Professional Breastfeeding Support Research Articles

Use of Virtual Breastfeeding Support Among Underserved, Rural Mothers

Direct-to-consumer telelactation is an innovative telemedicine service that connects women with remotely-located lactation consultants for breastfeeding support via personal devices. Telelactation may offer certain advantages relative to in-person support, including improved convenience and timeliness and reduced costs. Given documented unmet need for lactation support in the US, these services also have the potential to increase access to professional breastfeeding support in underserved communities; however, to date, there is no published research on use of direct-to-consumer telelactation among underserved mothers. In 2016, we began recruitment for a randomized controlled trial of …

The program of psychological and breastfeeding support "Maternity step by step": an example of effective solution for the prevention, diagnostics and treatment of prenatal and postpartum depression.

Postpartum depression affects about 13-20% of women. Depression during pregnancy is observed in 19% of pregnant women. In Poland we lack asupport system for this group of patients. This article presents the elements of the pilot program of psychological interventions and breastfeeding support "Motherhood: step by step", financed by the municipality of Gdansk. The aim of the program was to provide inhabitants of Gdansk with professional breastfeeding support and psychological help during pregnancy and in the first year of infant's life. The study involved three groups of women: 36 mothers participating in psychological consultations and short-term therapy, 123 women from breastfeeding support group and 104 women in the control group. The evaluation was based on questionnaires prepared by the researchers, the General Health Questionnaire-28 and the Parenting Stress Index -3rd version. The evaluation showed a significant decrease in symptoms of mental disorders in both groups of treated women: women from psychological intervention and breastfeeding intervention group. In women from psychological intervention group a significant decrease in parental stress was observed. Conducted analyses showed that the implemented program is characterized by high effectiveness and may be recommended for the continuation in the subsequent years. It may be considered as asolution for changes in the new standards for perinatal care in Poland.

Designing a model of breastfeeding support in Australia: An appreciative inquiry approach.

In Australia, one of the most frequent reasons for not breastfeeding is a previously unsuccessful experience. This qualitative study used an appreciative inquiry approach to co-design a model of peer and professional breastfeeding support, in a metropolitan area of New South Wales (NSW) Australia, in collaboration with women who have had previous negative experiences of breastfeeding. In total, 30 mothers, health professionals and peer supporters participated in a two-part study, involving interviews and a collaborative workshop. The data were analysed using content analysis. The appreciative inquiry approach led to a solution focused attitude among participants and a commitment to improving breastfeeding support. We noted a level of apathy when the participant groups were interviewed individually prior to the collective workshop. During the collaborative workshop, all three participant groups came together to look at what was currently working well and designed improvements for the future. Midwifery care was identified as important for the start of the breastfeeding journey, during pregnancy and for the first 1-2weeks after birth, but thereafter it was community and trained peer counsellors who were prioritised for breastfeeding support. Participants identified the need for a variety of support options including face-to-face meetings, Skype meetings, phone calls and/or texting. Workshop participants emphasised the need for women, especially those with previous negative experiences, to be linked in with their local peer support community group. An appreciative inquiry approach brought together all key stakeholders to develop practice-based change which included the end user and care providers. The collaborative workshop enabled participants to come together, as individuals, rather than as designated health professionals or trained peer counsellors, or breastfeeding women with negative experiences. This led to a unified approach and a harnessing of collective energy to initiate positive change.

Breastfeeding Support and Counseling: A Practical Guide for the General Practitioners in Outpatient Clinics

Many studies have cited the need for more time and adequate training in breastfeeding (BF) support and counseling for health care professionals in the outpatient setting. As a pediatric nurse practitioner, primary care provider (PCP), and an International Board Certified Lactation Consultant (IBCLC), this dilemma is well understood. With the establishment of baby-friendly hospitals, BF mothers receive the much needed BF counseling and support before going home. However, the length of hospital stays for mothers with healthy, full-term newborns (NBs) has dramatically decreased with the advancement of technologies in the healthcare field. Grassley, Schleis, Bennett, Chapman and Lind (2014) found that 38% of NBs whose mothers planned to exclusively breastfeed (BF) received formula before hospital discharge in their retrospective review of 302 hospital charts. Professional BF support in the outpatient setting is inadequate or insufficient. The first 2 weeks of life are crucial to the continuation of exclusive breastfeeding (EBF) or its termination. Most NBs are seen for hospital discharge follow-up within 5 days. PCPs have the ideal opportunity to address BF support and/or counseling at this crucial time with BF mothers and their support person(s) to promote, sustain, and maintain EBF.

Effect of breastfeeding on postpartum depressive symptoms among adolescent and young adult mothers

Purpose: To describe the association between breastfeeding and postpartum depressive symptoms among a sample of adolescent and young adult mothers and to determine whether breastfeeding difficulty moderates this association.Materials and methods: Data were derived from a prospective cohort of pregnant adolescent and young adult females (ages 14–21) as they transitioned to parenthood. This analysis uses data collected during pregnancy and at 6 months postpartum among mothers (n = 137) who initiated breastfeeding. Multivariable linear regression was used to adjust for prenatal depressive symptoms and other potential confounders.Results: Postpartum depressive symptoms were not significantly associated with breastfeeding duration or breastfeeding at 6 months. Early breastfeeding difficulty moderated the association between depressive symptoms and breastfeeding at 6 months. Among young mothers who were still breastfeeding at 6 months, those who reported no early breastfeeding difficulties had the lowest depressive scores and those who reported much early breastfeeding difficulty had the highest depressive scores at 6 months.Conclusions: Minimizing challenges with breastfeeding may help improve postpartum mental health among adolescent and young adult mothers. Health care providers should help young pregnant women manage expectations about breastfeeding and ensure that they are linked to appropriate professional breastfeeding support during the early postpartum period.

Canadian adolescent mothers' perceptions of influences on breastfeeding decisions: a qualitative descriptive study.

BackgroundThere is increased recognition of the importance of breastfeeding at a national level as evidenced by the increased number of Canadian mothers initiating breastfeeding. However, adolescent mothers (<19 years), compared to all other mothers, have lower rates of breastfeeding initiation and duration. The purpose of this study was to examine the facilitating influences and barriers to initiating, and continuing breastfeeding, as perceived by adolescent mothers in Durham Region, Ontario, Canada.MethodsThe principles of interpretive description guided this qualitative study. A purposeful, homogenous sample of 16 adolescent mothers (15–19 years) were recruited to complete individual, semi-structured, face-to-face interviews. Conventional content analysis was used to code data, identify concepts and synthesize them into overall themes.ResultsAdolescent mothers in this study expressed that the decision to breastfeed was made prenatally and while partner and family member opinions about breastfeeding initiation were influential, the decision was made independently. Mothers were primarily motivated to initiate breastfeeding due to the health benefits for the infant. Lower breastfeeding duration rates were found among mothers who decided to only “try” breastfeeding when compared to the mothers who committed to breastfeeding. Influences on continued breastfeeding included: 1) the impact of breastfeeding on social and intimate relationships; 2) the availability of social support; 3) the physical demands of breastfeeding; 4) mothers’ knowledge of breastfeeding practices and benefits; and 5) mothers’ perceived sense of comfort in breastfeeding.ConclusionsThe results of this study provide health care providers new conceptual insight and understanding of the factors that influence adolescents’ decisions to “try” breastfeeding and to continue providing breastmilk to their infants. Professional implications drawn from this study include active engagement of adolescents in the pre and postnatal periods, including early assessment of potential barriers surrounding breastfeeding decisions. This early professional interaction highlights the professional as a form of support, and allows for sharing of evidence-informed breastfeeding information and practical breastfeeding skills. Inclusion of adolescents’ positive social support networks should be emphasized in professional breastfeeding support. Motivational interviewing is a promising prenatal strategy to influence behavior change and reduce ambivalence in decision-making about breastfeeding, creating opportunities for health care providers to tailor interventions.

Breastfeeding patterns in infants with Down's syndrome: A literature review

This article reports on the findings of a literature review undertaken to examine factors that influenced breastfeeding among mothers of babies with Down's syndrome. Seven studies were identified, with the earliest published in 1983. The review indicates that higher rates of breastfeeding initiation were associated with professional breastfeeding support, whereas barriers to breastfeeding initiation were linked to the infants' inability to feed or to issues with the medical condition. The review underlines that despite the clearly identified health benefits of breastfeeding there is limited evidence on how new mothers of infants with Down's syndrome are supported to take advantage of such health benefits. More focussed research is urgently needed to seek a deeper understanding of the support needs of both mother and infant to enhance the breastfeeding experience. Such a concerted effort would provide a more up-to-date evidence base to health professionals directly involved in the maternity care of these women.

Early breastfeeding outcomes in gestational diabetic primiparas delivering term infants

By definition, gestational diabetes resolves after childbirth, but associations with establishing breastfeeding (BF) have not been documented. We recently reported the prevalence of early lactation difficulties among a cohort of 431 first‐time mothers delivering healthy term infants and initiating BF. Our objective here is to compare the prevalence of delayed onset of lactogenesis (delayed OL, defined as maternal perception of onset after 72 h) and other early BF outcomes between cohort participants with gestational diabetes (GD, n=27) and those without gestational, type 1 or type 2 diabetes (NoD, n=397). GD women were more likely to be obese (P=.007), but were similar in prenatal BF intentions and delivered infants of similar birth weight. In the first 24 h, GD infants (vs. NoD) were less likely to “breastfeed well” at least twice (69% vs. 88%, P=.007) and more likely to be given &gt; 60 mL formula (15% vs. 6%, P=.08). The prevalence of delayed OL (GD vs. NoD) was 63% vs. 43% overall (P=.04) and 64% (7 of 11) vs. 36% (99 of 262) in the non‐obese subset, P=.08. By 72 h, 54% of GD infants (vs. 26% of NoD) received &gt; 60 mL formula (P=.003). GD infants continued to be significantly more likely to receive formula at 3–7 (78% vs. 45%, P=.001) and 8–14 (59% vs. 31%, P=.007) days of age, despite similar maternal BF intentions. GD mothers are at risk for early lactation difficulties and should routinely be provided with professional BF support.

Effect of Professional Postpartum Support on Infant Feeding Patterns Among Breastfeeding Participants in the WIC Program

The purpose of this study was to determine if professional breastfeeding support could postpone formula introduction and prolong breastfeeding among participants in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). Fifty women in the experimental group received home visits and phone calls from a lactation educator following hospital discharge; 50 control group women were encouraged to contact a lactation educator as needed. Infants' ages at formula introduction and breastfeeding continuation rates were not significantly different between the groups. Common reasons for breastfeeding cessation included returning to work/school, inadequate milk supply, and latch‐on/suckling problems. Use of telephone contacts, delay of breastfeeding support until after hospital discharge, and early formula supplementation may have contributed to the ineffectiveness of the intervention.