Exploring the use and experience of an infant feeding genogram to facilitate an assets-based approach to support infant feeding

Abstract

Background A lack of perceived social support influences women’s infant feeding behaviours. The Infant Feeding Genogram is a visual co-constructed diagram which details people/services that can provide support to women and can facilitate a connection between mothers and their existing assets landscape. The aim of this study is to explore women’s and infant feeding helpers’ experiences and use of an infant feeding genogram delivered to the intervention group of the “Assets-based infant feeding help Before and After birth (ABA)” randomised feasibility trial. Methods 103 primiparous mothers aged 16+ years were recruited to the trial (trial registration number) in two sites (Site A and Site B) with low breastfeeding prevalence in the UK. Infant feeding helpers (IFHs) co-constructed a genogram at the first antenatal meeting for the intervention group (n = 50), and then provided proactive, woman-centered support from ~ 32 weeks gestation to up to 5 months postnatal. Infant feeding helpers' and women’s experiences of the infant feeding genogram were collected via interviews or focus groups. Completed genograms were shared with researchers. Content analysis of the genograms and qualitative data from the interviews and focus groups were analysed thematically. Results Data comprised 32 completed genograms, and qualitative insights from all 13 infant feeding helpers (two focus groups; 4 interviews) and interviews with a purposive sample of 21 of 50 intervention group women between 4 and 21 weeks after birth. Content analysis of the genograms highlighted variations, with more personal, individualised genograms completed at Site B compared to Site A. The perceived impact of the genogram was related to the IFHs’ application of the tool. The genogram was either used as intended to raise women’s awareness of available assets and motivate help-seeking behaviour, or as a data collection tool with limited perceived utility. Negative and positive unintended consequences of genogram use were highlighted. Conclusions The genogram has the potential to offer a woman, family and community-centred approach that focusses on building assets for infant feeding. However, variations in genogram application indicate that revised training is required to clarify the purpose and ensure it is used as intended. Trial registration ISRCTN ISRCTN14760978; Registered 30 January 2017.

Who Gets to Breastfeed? A Narrative Ecological Analysis of Women's Infant Feeding Experiences in the UK

“…A strategy to help facilitate these behaviors is through assetsbased approaches, ensuring information is readily available and through peer support interventions. The ABA feasibility study and ongoing ABA-feed trial explicitly encourage women to access information and support through their personal, social and community networks (Clarke et al, 2020a;Ingram et al, 2020;Thomson et al, 2020).…”

“…The ABA study explored the feasibility, acceptability, and utility of a new model of peer support. The model was underpinned by behavior change theory and offered an assets-based approach that focussed on positive capabilities of individuals and communities, including use of a Genogram (aka friends and family diagram) and assets leaflet (Clarke et al, 2020a;Ingram et al, 2020;Thomson et al, 2020). Trained peer supporters (named Infant Feeding Helpers) provided women with an antenatal contact (∼30-32 weeks gestation), daily support (text, telephone) for 2 weeks immediately after birth, and for ongoing support up to 8 weeks post-natal, with frequency and types of contact organized on a peer-mother negotiated basis (Clarke et al, 2020a,b).…”

The Lived Experiences of Women without COVID-19 in Breastfeeding Their Infants during the Pandemic: A Descriptive Phenomenological Study

“…To avoid contact with other people due to social distancing requirements, breastfeeding mothers expressed that they had negative feelings and stayed at home with limited social contact with people, resulting in declining social opportunities and support services [ 59 ]. It is vital to provide professional peer and healthcare support, and communication, during the early weeks of breastfeeding for mothers and their babies, to enhance successful breastfeeding [ 60 , 61 , 62 , 63 ]. During the early weeks of breastfeeding, participants of this study who particularly required care terminated breastfeeding due to an absence of practical, emotional, professional peer and healthcare support, and social gatherings.…”

The genogram as a recruitment tool for identifying primary caregivers of youth living with sickle cell disease preparing for transition

“…Genograms have a rich history of being used in clinical settings to assist with collecting family level data on everything from genetic risks (Daly et al, 1999; Samson et al, 2019) to family structures/resources/relationships (Darwent et al, 2016; Liossi et al, 1997; Perez et al, 2010; Watts & Shrader, 1998); and as a tool to personalize family interventions (Abatemarco et al, 2012; Arias, 2017; Clarke et al, 2020; Thomson et al, 2020). Genograms play a role in family research and have demonstrated utility as an assessment tool, and as a means to assess complex topics such as family stress management skills and handling conflict resolution (Leonidas & Santos, 2015), or to understand health status and risk factors across individual, family and community levels (McGuinness et al, 2005).…”