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Bai R, Cheng Y, Shan S, Zhao X, Wei J, Xia C. The breastfeeding experience of women with multiple pregnancies: a meta-synthesis of qualitative studies. BMC Pregnancy Childbirth 2024; 24:492. [PMID: 39039472 PMCID: PMC11265131 DOI: 10.1186/s12884-024-06697-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 07/15/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND The experiences and challenges associated with breastfeeding multiple births can be considerably more complex than those of singletons. Multiple births refer to the delivery of more than one offspring in a single birth event. Emphasizing the needs and experiences of mothers with multiple births during breastfeeding can enable healthcare providers to design targeted interventions that enhance breastfeeding rates. However, existing breastfeeding and health education resources and practices do not fully meet the needs of women who breastfeed multiples. This review aimed to review and synthesize qualitative studies on the breastfeeding experiences of women with multiple births. METHODS A systematic search was conducted in 10 electronic databases for papers published from the inception of the database to March 2024. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research was utilized to evaluate the methodological quality of the studies included. The thematic synthesis method of Thomas and Harden was employed to integrate and analyze the included literature to derive new categories and conclusions. FINDINGS Eight studies met the inclusion criteria and quality assessment criteria for this study. Through the integration of their results, four themes were identified: the choice and willingness to breastfeed multiple births; the challenges of breastfeeding multiple births; stage management and individualised adaptation of breastfeeding; and the experience of support. CONCLUSION Throughout the feeding process from pregnancy to the postpartum period, mothers with multiple births often have predominantly negative experiences with breastfeeding. Consequently, hospitals should create a multidisciplinary follow-up team comprising obstetrics, neonatology, psychology, and community services to offer specialized and personalized support to these women at various stages. SYSTEMATIC REVIEW REGISTRATION [ https://www.crd.york.ac.uk/PROSPERO/ ], identifier [PROSPERO 2024 CRD42024520348].
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Affiliation(s)
- Ruxue Bai
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang City, 110004, Liaoning Province, China
| | - Yifan Cheng
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang City, 110004, Liaoning Province, China
| | - Siyu Shan
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang City, 110004, Liaoning Province, China
| | - Xinmiao Zhao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang City, 110004, Liaoning Province, China
| | - Jun Wei
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang City, 110004, Liaoning Province, China.
| | - Chunling Xia
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang City, 110004, Liaoning Province, China.
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Arnedillo-Sánchez S, Suffo-Abouza JA, Carmona-Rodríguez MÁ, Morilla-Romero-de-la-Osa R, Arnedillo-Sánchez I. Importance Assigned to Breastfeeding by Spanish Pregnant Women and Associated Factors: A Survey-Based Multivariate Linear Correlation Study. Nutrients 2024; 16:2116. [PMID: 38999864 PMCID: PMC11242974 DOI: 10.3390/nu16132116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 06/28/2024] [Accepted: 06/30/2024] [Indexed: 07/14/2024] Open
Abstract
Breastfeeding education, across all disciplines, is often inconsistent and lacking in expertise and confidence. However, recommendations from health professionals, the sociocultural environment, and previous knowledge and experiences significantly influence women's decision to breastfeed. This study aimed to identify factors that promote the assignment of greater importance to breastfeeding and associated practical benefits. This retrospective cross-sectional study included 276 participants who completed a self-administered questionnaire. Descriptive and bivariate analyses were performed, and multivariate linear models were applied to identify factors influencing the importance assigned to breastfeeding. Most participants were married or in a relationship, were native Spaniards, had secondary or higher education, and had an average age of 32.6 years. Seventy percent met the physical activity recommendations, and 91% felt comfortable with their body image during pregnancy. The importance assigned to breastfeeding was high across various aspects, except for postpartum weight loss and body image. Group prenatal care was only significantly associated with the importance assigned to the breastfeeding technique (how to breastfeed). The obesogenic environment and the importance assigned to nutritional aspects and physical activity also turned out to be predictors, although not for all models. In our region, the educational strategy of antenatal care groups could contain gaps regarding the mother's health, which should be addressed in the future to improve results regarding the initiation and continuation of breastfeeding.
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Affiliation(s)
- Socorro Arnedillo-Sánchez
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, 41009 Seville, Spain; (S.A.-S.); (J.A.S.-A.); (M.Á.C.-R.)
- Midwifery Training Unit, Department of Materno-Fetal Medicine, Genetics and Reproduction, Hospital Universitario Virgen del Rocio, 41013 Seville, Spain
- Institute of Biomedicine of Seville, Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, 41013 Seville, Spain
| | - Jose Antonio Suffo-Abouza
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, 41009 Seville, Spain; (S.A.-S.); (J.A.S.-A.); (M.Á.C.-R.)
| | - Miguel Ángel Carmona-Rodríguez
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, 41009 Seville, Spain; (S.A.-S.); (J.A.S.-A.); (M.Á.C.-R.)
| | - Rubén Morilla-Romero-de-la-Osa
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, 41009 Seville, Spain; (S.A.-S.); (J.A.S.-A.); (M.Á.C.-R.)
- Institute of Biomedicine of Seville, Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, 41013 Seville, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Inmaculada Arnedillo-Sánchez
- School of Computer Science & Statistics, O’Reilly Institute, Trinity College Dublin, College Green 2, D02 PN40 Dublin, Ireland;
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Veiga ACD, Medeiros LDSD, Backes DS, Sousa FGMD, Hämel K, Kruel CS, Haeffner LSB. Interprofessional qualification of prenatal care in the context of primary health care. CIENCIA & SAUDE COLETIVA 2023; 28:993-1002. [PMID: 37042908 DOI: 10.1590/1413-81232023284.14402022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 09/18/2022] [Indexed: 04/13/2023] Open
Abstract
This study aims to describe and analyze an interprofessional educational intervention for the qualification of prenatal care in the context of primary health care. METHOD action-research comprising a prenatal care qualification course with 65 primary health care professionals. Collaborative learning activities were conducted in synchronous and asynchronous meetings. RESULTS the reflexive thematic analysis of participants' experiences, views and perceptions on the meanings of the intervention revealed three categories: quality of prenatal care: conceptions and meanings; collaborative learning: strategy to overcome linear and isolated care; the need to evolve from acting locally to thinking globally. CONCLUSION the analysis of the interprofessional educational intervention for the qualification of prenatal care in the context of primary health care showed that constructivist, participatory and interprofessional approaches are relevant and pertinent to broaden theoretical perceptions and give new meanings to the work process at different settings of the health network.
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Affiliation(s)
- Andressa Caetano da Veiga
- Programa de Pós-Graduação em Saúde Materno-Infantil, Universidade Franciscana. R. Duque de Caxias 938. 97010-200 Santa Maria RS Brasil.
| | | | - Dirce Stein Backes
- Programa de Pós-Graduação em Saúde Materno-Infantil, Universidade Franciscana. R. Duque de Caxias 938. 97010-200 Santa Maria RS Brasil.
| | | | - Kerstin Hämel
- School of Public Health, Bielefeld University. Bielefeld Alemanha
| | - Cristina Saling Kruel
- Programa de Pós-Graduação em Saúde Materno-Infantil, Universidade Franciscana. R. Duque de Caxias 938. 97010-200 Santa Maria RS Brasil.
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Santini TP, Muhlen ESV, Marchiori MRCT, Kruel CS, Backes DS. Best Practices in Maternal and Child Health from the Perspective of Healthcare Professionals. AQUICHAN 2023. [DOI: 10.5294/aqui.2023.23.1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Objective: To understand healthcare professionals’ perception of best practices in maternal and child health. Materials and methods: This qualitative exploratory-descriptive study was conducted between December 2020 and March 2021. The study corpus consisted of 23 healthcare professionals from southern Brazil. Data were collected using a semi-structured script and coded based on Minayo’s thematic content analysis proposed. Results: Data analysis enabled the delimitation of two thematic categories: “best practices in maternal and child health: from idealization to accomplishment” and “strategies to qualify the maternal and child healthcare network.” Conclusions: Healthcare professionals recognize the relevance of best practices in maternal and child health, although this process must be expanded and consolidated. Continuing education, hospitality, ambiance, improved access, and the professional-user connection stand out among the qualifying strategies.
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Webber E, Wodwaski N, Busch D. Breastfeeding and Human Lactation Curriculum Survey of Midwifery Programs in the United States. J Midwifery Womens Health 2022; 67:635-643. [PMID: 35522123 DOI: 10.1111/jmwh.13367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 03/20/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The health attributes and advantages of breastfeeding are well documented in the literature. Current research identifies the importance of comprehensive lactation knowledge among health care professionals to improve breastfeeding outcomes. Educational curricula to incorporate lactation content is necessary for student preparedness to provide competent care. Midwives are in a unique position to support, promote, and manage breastfeeding. The purpose of this study was to survey Accreditation Commission for Midwifery Education (ACME)-accredited midwifery education programs in the United States for their breastfeeding curricular content including opportunities for clinical experiences in managing and counseling breastfeeding parents. METHODS A descriptive survey was deployed online to midwifery programs listed by the American College of Nurse-Midwives, with a response completion rate of 44.7%. Data collection included program descriptors, hours of lactation content, educational topics, faculty preparation, use of simulation, and clinical breastfeeding experiences. RESULTS Descriptive analyses revealed differences among the midwifery education programs surveyed regarding the amount of lactation content and clinical opportunities. Two programs offer a course specific to breastfeeding, with the remaining programs providing lactation content threaded throughout their curricula; 29.4% of programs offer 3 to 4 hours of lactation content, 35.3% report 5 to 8 hours of content, and 11.8% provide at least 10 hours of content. One program reports 18+ hours of content provided in both didactic and clinical settings. All programs report providing breastfeeding clinical opportunities for students; 18% of programs offer simulation experiences. No programs report using standardized lactation clinical competencies. DISCUSSION Midwives play a pivotal role in breastfeeding promotion, counseling, and clinical support. Standardization of didactic lactation education will assist programs in future curriculum mapping. Given the variability of clinical settings and patient access, creating clinical competencies and providing lactation simulation experiences may offer midwifery students a broader opportunity to gain critical skills in lactation management to best support breastfeeding families.
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Affiliation(s)
- Elaine Webber
- McAuley School of Nursing, University of Detroit Mercy, Detroit, Michigan
| | - Nadine Wodwaski
- McAuley School of Nursing, University of Detroit Mercy, Detroit, Michigan
| | - Deborah Busch
- The Johns Hopkins School of Nursing, Baltimore, Maryland
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Rosen-Carole C, Halterman J, Baldwin CD, Martin H, Goldstein NP, Allen K, Fagnano M, Widanka H, Dozier A. Prenatal Provider Breastfeeding Toolkit: Results of a Pilot to Increase Women's Prenatal Breastfeeding Support, Intentions, and Outcomes. J Hum Lact 2022; 38:64-74. [PMID: 33823702 PMCID: PMC8492789 DOI: 10.1177/08903344211008797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Breastfeeding rates for United States women with lower incomes fall below the government's Healthy People 2020 Goals. Breastfeeding recommendations combined with support from providers and peer counselors help women decide to begin and sustain breastfeeding, but peer counselor uptake is low. RESEARCH AIM To evaluate changes in referrals to Women, Infants, and Children's Supplemental Nutrition Program peer counselors, reported prenatal provider education and support, and breastfeeding outcomes (intention, initiation, 1-month duration of any and exclusive breastfeeding) after a prenatal breastfeeding promotion intervention. METHOD In this pre-post intervention study (2015-2016; upstate New York), providers implemented a Toolkit to discuss infant feeding recommendations and initiate peer counselor referral. We surveyed women pre- and post-implementation (after delivery; 1 month postpartum) about prenatal breastfeeding intentions, provider support, and breastfeeding outcomes. Analyses controlled for secular trends. RESULTS Pre-intervention (n = 71) and post-intervention (n = 70) participants were 49% Black, 61% publicly insured, and 16% uninsured. More post-intervention participants had > 1 Toolkit use (76%), peer counselor program referrals (60.0% post vs. 36.6% pre, p < .01), reported any breastfeeding intention (89% vs. 72%, p = .013), and intended to breastfeed for > 1 year (31% vs. 14%, p = .014). Post-intervention breastfeeding initiation and exclusivity were higher, but not significantly different. Post-intervention participants reported better prenatal breastfeeding support. CONCLUSIONS Implementing a prenatal Breastfeeding Toolkit, including facilitating peer counselor referral, was associated with increases in provider counseling, participants' breastfeeding intentions, and uptake of peer counselors. Replicating this approach may reinforce efforts to support breastfeeding in similar practices serving women with lower incomes.
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Affiliation(s)
- Casey Rosen-Carole
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry
| | - Jill Halterman
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry
| | - Constance D. Baldwin
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry
| | - Hayley Martin
- Public Health Sciences, University of Rochester School of Medicine and Dentistry
- University of Rochester School of Medicine and Dentistry
| | | | - Katherine Allen
- Department of Pediatrics, University of Minnesota at Minneapolis, MN
| | - Maria Fagnano
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry
| | - Holly Widanka
- Public Health Sciences, University of Rochester School of Medicine and Dentistry
| | - Ann Dozier
- Public Health Sciences, University of Rochester School of Medicine and Dentistry
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Gu C, Lindgren H, Wang X, Zhang Z, Liang S, Ding Y, Qian X. Developing a midwifery service task list for Chinese midwives in the task-shifting context: a Delphi study. BMJ Open 2021; 11:e044792. [PMID: 34266838 PMCID: PMC8286777 DOI: 10.1136/bmjopen-2020-044792] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 06/16/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To develop and validate a midwifery-led task list in the task-shifting context. DESIGN An extensive literature review followed by a two-iterative Delphi survey. SETTING Twenty university hospitals, three non-university hospitals and four university colleges from nine provincial regions of China. PARTICIPANTS Purposive non-probability sampling of a national panel of experts in maternal healthcare, obstetrics, nursing and midwifery. Experts in the panel were asked to rate each midwifery service item regarding importance, feasibility and advancement on a 5-point scale, in order to determine those best suited for midwifery-led practice in China. RESULTS Two rounds of Delphi surveys were completed before consensus was achieved, with effective response rate ranging from 96.4% (27/28) to 100% (27/27), indicating a high positive coefficient of the experts. The authority coefficient of experts was 0.882, indicating the high reliability of this study. The Kendall harmony coefficient (W) in the two rounds of consultations was 0.196 (p<0.001) and 0.324 (p<0.001), respectively. A detailed, three-level midwifery-led task list was developed, including 3 domains of midwifery practice (first-level indicators), 13 types of task (second-level indicators) and 58 midwifery service items (third-level indicators). The 3 domains of midwifery practice involved the appropriate scope of practice for Chinese midwives, including antenatal care, intrapartum care and postnatal care. The 58 service items embraced core components of caring task in the Chinese midwifery profession. CONCLUSION This study outlines the first midwifery-led task list that defines clearly the Chinese midwives' scope of practice. It will provide a foundational framework for future midwifery practice in China and abroad, and can be used to inform the design of midwifery-led task shifting interventions in various maternity settings.
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Affiliation(s)
- Chunyi Gu
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China
- Global Health Institute, Fudan University, Shanghai, China
| | - Helena Lindgren
- Department of Women's and Children's Health, Reproductive Health, Karolinska Institute, Stockholm, Sweden
| | - Xiaojiao Wang
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Zheng Zhang
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Shuang Liang
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yan Ding
- Department of Nursing, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xu Qian
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China
- Global Health Institute, Fudan University, Shanghai, China
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Oueidat H, Charafeddine L, Nimer H, Hussein H, Nabulsi M. Knowledge and attitudes of Lebanese women towards Baby Friendly Hospital Initiative practices. PLoS One 2020; 15:e0238730. [PMID: 32915827 PMCID: PMC7485862 DOI: 10.1371/journal.pone.0238730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 08/22/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The World Health Organization and United Nations Children's Fund launched the Baby Friendly Hospital Initiative (BFHI) to encourage best infant breastfeeding practices immediately after birth. In Lebanon, few hospitals are currently accredited as Baby Friendly. AIM To assess the knowledge of Lebanese women of BFHI steps, and to explore their attitudes towards Baby Friendly Hospitals, Skin-to-Skin Contact and Kangaroo Care practices. METHODS A cross-sectional survey of a random sample of healthy pregnant women from Lebanon's six governorates. RESULTS The mean (SD) age of the participants (N = 517) was 28.6 (4.7) years. Most participants were unfamiliar with the terms Baby Friendly hospital (93.7%), skin-to-skin contact or kangaroo care (75%), or were inadequately instructed on how to initiate (54.2%) or continue (46.2%) breastfeeding. However, when provided with information about the benefits of BFHI practices, most mothers (> 90%) stated that they would deliver in Baby Friendly hospitals. About 68.4% of mothers refused to give donor human milk to their sick premature infants because of religious beliefs. Knowledge of Baby Friendly hospitals was significantly associated with university education (p = 0.029), higher monthly income (p = 0.042), and previous experiences of skin-to-skin contact (p<0.001), rooming in (p = 0.037), or breastfeeding support (p = 0.036). CONCLUSION There is a need for national awareness campaigns that address both the numerous advantages of the BFHI practices and Lebanese women's knowledge gaps about these practices. Such knowledge will help scale up the implementation of BFHI practices in hospitals in Lebanon, thus increasing breastfeeding rates and positively impacting the health of infants and mothers.
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Affiliation(s)
- Hala Oueidat
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Lama Charafeddine
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Hana Nimer
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Hiba Hussein
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Mona Nabulsi
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
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Nunes RD, Puel AG, Gomes N, Traebert J. Evaluating the effectiveness of an educative workshop for pregnant women using pre and post intervention surveys. CAD SAUDE PUBLICA 2019; 35:e00155018. [PMID: 31618384 DOI: 10.1590/0102-311x00155018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 08/05/2019] [Indexed: 11/21/2022] Open
Abstract
This paper will report the findings of an education intervention performed by a workshop aimed to provide pregnant women with knowledge about pregnancy, delivery, breastfeeding and newborn care. A cross-sectional study, using a pre and post-intervention research design, was performed with 105 pregnant women from an obstetric service for a two-year period. Time points (pre and post) were compared using either Student t test and ANOVA. Significance was set at p ≤ 0.05. After the intervention all items increased their level from the three stations: antenatal care (20.4%), labor and delivery (36.8%) and postnatal and breastfeeding (32.1%). The total score of the surveys also increased 31.7% when comparing the pre and post applications (p < 0.001). It was evidenced the importance of strategies to improve knowledge about pregnancy and its surroundings to pregnant women. The workshop proposal presented increases in its knowledge and can most likely bring better results in short and long-term outcomes.
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Affiliation(s)
| | | | - Natália Gomes
- Universidade do Sul de Santa Catarina, Palhoça, Brasil
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Wallenborn JT, Wheeler DC, Lu J, Perera RA, Masho SW. Importance of Familial Opinions on Breastfeeding Practices: Differences Between Father, Mother, and Mother-in-Law. Breastfeed Med 2019; 14:560-567. [PMID: 31298574 DOI: 10.1089/bfm.2019.0049] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Multiple types of individuals compose a mother's social support network. Women may value opinions of individuals' within their support network differently. Our study examined the relationship between breastfeeding opinions from individuals within the social support network and breastfeeding initiation and duration. Materials and Methods: Data from the Infant Feeding Practices Survey II were analyzed. The importance of individuals' opinions on a mother's breastfeeding decision was investigated for the baby's father, the participant's mother and mother-in-law, the infant's pediatrician, and the participant's obstetrician. The main outcomes were breastfeeding initiation (yes; no) and breastfeeding duration (weeks). Logistic regression provided the odds of never breastfeeding, while Cox proportional hazard models were used to assess the risk of breastfeeding cessation. Results: Women who stated that the father's opinion was not at all important were more likely to never breastfeed and prematurely cease breastfeeding compared to women who stated that the father's opinion was very important for their breastfeeding decisions. Conversely, women had lower odds of never breastfeeding and a decreased risk of breastfeeding cessation if they reported that the mother-in-law's opinion was not at all important or not very important compared to women who reported that the mother-in-law was very important. No statistically significant relationship was found between the participant's mother and breastfeeding initiation and cessation. Conclusion: This study found a hierarchical association between individuals in a social support network and breastfeeding initiation and duration. Inverse relationships were found between the importance of fathers' and mother-in-laws' opinions. Interventions aimed at increasing breastfeeding initiation, and duration rates should include a wider range of individuals within a social support network.
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Affiliation(s)
- Jordyn T Wallenborn
- Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - David C Wheeler
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Juan Lu
- Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Robert A Perera
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Saba W Masho
- Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, Virginia
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