Mining for liquid gold: midwifery language and practices associated with early breastfeeding support

Abstract

Internationally, women give mixed reports regarding professional support during the early establishment of breastfeeding. Little is known about the components of midwifery language and the support practices, which assist or interfere with the early establishment of breastfeeding. In this study, critical discourse analysis has been used to describe the language and practices used by midwives when supporting breastfeeding women during the first week after birth. Participant observation at two geographically distant Australian health care settings facilitated the collection of 85 observed audio-recorded dyadic interactions between breastfeeding women and midwives during 2008-2009. Additionally, 23 interviews with women post discharge, 11 interviews with midwives and four focus groups (40 midwives) have also been analysed. Analysis revealed three discourses shaping the beliefs and practices of participating midwives. In the dominant discourse, labelled 'Mining for Liquid Gold', midwives held great reverence for breast milk as 'liquid gold' and prioritised breastfeeding as the mechanism for transfer of this superior nutrition. In the second discourse, labelled 'Not Rocket Science', midwives constructed breastfeeding as 'natural' or 'easy' and something which all women could do if sufficiently committed. The least well-represented discourse constructed breastfeeding as a relationship between mother and infant. In this minority discourse, women were considered to be knowledgeable about their needs and those of their infant. The language and practices of midwives in this approach facilitated communication and built confidence. These study findings suggest the need for models of midwifery care, which facilitate relationship building between mother and infant and mother and midwife.

Shame if you do – shame if you don't: women's experiences of infant feeding

“…To illuminate the ‘quality’ of breastfeeding support further, Burns et al . () identified two discourses in the language and practices of midwives that led to disconnected encounters, both of which are evident in the current study. One discourse (i.e.…”

“…However, Burns et al . () also identified a minority discourse (i.e. ‘breastfeeding is a relationship’) where midwives regarded breastfeeding as a relationship and therefore acknowledged the mother–baby relationship being central to the breastfeeding experience.…”

“…; Burns et al . ) are equally applicable to non‐breastfeeding mothers and their relationships with their supporters, which would also benefit decisively from an authentic presence.…”

‘This little piranha’: a qualitative analysis of the language used by health professionals and mothers to describe infant behaviour during breastfeeding

“…In these interactions, alternative patterns of communication were observed with midwives positioning the mother as an expert in the care and knowledge of her infant (Burns et al . ). These midwives approached breastfeeding as predominantly about the relationship between the woman and her infant.…”

“…This ultimately enhanced mother–infant connectivity and synchronicity and increased maternal confidence with breastfeeding (Burns et al . ). In this approach, health professional language provided a variety of more realistic and positive interpretations of infant behaviour, which influenced the mothers' own understanding of her baby.…”