Concordance as a Person‐Centered Measure of Breastfeeding Success: From Adequacy to Agency

Abstract

Health benefits associated with breastfeeding are supported by extensive research. Measurements of breastfeeding success in clinical and research settings have focused on maximizing adherence to population‐level health recommendations for infant feeding (compliance). Concordance, a new adjunct measure of breastfeeding success, uses a comparison between the parent's intended feeding method and the actual feeding method to better assess whether the person's goals for infant feeding have been met. This measure uses a modified patient‐centered outcomes research question to evaluate success in a person‐centered framework and is congruent with patient‐centered individualized care and shared decision making. Use of concordance as an adjunct success metric in evaluation of interventions and clinical programs will provide an opportunity to approach breastfeeding promotion holistically and incorporate the parent's desired outcome(s) as central to that success.

Postnatal Unit Experiences Associated With Exclusive Breastfeeding During the Inpatient Stay: A Cross-Sectional Online Survey

“…Low and variable rates of exclusive and continued breastfeeding suggested that many mothers in the United States do not meet their breastfeeding goals. It is important to work toward “concordance” of breastfeeding success from maternal perspectives (Eagen-Torkko, 2019) by establishing more supportive and inclusive postpartum clinical environments.…”

Breastfeeding as a Quality Measure

“…8,13,14 Exclusivity of breastfeeding in the immediate postpartum period is highly correlated with breastfeeding at 2 months and 6 months. 8,15,16 As a nationally endorsed quality measure, it is perhaps the most passionately contested throughout nursing stations, boardrooms, and within the literature for over a decade. 8,[17][18][19][20][21][22][23] The debate centers around the right to choose formula, autonomy, and fear of coercion.…”

Adjusting for Patient Context in Inpatient Breastfeeding Education: A Human Factors Perspective

“…Similar perspectives are emerging in the breastfeeding literature. In the current issue of this journal, Eagen‐Torkko presents a complementary argument in a discussion of concordance, highlighting that breastfeeding outcomes should be measured by taking into account the patient context and goals . In the immediate postpartum hospitalization, despite receiving initial latching support as per Baby‐Friendly guidelines, women may not receive a breastfeeding consultation for hours if not days after birth.…”