfeeding efforts. The fourth theme showed how young mothers sought alternative support in online environments to avoid negative interactions. Online spaces provided anonymity, convenience, experiential knowledge and social connections with shared values. This facilitated identity strengthening, empowerment and stigma resistance.ConclusionOur research highlights the importance of online communities as a tool for young mothers to navigate and resist the societal stigmas surrounding breastfeeding. Online spaces can provide a unique structure that can help counteract the adverse effects of social and historical determinants on breastfeeding rates by fostering a sense of inclusion and support. These findings have implications for the development of breastfeeding promotion strategies for young mothers and highlight the potential of peer support in counteracting the negative impacts of stigma. The research also sheds light on the experiences of young mothers within the health professional relationship and the effects of stigma and cultural health capital on their engagement and withdrawal from services. Further research should examine how sociocultural barriers to breastfeeding stigmatise and marginalise young mothers and continue to reflect on their socio-political and economic positioning and how it can exacerbate inequities.

Breastfeeding initiation, duration, and experiences of mothers of late preterm twins: a mixed-methods study

BackgroundTwins and late preterm (LPT) infants are at an increased risk of being breastfed to a lesser extent than term singletons. This study aimed to describe the initiation and duration of any and exclusive breastfeeding at the breast for mothers of LPT twins and term twins during the first 4 months and to explore the breastfeeding experiences of mothers of LPT twins.MethodsA sequential two-sample quantitative–qualitative explanatory mixed-methods design was used. The quantitative data were derived from a longitudinal cohort study in which 22 mothers of LPT twins and 41 mothers of term twins answered questionnaires at one and four months after birth (2015–2017). The qualitative data were obtained from semi-structured interviews with 14 mothers of LPT twins (2020–2021), based on results from the quantitative study and literature. Analysis included descriptive statistics of quantitative data and deductive content analysis of the qualitative data, followed by condensation and synthesis.ResultsAll mothers of LPT twins (100%) and most mothers of term twins (96%) initiated breastfeeding. There was no difference in any breastfeeding during the first week at home (98% versus 95%) and at 1 month (88% versus 85%). However, at 4 months, the difference was significant (44% versus 75%). The qualitative data highlighted that mothers of LPT twins experienced breastfeeding as complex and strenuous. Key factors influencing mothers’ experiences and decisions were their infants’ immature breastfeeding behaviors requiring them to express breast milk alongside breastfeeding, the burden of following task-oriented feeding regimes, and the lack of guidance from healthcare professionals. As a result, mothers started to question the worth of their breastfeeding efforts, leading to changes in breastfeeding management with diverse results. Support from fathers and grandparents positively influenced sustained breastfeeding.ConclusionsMothers of LPT twins want to breastfeed, but they face many challenges in breastfeeding during the first month, leading to more LPT twins’ mothers than term twins’ mothers ceasing breastfeeding during the following months. To promote and safeguard breastfeeding in this vulnerable group, care must be differentiated from routine term infant services, and healthcare professionals need to receive proper education and training.

The Influence of Education and Specialty Certification on Nurses' Intent to Support Breastfeeding Post-Birth.

Breastfeeding is something that many new mothers aspire to do, but also something that many struggle with in the days following birth. Nursing support in the hospital can make a huge difference in the success of this endeavor for many patients. It is important for nurse educators that work with the obstetric population, and the nurses that care for them, to understand what drives nurses to be supportive of patients who have recently given birth in their breastfeeding efforts. This will allow for appropriate interventions to be implemented to increase the level of support. This study seeks to determine if a relationship exists between nurses' level of education and specialty certification, and their intent to provide support to new mothers in their efforts to breastfeed their babies.

The Role of Public Health Center Staffs in Socialization, Education and Campaign to Increase Exclusive Breastfeeding Coverage

Background: The achievement of breastfeeding in Surakarta City in 2017 was 76.7% while the target of infants with exclusive breastfeeding is 80%. The lowest achievement of exclusive breastfeeding was at Gilingan Public Health Center (66.1%). The role of health center staff is very important in improving and supporting social breastfeeding efforts. 
 Methods: The study was descriptive qualitative research using a case study approach. The informant of this research consists of 2 main informants and 3 triangulation informants with a purposive sampling technique. 
 Results: The role of health center staff in socialization were in the form of counseling and individual counseling; education program were in the form of class for pregnant women and class for parents with under-five children. There has been no health campaign implementation in the World Breastfeeding Week celebration. 
 Conclusions: The socialization and education program could be implemented but for the campaign has not been implemented. It was because of a lack of coordination by Gilingan Public Health Center’s staff.

Factors influencing the implementation of the Becoming Breastfeeding Friendly initiative in Ghana.

Becoming Breastfeeding Friendly (BBF) is an initiative designed to help countries assess their readiness to scale-up breastfeeding programs and develop key recommendations to strengthen their breastfeeding environment. In 2016, Ghana was one of two countries to first pilot BBF. In applying BBF, a committee of 15 Ghanaian nutrition, health, and breastfeeding experts implemented the BBF toolbox over 8months. Following implementation, semistructured interviews were conducted with 12 committee members (CMs) to (a) identify facilitators and barriers to implement BBF and (b) determine factors needed to strengthen the breastfeeding environment in Ghana. Using a grounded theory approach, five domains were identified. First, a dynamic committee of key stakeholders drove the implementation of BBF. Second, CMs faced some logistical and methodological challenges, including difficulty accessing data and the need for strong in-country technical support for adhering to the BBF process. Third, CMs felt well positioned to facilitate and lead the dissemination and implementation of recommendations. Fourth, accountability would be essential to properly translate recommendations. Fifth, to move recommendations to action, advocacy would be a required first step, and BBF was proposed to facilitate this step. BBF provided an in-depth analysis of Ghana's current breastfeeding environment to help Ghana strengthen its breastfeeding governance, policies, and programs while informing CMs' government and non-governmental organizations' breastfeeding efforts.

Incorporating "Father-Friendly" Breastfeeding Language in Maternity Settings.

The purpose of this commentary is to provide perinatal providers with the tools they need to incorporate fathers into the breastfeeding relationship. Research shows that engaged fathers increase initiation rates, decrease the rate of breastfeeding complications that lead to premature cessation, and increase the duration and exclusivity of a mother's breastfeeding efforts. Despite this evidence, studies frequently show that fathers report being ignored or excluded from breastfeeding education. This is likely an oversight on the behalf of perinatal providers rather than a conscious effort. Ultimately, however, perinatal providers need to be prepared to address the concerns of all parents who will provide care to the infant and not the mother alone. This commentary discusses the value of fathers as breastfeeding supporters and offers evidence-based teaching strategies requested by fathers. This commentary also identifies and describes 4 father-friendly breastfeeding promotion resources and highlights the techniques used to draw fathers into the mother's breastfeeding efforts.

Clinical Management of the Breast-Feeding Mother-Infant Dyad in Recovery From Opioid Dependence.

Human milk is one of the most health-promoting and cost-effective nutritional substances known to humankind. Breastmilk provides substantial and remarkable physiological and psychological health benefits. Within the last decade, there has been a resurgence of breast-feeding in the United States and worldwide and an increased awareness of the immense health benefits for mothers, infants, and societies that support it. Each mother-baby dyad is a unique pair, with distinct relationships, biases, barriers, and obstacles. This article aims to address clinical management for the opioid-recovering breast-feeding dyad and to translate current evidenced-based practice findings, recommendations, and resources to best support this unique population. The recovering breast-feeding mother and newborn with opioid dependence deserve special consideration and expert care to foster their recovery and breast-feeding efforts. It is our moral and ethical responsibility as healthcare professionals to enable, foster, and promote breast-feeding among all families, especially those who stand to benefit the greatest. Substance recovery cannot be treated in isolation, nor can breast-feeding efforts; an interdisciplinary professional team effort promises the greatest chances for recovery success. With appropriate evidence-based practice support, training, and intervention by knowledgeable professionals, many women can overcome the biases and obstacles associated with opioid recovery to successfully breast-feed their babies.

Breastfeeding and Methadone Therapy: The Maternal Experience

Paper Presentation Objective To describe perceptions surrounding breastfeeding decisions and management among pregnant and postpartum women taking methadone. The results of the study are expected to inform the development of targeted breastfeeding interventions for this group. Design Qualitative content analysis using maternal individual interviews (during pregnancy) and focus groups (after delivery). Setting Recruitment and interviews occurred at an outpatient obstetric clinic at a large, urban teaching hospital and a drug treatment program for pregnant women. Sample Seven women in their second or third trimesters participated in individual interviews. Four women in their first years postpartum participated in one of two small focus groups. Women were 18 to 45 years old, prescribed methadone from a drug treatment program, and expressed an interest in breastfeeding. Methods Semistructured, audiotaped interviews and focus groups were conducted by the principal investigator. Transcripts were analyzed and coded for major themes by each author independently and then compared. Results Motivating factors to breastfeed were similar to those described in the general population, but breastfeeding was also seen as a means to alleviate infant withdrawal symptoms. Some women experienced intense guilt about their methadone use and viewed provision of breast milk and/or the physical act of breastfeeding as atonement to the infant. Pregnant participants wanted information about what to expect in the postnatal hospital course and expressed concerns about fitting breastfeeding into daily life, breastfeeding in public, the possibility that breastfeeding would be unsuccessful, and whether the infant could overdose on methadone or contract Hepatitis C from breast milk. Postpartum women reported that nurses did not want to take the time to assist with breastfeeding or intentionally sabotaged breastfeeding efforts. For pregnant and postpartum participants, breastfeeding support was inconsistent. Information from peers was valued but sometimes deemed untrustworthy. More prenatal and postpartum instruction was needed on breastfeeding mechanics, including pumping milk during infant separation. Participants suggested that breastfeeding education include peer‐support under the guidance of a knowledgeable professional, a discussion of breastfeeding benefits, and early hands‐on breastfeeding assistance. Conclusion/Implications for Nursing Practice Despite evidence of unique breastfeeding benefits for methadone‐exposed mothers and infants, research suggests that breastfeeding rates in this population are less than half that reported nationally. The reasons for this disparity have not been adequately investigated. Healthcare providers who care for methadone‐exposed mothers and infants should be educated on therapeutic communication, up‐to‐date contraindications to breastfeeding, the benefits of breastfeeding in methadone‐exposed couplets, and basic breastfeeding interventions, including milk expression.

Maternal‐newborn nurses’ experiences of inconsistent professional breastfeeding support

This paper is a report of a study to describe the meaning and significance of common, essential elements of inconsistent professional breastfeeding support as revealed through the experiences of maternal-newborn nurses in a hospital. Professional breastfeeding support has been found to have a beneficial effect on breastfeeding, although mothers also report that inconsistent professional breastfeeding support has a negative influence on their breastfeeding efforts. An existential-phenomenological approach was used, and interviews were conducted with 12 maternal-newborn nurses between October 2005 and January 2006. Interview transcripts were subjected to thematic analysis. Inconsistency in professional breastfeeding support was directly related to the fact that 'supporting' breastfeeding is a dynamic, multidimensional process with relational, contextual and situational components. Eight themes were identified: Inconsistencies still exist but things are changing; A need for 'buy in'; There is no escaping personal experience; What works for one does not work for all; Time impacts recommendations; We have a privileged vantage point; 'My job': what it is and what it is not and After all, breastfeeding is a maternal 'choice'. Addressing inconsistent professional breastfeeding support involves understanding the multiple institutional and personal factors that influence this phenomenon. Because multiple practitioners assist each mother-infant dyad in learning to breastfeed, fostering strong collaborative relationships within this support team is essential. Regular opportunities for all team members to dialogue and actively participate in the updating of breastfeeding policies may increase 'buy in', promote greater collaboration and decrease both conflict and inconsistencies.