Welcoming, supportive care in US birthing facilities and realization of breastfeeding goals

First-time parents' perception of midwives' and other healthcare professionals' support behaviours: A qualitative study

PROBLEM

Parents often report not being satisfied with the support received from midwives and nurses during their postpartum hospital stay.

BACKGROUND

Social support is an important protective factor during the transition to parenthood. However, little is known on how first-time parents perceived the behaviours demonstrated by healthcare professionals to support them.

OBJECTIVE

To describe social support behaviours of midwives and nurses as perceived by first-time parents during the early postpartum period.

METHODS

This qualitative study used individual semi-structured interviews to collect data. A purposeful sample of first-time parents staying on the postpartum ward of a Swiss university hospital were included. Thematic analysis was performed to identify themes and sub-themes.

FINDINGS

A total of 26 parents (15 mothers and 11 fathers) were interviewed. Parents reported behaviours perceived either as positive or negative. These behaviours were summarized into five themes: "Welcoming parents on the postpartum ward", "Establishing a partnership with parents", "Guiding parents in acquiring their new parenting role", "Caring for parent's emotions", and "Creating a peaceful environment".

DISCUSSION AND CONCLUSION

This study reported a wide variety of professional support behaviours. Behaviours promoting individualised care and related to empowering parents in their infant care were perceived as helpful by parents. Midwives and nurses should be aware of the way they provide support, as this shapes the early postpartum experience of first-time parents. Being sufficiently staffed and being well-trained, especially in providing interpersonal support, could help midwives and nurses provide better sensitive individualised care.

A comprehensive evaluation of milk protein molecular weight distribution based on exclusion chromatography dataset

Molecular weight is one of the main characteristic parameters of proteins, which is the basis for the functional properties of milk protein. This research aims at establishing molecular weight distribution pattern of milk protein based on exclusion chromatography. The method selected Na3PO4-Na2SO4 (0.1 M, pH 6.7) buffer as the mobile phase and detected at 220 nm by HPLC-UV. The protein molecular weight distributions were determined and compared for human milk, bovine milk, and infant formula. The proportion of macromolecular proteins is much higher in infant formula compared to human or bovine milk. The protein molecular weights of human and bovine milk are significantly different around 90, 20, 14, and 2 kDa. The results provide holistic compare of bovine milk, human milk, and infant formula through protein molecular distribution. The new evaluation indicators for protein will drive technological simulation of infant formula.

Experiences of breastfeeding peer counseling among women with low incomes in the US: a qualitative evaluation

BACKGROUND

Person-centered breastfeeding counseling is a key but often overlooked aspect of high-quality services. We explored women's experiences of the Breastfeeding Heritage and Pride™ program, an evidence-based breastfeeding peer counseling program serving women with low incomes in the United States.

METHODS

This study was conducted through an equitable community-clinical-academic partnership and guided by the World Health Organization (WHO) quality of care framework for maternal and newborn health, which highlights three domains of positive experiences of care: effective communication; respect and dignity; and emotional support. In-depth interviews were conducted with a purposive sample of women participating in the Breastfeeding Heritage and Pride™ program. Women were asked to describe their experiences with the program including examples of when good quality counseling was or was not provided. Each interview was conducted in English or Spanish, audio-recorded, and transcribed verbatim. Data were analyzed using reflexive thematic analysis. Once themes were generated, they were organized according to the three care experience domains in the WHO quality of care framework.

RESULTS

Twenty-eight in-depth interviews were conducted with a racially/ethnically and socio-economically diverse sample of women. Three themes described effective communication practices of peer counselors: tailoring communication to meet women's individual needs; offering comprehensive and honest information about infant feeding; and being timely, proactive, and responsive in all communications across the maternity care continuum. Two themes captured why women felt respected. First, peer counselors were respectful in their interactions with women; they were courteous, patient, and non-judgmental and respected women's infant feeding decisions. Second, peer counselors showed genuine interest in the well-being of women and their families, beyond breastfeeding. The key theme related to emotional support explored ways in which peer counselors offered encouragement to women, namely by affirming women's efforts to breastfeed and by providing reassurance that alleviated their worries about breastfeeding. These positive experiences of counseling were appreciated by women.

CONCLUSIONS

Women described having and valuing positive experiences in their interactions with peer counselors. Efforts to expand access to high-quality, person-centered breastfeeding counseling should, as part of quality assurance, include women's feedback on their experiences of these services.