Women’s advice to healthcare professionals regarding breastfeeding: “offer sensitive individualized breastfeeding support”- an interview study

Abstract

BackgroundThe World Health Organization recommends exclusive breastfeeding for 6 months followed by continued breastfeeding with complementary food up to 2 years of age or beyond. Few women achieve this recommendation in Sweden, and they often stop breastfeeding earlier than they would like. Investigating women’s advice to healthcare professionals is important for the provision of optimal breastfeeding support. The aim of this study was to explore women’s advice to healthcare professionals regarding support for continuing to breastfeed for at least 6 months.MethodsThis investigation used an exploratory study design, and a purposive sample of women was recruited between 2015 and 2016 through social media platforms. The work is a follow-up of an earlier study exploring women’s perceptions of the factors that assisted them in breastfeeding for at least 6 months. Telephone interviews were conducted with 139 Swedish women who reported that they had breastfed for at least 6 months. Women were asked the question, “Do you have any advice that you would like to give to healthcare professionals regarding breastfeeding support?”. The data were analysed using content analysis.ResultsThe theme, “Professionals need to offer women sensitive, individualized breastfeeding support to promote a positive breastfeeding experience”, describes the women’s advice based on five categories: 1) providing evidence-based care, 2) preparing expectant parents during pregnancy, 3) creating a respectful and mutual dialogue, 4) offering individual solutions to breastfeeding problems, and 5) offering practical support.ConclusionsThis study highlights the importance of professionals providing evidence-based breastfeeding support in a sensitive and individualized manner. This consideration is an important prerequisite to strengthening women’s self-confidence and assisting them in reaching their breastfeeding goals, which may enhance the positive nature of their breastfeeding experience.

“They Just Need to Come Down a Little Bit to Your Level”: A Qualitative Study of Parents’ Views and Experiences of Early Life Interventions to Promote Healthy Growth and Associated Behaviours

“…In line with previous research, participants were generally supportive of health professionals raising issues such as maternal weight and pregnancy weight gain [25,26,74,82,83] and to child growth/weight [29], even if they would be hard to hear, if done in a non-judgemental, supportive way. Continuity of care, and the associated development of trusting, respectful relationships and rapport with health professionals, were highly valued by parents in this study, similar to prior research concerning antenatal care [74], weight and/or gestational weight gain [84][85][86], and infant feeding [47,64]. Thus, parents desire more support and for health professionals-with whom they have good rapport with-to be more pro-active in raising such issues.…”

“…The first theme reinforces much of what is known about the transition to parenthood, a challenging time for both mothers and fathers [39][40][41][42][43][44]. Parents often felt they had a lack of knowledge and felt insufficiently prepared for the realities of parenting, particularly breastfeeding, which has been noted elsewhere [45][46][47]. Consistent with previous research, our study findings highlight the judgement, stigma, and guilt/shame that parents perceive around parenting and infant growth [29,48], but particularly in relation to infant feeding [23,44,[49][50][51][52][53][54][55].…”

The risk-risk trade-offs: Understanding factors that influence women’s decision to use substances to boost breast milk supply

“…At a time when some women admitted feeling overwhelmed, sleep deprived, hormonal and not being able to rationalise, the presentation of contradictory information complicated the informed decision-making process. Moreover, the inconsistent information was often not only at odds with the predominant 'breast is best' messaging in health care but also signals that women's values and beliefs (including their breastfeeding goals) may not always be factored into the information and support they receive, which has been demonstrated in research in other high income country settings [36,37].…”

“…As well, it may also suggest that some women have unrealistic expectations about the effectiveness of galactagogues. To address these issues, we argue that breastfeeding advice and support would be more beneficial if it contained clearer and concise information about the effectiveness of galactagogues and the reasons they are used, in order to manage expectations and avoid possible negative impacts on maternal agency, confidence, anxiety and self-efficacy, which can have negative psychological effects {Henderson, 2016, The price mothers pay', even when they are not buying it: Mental health consequences of idealized motherhood} [36,37].…”

“…The importance of empowering breastfeeding support has been widely recognised and is an ongoing and urgent priority requiring increased investment to improve lactation support [1]. Ways of addressing support needs have been explored in a recent study by Blixt et al [36] who provide a comprehensive summary of the type of breastfeeding support women are specifically seeking. They outline five key categories including evidence-based care, earlier preparation for possible breastfeeding challenges during pregnancy, respectful and mutual dialogue, individual solutions to problems or concerns and practical support.…”