Breastfeeding Rates In Ireland Research Articles

Exploring Breastfeeding Mothers’ and Lactation Consultants’ Experiences of Lactation Consultancy Throughout the Restrictions Put in Place Due to the COVID-19 Pandemic

Background Breastfeeding rates in Ireland are among the lowest in the world. Lactation consultancy provides mothers with support and information on how to cope with any challenges they encounter. There is emerging evidence that COVID-19 restrictions impacted access to and the quality of breastfeeding support. The aim of this study was to explore breastfeeding mothers’ and lactation consultants’ experiences of breastfeeding support throughout the COVID-19 restrictions in Ireland. It also aimed to explore what adaptations had to be made to the delivery of lactation consultancy and how these changes impacted mothers’ experiences of breastfeeding support. Methods A qualitative research design was chosen. Semi-structured interviews were conducted with eight participants, three breastfeeding mothers and five lactation consultants. Interviews were conducted online via Zoom, audio-recorded and transcribed. The data were analysed using thematic analysis. Results Five key themes were identified: ‘Lack of Support’, ‘Adapting to COVID-19 Restrictions’, Emotional Response to COVID-19 and Restrictions’, Vaccination as a Barrier to and Facilitator of Support’ and Inconsistency of Lactation Support Across Ireland’. Both lactation consultants and mothers identified similar issues however, slight variations within lactation consultants' perceptions of mothers’ and mothers’ attitudes towards online services were seen. An unanticipated finding was the lack of support in hospitals pre-COVID-19. Conclusions Both mothers’ and lactation consultants’ experiences of lactation consultancy were impacted by the COVID-19 restrictions. Although exacerbated by COVID-19, the lack of support in hospitals existed before COVID-19. Provision of better breastfeeding support is required. Increased availability of lactation consultants and the implementation of breastfeeding rooms within hospitals is required in addition to debrief counselling sessions for lactation consultants. Further research is required to understand the unavailability of lactation consultants in hospital settings and to identify how to manage breastfeeding support in future emergency situations.

Exploring facilitators for breastfeeding among Irish mothers: a systematic literature review

Abstract Background Irish women have one of the lowest rates of breastfeeding in Europe. This review aimed to identify the reported barriers, benefits, and opportunities to increase breastfeeding rates among Irish women. Methods The current study implemented a systematic search strategy by using PRISMA guidelines. The research databases PubMed, Mendeley, Web of Science, and Google Scholar were utilized. A deductive thematic analysis of the articles was performed. Results Of the 776 identified articles, 20 were included in this literature review. Some of the identified perceived barriers to breastfeeding were: i) Lack of support from healthcare professionals (ii) Negative cultural attitude/social stigma (iii) Embarrassment (iv) Lack of breastfeeding knowledge/advice (v) Lack of public spaces for breastfeeding vi) Low socioeconomic status (vii) Early return to work postpartum viii) Lack of public/work spaces to pump ix) Hospital environment and resources. The identified opportunities were: (i) Policy changes for breastfeeding (ii) Changing social norms for breastfeeding (iii) Breastfeeding education for adolescents and the general public (iv) Social Marketing Campaign. Discussion: This review reveals that efforts toward shifting cultural perceptions through social marketing strategies and public education campaigns might be needed to address the individual barriers to breastfeeding. In addition, many identified barriers could be eliminated by policy implementation that supports breastfeeding. Lastly, health professionals could use current results to guide their practice and provide care more effectively. Conclusions This review suggests that the problem of low breastfeeding rates in Ireland is caused by the interplay of multiple factors on various levels of the socioecological model. Therefore to increase breastfeeding rates among the target population, a multifactorial approach is needed. Future programs, interventions, and efforts should consider that. Key messages • The efforts toward shifting cultural perceptions through social marketing strategies, public education campaigns, and policy implementation might be needed to increase breastfeeding in Ireland. • To increase breastfeeding rates among the target population, a multifactorial approach is needed.

This study aimed to explore women’s experiences of infant feeding in Ireland

Abstract Background While breastfeeding may be among the most effective ways to ensure child health and survival, breastfeeding rates in Ireland are consistently low. This study aimed to explore women's experiences of infant feeding in Ireland. Methods Thematic analysis of feeding-related free-text comments from the National Maternity Experience Survey 2020 was undertaken. The survey collected data on the experiences of women who were 16 years or older and gave birth in one of Ireland's 19 maternity hospitals or units or had a home birth. Results 3,204 women participated in the survey (50% response rate). In the first few days after birth, 41.9% of women breastfed exclusively, 29.0% used formula and breast milk, and 29.1% bottle fed only. 824 comments related to feeding were received. A number of themes were identified, including support and encouragement from healthcare professionals, information and education regarding feeding, and pressure and respect for personal preferences. Women highlighted that while breastfeeding was encouraged in antenatal care, this was not always the case in the postnatal ward, where formula was readily available, with an apparent lack of resources for breastfeeding women. Some women described feeling pressured to use a feeding method that was not their first preference, with some feeling pushed to breastfeed when this may not have been their wish, while women who wished to breastfeed felt pressured to supplement with formula. Staffing shortages on postnatal wards, a lack of lactation consultants and contradictory advice from healthcare professionals exacerbated difficulties with both feeding methods. Conclusions Some women experience a lack of practical support with infant feeding, regardless of feeding method, and clear and concise information on feeding practices is needed. The addition of lactation consultants, home supports and further education and training could benefit mothers on their breastfeeding journey. Key messages Barriers to breastfeeding included a lack of support from healthcare professionals and conflicting information. It is important to support women regardless of their chosen feeding method.

How to promote exclusive breastfeeding in Ireland: a qualitative study on views of Chinese immigrant mothers

BackgroundThe exclusive breastfeeding rate in Ireland is very low with extremely slow annual growth. The population of immigrants in Ireland is increasing. Improving exclusive breastfeeding practice among immigrants may contribute to the overall improvement of exclusive breastfeeding rates in Ireland. This study was conducted to elicit suggestions on improving exclusive breastfeeding rate for the first 6 months among Chinese immigrants in Ireland.MethodsFourteen semi-structured in-depth interviews were conducted with Chinese immigrant mothers residing in Ireland, who breastfed exclusively for 4 to 6 months. Interviews were recorded and transcribed in Chinese. Data were analyzed using a qualitative thematic analysis. Themes were developed through categorization of codes and via in-depth discussion between two researchers.ResultsThemes generated from the thematic content analysis were: 1) suggestions for new mothers: being strong mentally and getting support from family and friends; 2) suggestions for employers: creating a supportive workplace by setting up private rooms and breastmilk storage facilities; 3) suggestions for healthcare professionals: advocating breastfeeding in the hospital and addressing cultural differences by recruiting multilingual staff; 4) suggestions for the government: promoting breastfeeding by initiating societal and policy changes.ConclusionsThe key findings emerging from this study may be considered in the development of breastfeeding promotion strategies in Ireland. Our findings could also have implications for other English-speaking countries with low rates of exclusive breastfeeding.

A Qualitative Exploration of the Attitudes and Experiences of Polish Breastfeeding Mothers in Ireland.

Breastfeeding rates in Ireland are among the lowest in the world. Improving the prevalence of breastfeeding is an objective of the Irish Health Service Executive, with the recognition that this would improve public health. Polish people represent the largest immigrant group in Ireland, and Polish women are more likely to initiate breastfeeding than Irish women. This study had two aims: (1) to describe the breastfeeding experiences and attitudes among Polish mothers living in Ireland, and (2) to explore similarities and differences in infant feeding experiences, attitudes, and beliefs among Polish and Irish women, as perceived by Polish women. Semi-structured interviews were conducted in Polish with Polish mothers (N = 16) who had lived in Ireland for 10 years or less. Interviews were audio recorded, transcribed, and translated into English. Data were analyzed using qualitative thematic analysis. Coding was a cyclical process; codes were amended and refined through iterative reading of the transcripts. Themes were developed through categorization of codes and via in-depth discussion between two analysts. Three major themes were developed after analyzing the data. First, there is no universal correct way to provide support for infant feeding; women would like individualized support based on their infant-feeding decisions. Second, breastfeeding is an inherent part of Polish culture and formula feeding is part of Irish culture. Finally, the Irish social environment is supportive of breastfeeding and breastfeeding in public is acceptable in Ireland. Although the Irish social environment is supportive of breastfeeding, the infant-formula culture is a barrier to breastfeeding. Future research should explore ways to change societal attitudes towards breastfeeding in Ireland.

Dietitians supporting breastfeeding: a survey of education, skills, knowledge and attitudes.

Breastfeeding rates in Ireland are among the lowest in the world; thus, it is important to understand what knowledge and skills exist and what are the education needs of dietitians. There has been no Irish research on dietitians' perception of their role in promoting, protecting and supporting breastfeeding. The aim of this study was to explore the breastfeeding-related education that dietitians participated in, their breastfeeding-related skills, knowledge and attitudes towards breastfeeding. An e-survey was conducted among members of the Irish Nutrition and Dietetic Institute. Fifty-nine percent of the 181 respondents received education or training on breastfeeding since qualifying with a trend of more training time on general breastfeeding knowledge and less time on clinical issues. There were lower confidence in skills, and role expectations related to clinical practice and clinical skills were perceived as required by only a few dietitians in specific roles. Personal breastfeeding experience was associated with greater confidence in their breastfeeding-related skills and a greater likiehood of reportingpositive attitudes. The main source of information about breastfeeding was own reading or experience. Most respondents (64%) felt that their practice would benefit from additional training. The most frequently reported barriersto providing breastfeeding-related care were "I lack the skill", "I lack the confidence", and "I lack the knowledge to provide assistance with breastfeeding". Further examination of the role of the dietitian and the establishment of expected competencies would provide a clear framework for future training and education of dietitians towards increasing breastfeeding prevalence in Ireland.

Examination of weight status, parity and maternal education factors on intentions to breastfeed and breastfeeding duration in an Irish cohort.

AbstractIntroductionBreastfeeding can improve health outcomes for mothers and babies and is an important factor in the reduction of obesity. However, breastfeeding rates in Ireland are amongst the lowest internationally, with rates of 59.9% in 2016.Materials & MethodsThe objective of this study was to assess intention to breastfeed at booking, feeding status at hospital discharge, one and three months postnatal and influencing factors.Secondary data from 124 healthy pregnant women participating in an RCT in the National Maternity Hospital who recorded their intention to breastfeed at booking were included. Observational data including demographic and lifestyle data was collected from participants.ResultsOf the 124 women, 80.7% were Irish, 86.2% had achieved third level education, and 43.5% (n = 54) were multiparous. Mean age was 32.7years and mean BMI 24.9kg/m2. 91.1% (n = 113) reported intending to breastfeed at booking. Upon hospital discharge, 91% of those intending to breastfeed had initiated breastfeeding (n = 101/111). 78.6% (n = 77/98) and 66.7% (n = 58/87) of those who had intended to breastfeed remained breastfeeding at one and three months postnatal respectively. Intention to breastfeed in early pregnancy was significantly higher amongst women with third level education (p < 0.001). Intention to breastfeed did not differ significantly with maternal age, ethnicity, BMI, or parity, however, women who had breastfed previously were more likely to intend to breastfeed for future infants (p < 0.001). Women with higher education were more likely to breastfeed at discharge, one and three months postnatal (p < 0.05). Although maternal BMI was not associated with intention to breastfeed, women who did not initiate breastfeeding at hospital discharge had a significantly higher BMI (M = 27.22kg/m2, SD = 4.53, p = 0.018) compared to women who initiated breastfeeding (M = 24.68kg/m2, SD = 3.05). Similarly, of those intending to breastfeed, women who were not breastfeeding at three months postnatal had a significantly higher BMI (M = 26.33kg/m2, SD = 3.99, p = 0.01) than those continuing breastfeeding (M = 24.08kg/m2, SD = 2.61). There were no significant differences regarding feeding status with maternal ethnicity, age, or parity at discharge and one month postnatal (p > 0.05). However, primiparous women intending to breastfeed were significantly more likely to continue breastfeeding at three months compared to multiparous women (p < 0.05).DiscussionMany factors are shown to influence breastfeeding intention and duration including parity, education and BMI. It is important to identify these potentially inhibiting factors during pregnancy to develop support measures to encourage initiation and continuation of breastfeeding.

Antenatal breastfeeding self-efficacy and breastfeeding outcomes among mothers participating in a feasibility breastfeeding-support intervention.

Breastfeeding rates in Ireland are among the lowest worldwide. A feasibility study of a breastfeeding-support intervention explored maternal characteristics associated with antenatal breastfeeding self-efficacy and with infant-feeding mode at 6weeks postpartum among women giving birth in Ireland. We conducted a prospective study across two sites, urban and rural: The National Maternity Hospital (NMH), Dublin and Wexford General Hospital (WGH), Wexford. Nulliparous, pregnant women were recruited at approximately 32weeks gestation from the hospitals' antenatal out-patient departments. Participants attended an antenatal class with a support partner, received a one-to-one session with a lactation consultant after delivery and had access to a breastfeeding-support clinic and telephone advice postpartum. Our aim was to understand maternal variables associated with breastfeeding self-efficacy and infant-feeding mode. We explored associations between continuous and categorical variables and any breastfeeding and exclusive breastfeeding using t tests and Chi-squared analyses. One hundred mothers provided baseline data; 64 provided follow-up data. Lower maternal age and non-Irish nationality were associated with higher antenatal breastfeeding self-efficacy. At the rural unit, mothers with tertiary education were more likely to be exclusively breastfeeding than those with secondary education. Though not statistically significant, more normal-weight mothers from the urban unit were exclusively breastfeeding at 6weeks than overweight/obese mothers. Breastfeeding outcomes differed by maternal education. Future interventions should target mothers with lower education and possibly also overweight and obese mothers. Increasing breastfeeding self-efficacy, particularly among older and Irish-born mothers, may be a mechanism for improving breastfeeding outcomes.

Effect of frenotomy on breastfeeding variables in infants with ankyloglossia (tongue-tie): a prospective before and after cohort study

BackgroundControversy exists regarding ankyloglossia (tongue-tie) and its clinical impact on breastfeeding, including the benefits, or otherwise, of tongue-tie release (frenotomy). As exclusive breastfeeding rates in Ireland are already considerably low (46% on discharge home from the maternity unit following birth in 2014), it is imperative to protect and support breastfeeding, including identifying the associated effects that frenotomy might have on breastfeeding variables.ObjectiveTo determine the associated effects of frenotomy on breastfeeding variables in infants with ankyloglossia.MethodsA prospective before and after cohort study was conducted. Following ethical approval, two self-reported questionnaires were administered to women whose infants were undergoing frenotomy at seven healthcare clinics in the Republic of Ireland. Data on breastfeeding variables prior to the frenotomy procedure and at 1-month post-frenotomy were collected and compared. Descriptive statistics (frequencies and proportions) were used to analyse, separately, the pre- and post-frenotomy data. Inferential statistics (z-test scores for differences between proportions (alpha <0.05) and mean differences (MD) with 95% confidence intervals (CI)) were used for pre- and post-frenotomy comparative analyses.ResultsNinety-eight women returned the baseline questionnaire, and, of these, 89 returned the follow-up questionnaire. The most common reason for seeking a frenotomy was difficulty with latch (38%). Private lactation consultants were the main person recommending a frenotomy (31%). Rates of exclusive breastfeeding remained similar pre- and post-frenotomy (58% versus 58%), although rates of formula feeding increased two-fold at follow-up. Infants’ ability to extend their tongues to the lower lip after frenotomy was significantly increased (p < 0.0001). Almost all participants (91%) reported an overall improvement in breastfeeding post-frenotomy. Pain on breastfeeding was significantly reduced post-frenotomy (MD 2.90, 95% CI 3.75 to 2.05) and overall LATCH scale scores were significantly increased (MD -0.50, 95% CI -0.67 to −0.33).ConclusionsThis study supports the hypothesis that frenotomy has a positive effect on breastfeeding variables in infants with ankyloglossia. These findings, however, are based on a relatively small number of participants from one country only where breastfeeding rates are low. Further, larger studies are required to substantiate these findings.

The HSE Breastfeeding Action Plan 2016 – 2021

Introduction: Breastfeeding is the biologically normal feeding method for infants and young children and ensures optimum growth and development. The World Health Organisation recommends that all children are exclusively breastfed for the first six months of life and from six months to two years of age, mothers are recommended to continue breastfeeding, in combination with suitable complementary foods. Ireland has the lowest rate of breastfeeding in Europe, with a rate of ever breastfed at 57% (2016). Almost 38,000 of 66,000 babies born in Ireland annually are not breastfed. Breastfeeding contributes to improved health outcomes for mothers and babies, including reduced infection rates in babies; with fewer hospitalisations, and reduced rates of cancer in mothers. Policy Context: The need to increase breastfeeding rates in Ireland has been identified in a number of recent national strategies and policies, including ‘Better Outcomes, Brighter Futures’, ‘Healthy Ireland in the Health Services’ and ‘A Healthy Weight for Ireland’, and ‘Creating a Better Future Together; National Maternity Strategy 2016-2026’. Targeted Population: Although breastfeeding initiation rates in Ireland have risen in recent years, our breastfeeding rates remain low and 3 months the rate is 38%. There are marked socioeconomic variations in breastfeeding rates, with higher rates mothers in ‘higher professional’ and ‘skilled manual workers’ (63%) socio-economic groups. Breastfeeding is least common among ‘unemployed’ mothers (27%). There are also geographical variations in breastfeeding rates, with the lowest rates reported in the most deprived counties; Limerick and Donegal. International Evidence: There is substantial evidence to show that education, counselling and support have a major role to play in the promotion of breastfeeding, both in the antenatal period and the extended postnatal period. According to a Cochrane review by Renfrew et al, ‘all women should be offered support to breastfeed their babies to increase the duration and exclusivity of breastfeeding. Healthcare settings should provide such trained support as standard.’ Highlights: The HSE Breastfeeding Action Plan 2016 – 2021 sets out the priority areas to be addressed over the next 5 years, to improve breastfeeding supports, to enable more Irish mothers to breastfeed and to improve health outcomes for mothers and children in Ireland. The Action plan outlines the actions needed to enhance breastfeeding rates and provide skilled support to mothers, through our maternity services, hospitals, primary care services and in partnership with voluntary breastfeeding organisations and other stakeholders. The actions include the implementation of policies at hospital and community level; investment in breastfeeding training and skills development for healthcare staff; the provision of additional lactation specialist posts (CMS / CNS Lactation); and partnership working to promote a culture that accepts and supports breastfeeding. This will be achieved through: Improved governance and health service structures Breastfeeding training and skills development Health service policies and practices Support at all stages of the breastfeeding continuum Research, monitoring and evaluation

The influence of ethnicity on breastfeeding rates in Ireland: a cross-sectional study

BackgroundHistorically, breastfeeding rates in Ireland have been low compared with international averages. It has been suggested that maternal ethnicity and citizenship may influence breastfeeding rates, with ethnic minorities thought more...

Explaining the increase in breastfeeding at hospital discharge in Ireland, 2004–2010

Despite a steady increase in the rate of breastfeeding in Ireland over the period 2004-2010 (from 46.8% in 2004 to 55.7% in 2010), Irish rates of breastfeeding are still low by international standards. Over this period, the characteristics of mothers and babies changed, with mothers increasingly older, having fewer children and increasingly born outside the Republic of Ireland. The purpose of this paper is to understand the extent to which changing maternal and birth characteristics explained the increase in the breastfeeding rate in Ireland over the period 2004-2010. We apply non-linear decomposition techniques to micro-data from the 2004-2010 Irish National Perinatal Reporting System to examine this issue. The technique allows us to quantify the extent to which the increase in the breastfeeding rate over the period 2004-2010 is due to changing maternal and birth characteristics. We find that between 55 and 74% of the increase over the period can be explained by changing characteristics, with the increasing share of mothers from Eastern Europe, and increasing maternal age the most important contributors. These findings suggest that the existing policy initiatives have been relatively ineffective in increasing breastfeeding rates in Ireland, i.e. most of the observed increase occurred simply because the characteristics of mothers were changing in ways that made them increasingly likely to breastfeed.

What primary health professionals need to promote breastfeeding

Breastfeeding rates in Ireland remain among the lowest in Europe, with exclusive breastfeeding rates of 44% at discharge from hospital. The knowledge and attitudes of health professionals are important factors in the promotion and support of breastfeeding. This study was conducted to assess knowledge, attitudes and self-efficacy in breastfeeding in a group of primary health professionals, and the barriers to providing support. Data were collected from 256 primary care professionals (GPs, public health nurses (PHNs) and practice nurses) using a self-administered questionnaire. This study highlights some of the issues for health professionals in providing support for breastfeeding and a need for improved knowledge about the benefits of breastfeeding and how to provide practical support.

The prevalence and determinants of breast-feeding initiation and duration in a sample of women in Ireland

To assess breast-feeding initiation and prevalence from birth to 6 months in a sample of mothers in Dublin, and to determine the factors associated with breast-feeding initiation and 'any' breast-feeding at 6 weeks in a sample of Irish-national mothers. This prospective cross-sectional study involved the recruitment of women during the antenatal period, with subsequent follow-up of mothers who delivered healthy, term singleton infants, at 6 weeks and 6 months postpartum. Participants were recruited from antenatal clinics in the Coombe Women and Infants University Hospital, Dublin. In all, 401 Irish-national and forty-nine non-Irish-national mothers met the criteria for inclusion in the present study. Breast-feeding initiation rates of the Irish-national and non-Irish-nationals were 47% and 79.6%, respectively. Factors that were significantly (P = 0.000) associated with both breast-feeding initiation and 'any' breast-feeding at 6 weeks included mothers who were >or=35 years, educated to third level, reported positive postnatal encouragement to breast-feed from their partners and had a positive antenatal intention to breast-feed. The maternal negative perception that breast-feeding is an embarrassing way to feed an infant was demonstrated as a major barrier to initiation. Breast-feeding initiation and prevalence rates of the Irish-national population remain low and lag considerably behind national and international targets. Inclusion of the partner in breast-feeding promotional initiatives during the antenatal period may be crucial to increase breast-feeding rates in Ireland. Public health campaigns that focus on increasing the social acceptability of breast-feeding may prove effective in addressing this cultural barrier.