Different attitudes during breastfeeding consultations when infant formula was given: a phenomenographic approach

Abstract

BackgroundWHO and UNICEF believe that both antenatal and maternity care organizations are in an excellent position to protect and, if necessary, reinstate a culture that promotes breastfeeding, and that they are responsible for doing so. In Sweden, the number of breastfeeding women has been decreasing annually since 1996. Thus the aim of this study is to identify, describe and analyze the attitude midwives have towards the mother, child and breastfeeding when infant formula is given.MethodsFrom the theoretical standpoint of Buber's I-Thou and I-It concept, the different attitudes during breastfeeding consultations are interpreted. By using a phenomenographic approach based on 101 accounts of varying lengths from 39 midwives, different attitudes or approaches were identified.ResultsFour different approaches are distinguished in the breastfeeding consultation. The first is the family as a whole, the second is mother and child as separate and equal, the third views the mother as superior and the fourth views the child as superior.ConclusionsThe approach of the midwife is related to how she defines the overall perspective of the mother-child relationship and how she looks upon her relationship to the mother-child dyad. Her approach varies depending on whether she meets the mother and child as a subject, similar to herself, or whether she sees one of them as an object. A midwife may also take an outside position, as an object, thus excluding a genuine relationship with the mother. The results also indicate that health care professionals focus on parts of the whole instead of maintaining a holistic perspective.

Mothers of preterm infants’ experiences of breastfeeding support in the first 12 months after birth: A qualitative study

“…Furthermore, the attitudes of health professionals may affect the extent to which solutionfocused care was applied, for example, to give formula in a severe breastfeeding situation even though the mother wants to breastfeed. 21 Another example of the lack of ability to provide genuine breastfeeding support was that some mothers were abandoned in their breastfeeding. An explanation may be insecurity and/or a lack of knowledge and skills on the part of the individual health professional to support breastfeeding; this explanation is supported in a study by Dykes.…”

Human milk sharing practices in the U.S.

“…Milk sharing continues to grow because it is a highly accessible way for parents to feed their infants with human milk as recommended by the WHO and AAP when it would otherwise not be possible (Akre et al 2011). In fact, milk sharing recipients in the U.S. report higher rates of exclusive breast milk feeding 0–6 months and longer duration of any breastfeeding/breast milk feedings than the national averages (Palmquist & Doehler 2014).…”

“…The relative risks and benefits of human milk sharing have been the subject of numerous editorials, commentaries and a growing scientific literature (Arnold, 2009; Cohen et al 2010; Landers & Updegrove 2010; Akre et al 2011; Geraghty et al 2011; Gribble & Hausman 2012; Nelson 2012; Brent 2013; Geraghty et al 2013; Keim et al 2013, 2015; Landers & Hartmann 2013; Updegrove 2013a,b; Gribble 2014c; Keim et al . 2014a,b; Martino & Spatz 2014; Carter et al 2015).…”

“…Milk sharing provides parents with an alternative to infant formula and Holder pasteurized banked donor milk (BDM) when mother's own milk (MOM) requires supplementation or is not available, following World Health Organization (WHO) infant feeding guidelines (WHO 2003). Online social networking has been instrumental to the growth of milk sharing communities across the globe (Akre et al 2011; Geraghty et al 2011; Cassidy 2012a). While there are a multitude of reasons that people share breastfeeding and human milk, a majority of parents seeking shared milk online in the U.S. are breastfeeding mothers who have initiated breastfeeding and have experienced lactation insufficiency (Palmquist & Doehler 2014).…”

“…Lack of access to BDM explains, at least in part, growing interest in milk sharing (Akre et al 2011). Although HMBANA continues to expand its network of milk banks, the demand for human milk exceeds what they are currently able to provide (Updegrove 2013a).…”