1
|
Gallagher L, Brady V, Kuliukas L, Dykes C, Rubertsson C, Hauck YL. Australian, Irish, and Swedish women's comfort levels when breastfeeding in public. BMC Public Health 2023; 23:2535. [PMID: 38110935 PMCID: PMC10729571 DOI: 10.1186/s12889-023-17472-z] [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: 04/14/2023] [Accepted: 12/13/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Despite a flux of global initiatives to increase and sustain breastfeeding rates, challenges persist. The decision to commence and sustain breastfeeding is influenced by multiple, complex factors. Feelings of social embarrassment, shame, fear of judgement, and lack of confidence when breastfeeding in public, compound women's decisions to breastfeed and may result in formula feeding or early cessation of breastfeeding. A greater understanding of where and how women feel most comfortable when breastfeeding in public can assist in designing interventions to support the initiation and continuation of breastfeeding. METHODS A cross-sectional survey was conducted with women living in Australia (n = 10,910), Sweden (n = 1,520), and Ireland (n = 1,835), who were currently breastfeeding or who had breastfed within the previous two years. Our aim was to explore where, and how often women breastfeed in public and to compare their levels of comfort when breastfeeding in public. Data were collected in 2018 using an anonymous online survey over a four-week period in Ireland, Australia, and Sweden, and were analyzed using SPSS Version 25. RESULTS Most respondents were highly educated, with over 70% in each country reporting having a university or college degree. Observing women breastfeeding in public was more commonly reported to be a weekly or daily occurrence in Sweden (24.5%) and Australia (28%), than in Ireland (13.3%). Women in the participating countries reported breastfeeding in public most commonly whenever their babies needed feeding. Very few women never or rarely breastfed publicly. Coffee shops/cafes, restaurants, and parks were the most popular locations. In all three countries, partners were reported to be very supportive of breastfeeding in public, which enhanced breastfeeding women's comfort levels. When asked to score out of a maximum comfort level of 10, women reported higher mean levels of comfort when breastfeeding in front of strangers (Ireland M = 7.33, Australia M = 6.58, Sweden M = 6.75) than with those known to them, particularly in front of their father-in-law (Ireland M = 5.44, Australia M = 5.76, Sweden M = 6.66 out of 10), who scored lowest in terms of women's comfort levels. CONCLUSION This study offers important insights into the experiences and comfort levels of women breastfeeding in public. Limitations include the anonymous nature of the surveys, thus preventing follow-up, and variances in terminology used to describe locations across the three settings. Recommendations are made for research to determine the relationships between the frequency of breastfeeding in public and breastfeeding women's perceived comfort levels, the influence of family members' perceptions of breastfeeding in public and women's experiences, and the experience of women who feel uncomfortable while breastfeeding in public, with a view to developing support measures.
Collapse
Affiliation(s)
- Louise Gallagher
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, D02 T283, Ireland.
| | - Vivienne Brady
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, D02 T283, Ireland
| | - Lesley Kuliukas
- School of Nursing, Curtin University Perth, Perth, WA, Australia
| | | | - Christine Rubertsson
- Perinatal and Sexual Health, Department of Health Sciences, Medical Faculty, Lund University, Lund, Sweden
| | - Yvonne L Hauck
- School of Nursing, Curtin University Perth, Perth, WA, Australia
| |
Collapse
|
2
|
Yu PJ, Wu WR, Liu CY. Public policy on breastfeeding among working mothers in Taiwan: comparison between two national surveys. BMC Pregnancy Childbirth 2023; 23:768. [PMID: 37924019 PMCID: PMC10623794 DOI: 10.1186/s12884-023-06069-4] [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: 07/08/2023] [Accepted: 10/15/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Creating a supportive breastfeeding environment after childbirth and enabling women to work with reassurance are essential in maternal care services. The study aimed to explore the effectiveness of the utilization rate of public and workplace lactation rooms in relation to the breastfeeding rate among postpartum women returning to work in Taiwan. METHODS The study involved a secondary data analysis on 6,992 and 7,350 postpartum women surveyed in 2011 and 2016, respectively. Interviews were conducted with women six months postpartum. Logistic regression analysis was employed to calculate the odds ratio and investigate the differences in the utilization rates of public lactation rooms (PLR) and workplace lactation rooms (WLR) among working mothers over a five-year period, to confirm the effectiveness of public strategies. RESULTS Comparing the years 2011 and 2016, significant differences in the rates of exclusive breastfeeding (EBF) and any breastfeeding (ABF) among working mothers returning to work after an 8-week maternity leave, depending on whether they used PLR or WLR. The rates were higher in 2016 than in 2011. For mothers who used PLR, the breastfeeding rates for EBF at the second, fourth, and sixth months (2011 vs. 2016: 67.6% vs. 81.1%, 75.0% vs. 86.4%, 77.5% vs. 86.2%) and ABF at the second, fourth, and sixth months (2011 vs. 2016: 60.3% vs. 73.9%, 68.8% vs. 81.3%, 73.7% vs. 85.6%). For mothers who used WLR, the breastfeeding rates for EBF at the second, fourth, and sixth months (2011 vs. 2016: 51.3% vs. 58.7%, 54.7% vs. 61.4%, 57.5% vs. 59.3%) and ABF at the second, fourth, and sixth months (2011 vs. 2016: 48.4% vs. 57.0%, 52.3% vs. 60.5%, 54.1% vs. 62.4%). When comparing 2011 to 2016 from the second to the sixth month postpartum, adjusted odds ratios for EBF (PLR: 4.17-5.23 vs. 4.06-6.22, WLR: 1.71-1.83 vs. 1.30-1.61) and ABF (PLR: 6.44-7.02 vs. 9.27-9.90, WLR: 1.91-1.98 vs. 1.97-1.99) showed differences. CONCLUSION Lactation support rooms play a vital role in motivating working mothers to sustain breastfeeding upon their return to work. Incentivizing businesses to build additional lactation rooms and offering breastfeeding resources is essential in striving to enhance the global breastfeeding rate.
Collapse
Affiliation(s)
- Pei-Jung Yu
- Mackay Medical College, New Taipei City, Taiwan, R.O.C
| | - Wan-Ru Wu
- Tzu Chi University, Hualien City, Taiwan R.O.C
| | - Chieh-Yu Liu
- National Taipei University of Nursing and Health Science, Taipei City, Taiwan R.O.C..
| |
Collapse
|
3
|
Turner SE, Brockway M, Azad MB, Grant A, Tomfohr-Madsen L, Brown A. Breastfeeding in the pandemic: A qualitative analysis of breastfeeding experiences among mothers from Canada and the United Kingdom. Women Birth 2023:S1871-5192(23)00015-X. [PMID: 36669903 DOI: 10.1016/j.wombi.2023.01.002] [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: 05/16/2022] [Revised: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND Previous research shows that the COVID-19 pandemic resulted in both barriers and facilitators to breastfeeding. However, little research has looked specifically at first-time mothers' experiences of breastfeeding during the pandemic or compared experiences of mothers living in different countries. AIM This research explores mothers' breastfeeding experiences to describe how the COVID-19 pandemic has affected breastfeeding journeys in Canada and the United Kingdom. METHODS Ten semi-structured online interviews were undertaken with first-time mothers who breastfed their baby at least once during the COVID-19 pandemic and are living in Canada or the United Kingdom. Interview transcripts were coded inductively using thematic analysis. FINDINGS One overarching theme (all on mother) and four sub-themes were identified: 1) accessing and advocating for health care, 2) social support, 3) becoming a mother in isolation, and 4) breastfeeding baby. Similar themes were constructed for both countries. DISCUSSION Mothers reported that diminished health care and social support created challenges in their breastfeeding journey. Many mothers reported receiving virtual breastfeeding support, which was largely experienced as unhelpful. Some mothers reported fewer distractions from visitors and more one-on-one time with their infant, which helped them to establish breastfeeding and a strong mother-infant bond. CONCLUSION In both Canada and the United Kingdom, new mothers need consistent, reliable health care and social support when breastfeeding. This study supports the need to protect breastfeeding support in the midst of a global emergency and beyond to ensure positive breastfeeding experiences for both mother and baby.
Collapse
Affiliation(s)
- Sarah E Turner
- Children's Hospital Research Institute of Manitoba, 715 McDermot Ave, Winnipeg, Manitoba R3E 3P4, Canada; Manitoba Interdisciplinary Lactation Center (MILC), 715 McDermot Ave, Winnipeg, Manitoba R3E 3P4, Canada; Department of Community Health Sciences, University of Manitoba, 750 Bannatyne Avenue, Winnipeg, Manitoba R3E 0W3, Canada.
| | - Meredith Brockway
- Faculty of Nursing, University of Calgary, 2259 2800, Professional Faculties, University Way NW, Calgary, Alberta T2N 4V8, Canada
| | - Meghan B Azad
- Children's Hospital Research Institute of Manitoba, 715 McDermot Ave, Winnipeg, Manitoba R3E 3P4, Canada; Manitoba Interdisciplinary Lactation Center (MILC), 715 McDermot Ave, Winnipeg, Manitoba R3E 3P4, Canada; Department of Community Health Sciences, University of Manitoba, 750 Bannatyne Avenue, Winnipeg, Manitoba R3E 0W3, Canada; Department of Pediatrics and Child Health, University of Manitoba, 840 Sherbrook St, Winnipeg, Manitoba R3A 1S1, Canada
| | - Aimee Grant
- Centre for Lactation, Infant Feeding and Translation (LIFT), Swansea University, University Singleton Park Campus, Haldane Building, Sketty, Swansea SA2 8PP, United Kingdom; School of Health and Social Care, Swansea University, University Singleton Park Campus, Haldane Building, Sketty, Swansea SA2 8PP, United Kingdom
| | - Lianne Tomfohr-Madsen
- Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, 2125 Main Mall, Vancouver, BC V6T 1Z4, Canada
| | - Amy Brown
- Centre for Lactation, Infant Feeding and Translation (LIFT), Swansea University, University Singleton Park Campus, Haldane Building, Sketty, Swansea SA2 8PP, United Kingdom; School of Health and Social Care, Swansea University, University Singleton Park Campus, Haldane Building, Sketty, Swansea SA2 8PP, United Kingdom
| |
Collapse
|
4
|
Roberts D, Jackson L, Davie P, Zhao C, Harrold JA, Fallon V, Silverio SA. Exploring the reasons why mothers do not breastfeed, to inform and enable better support. Front Glob Womens Health 2023; 4:1148719. [PMID: 37122597 PMCID: PMC10132506 DOI: 10.3389/fgwh.2023.1148719] [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: 01/24/2023] [Accepted: 03/20/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction Infant and maternal breastfeeding benefits are well documented, globally. Despite efforts to increase global breastfeeding rates, the majority of high-income settings fall short of recommended targets. Breastfeeding rates in the UK are especially poor, and physiological difficulties (e.g., inverted nipples), fail to account for the observed breastfeeding intention-behaviour gap. Method The current online study sought to investigate the infant feeding experiences of 624 UK formula feeding mothers, through open text survey responses. Results A content analysis identified the following clusters of reasons for formula feeding: Feeding Attitudes, Feeding Problems, Mental Health, and Sharing the Load. Discussion Feeding Attitudes explained a large percentage of reasons given for formula feeding. Recommendations are made to improve antenatal breastfeeding education and to develop an intervention with an aim to improve maternal breastfeeding attitudes and subsequent practice. Feeding Problems also explained a large portion of combination feeding and started but stopped infant feeding accounts. The current paper calls for more comprehensive and tailored antenatal breastfeeding education to refine practical breastfeeding skills necessary for successful breastfeeding establishment and maintenance. Mental Health explained relatively small coverage. Suggestions are therefore made to train mental health practitioners on infant feeding with an aim to provide more extensive support, which may serve to disrupt the bidirectional relationship between poor mental health and poor breastfeeding outcomes. Finally, Sharing the Load explained moderate coverage across never breastfed, combination fed, and started but stopped feeding groups. Recommendations are made, in light of these findings, to tighten workplace legislation to protect breastfeeding women.
Collapse
Affiliation(s)
- Dean Roberts
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Leanne Jackson
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
- Correspondence: Leanne Jackson
| | - Philippa Davie
- Department of Women & Children’s Health, School of Life Course & Population Sciences, King’s College London, London, United Kingdom
| | - Catherine Zhao
- Department of Nutritional Sciences, School of Life Course & Population Sciences, King’s College London, London, United Kingdom
| | - Joanne A. Harrold
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Sergio A. Silverio
- Department of Women & Children’s Health, School of Life Course & Population Sciences, King’s College London, London, United Kingdom
| |
Collapse
|
5
|
Grant A, Pell B, Copeland L, Brown A, Ellis R, Morris D, Williams D, Phillips R. Views and experience of breastfeeding in public: A qualitative systematic review. MATERNAL & CHILD NUTRITION 2022; 18:e13407. [PMID: 35914544 PMCID: PMC9480936 DOI: 10.1111/mcn.13407] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 12/02/2022]
Abstract
Breastfeeding rates in many Global North countries are low. Qualitative research highlights that breastfeeding in public is a particular challenge, despite mothers often having the legal right to do so. To identify barriers and facilitators, we systematically searched the qualitative research from Organisation for Economic Co-operation and Development countries relating to breastfeeding in public spaces from 2007 to 2021. Data were analysed using the Thematic Synthesis technique. The review was registered with PROSPERO (registration number: CRD42017081504). Database searching identified 3570 unique records. In total, 74 papers, theses, or book chapters, relating to 71 studies, were included, accounting for over 17,000 mothers. Overall, data quality was high. Our analysis identified that five core factors influenced mothers' thought processes and their breastfeeding in public behaviour: legal system; structural (in)equality; knowledge; beliefs and the social environment. Macro-level factors relating to legislation and inequality urgently require redress if breastfeeding rates are to be increased. Widespread culture change is also required to enhance knowledge, change hostile beliefs and thus the social environment in which mother/infant dyads exist. In particular, the sexualisation of breasts, disgust narratives and lack of exposure among observers to baby-led infant feeding patterns resulted in beliefs which created a stigmatising environment. In this context, many mothers felt unable to breastfeed in public; those who breastfed outside the home were usually highly self-aware, attempting to reduce their exposure to conflict. Evidence-based theoretically informed interventions to remove barriers to breastfeeding in public are urgently required.
Collapse
Affiliation(s)
- Aimee Grant
- Centre for Trials ResearchCardiff UniversityCardiffUK
- Centre for Lactation, Infant Feeding and Translational ResearchSwansea UniversitySwanseaUK
| | - Bethan Pell
- Centre for Trials ResearchCardiff UniversityCardiffUK
- DECIPHerCardiff UniversityCardiffUK
| | - Lauren Copeland
- DECIPHerCardiff UniversityCardiffUK
- Division of Population MedicineCardiff UniversityCardiffUK
| | - Amy Brown
- Centre for Lactation, Infant Feeding and Translational ResearchSwansea UniversitySwanseaUK
| | - Rebecca Ellis
- Centre for Lactation, Infant Feeding and Translational ResearchSwansea UniversitySwanseaUK
| | - Delyth Morris
- Subject Librarian, Dental and MedicineCardiff UniversityCardiffUK
| | | | - Rhiannon Phillips
- Division of Population MedicineCardiff UniversityCardiffUK
- Cardiff School of Sport and Health SciencesCardiff Metropolitan UniversityCardiffUK
| |
Collapse
|
6
|
Affiliation(s)
- Leah S Aldridge
- National Lactation Consultant Alliance, Inc., Atlanta, GA, USA
| |
Collapse
|
7
|
Newell C, Sandoz E, Tyndall I. A Pilot Study of the Impact of Brief Exposure to Images of Breastfeeding Mothers on Attitudes Toward Mother's Breastfeeding in Public. HEALTH COMMUNICATION 2022; 37:185-190. [PMID: 33019836 DOI: 10.1080/10410236.2020.1830511] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The wider societal attitudes held toward mothers' breastfeeding in public seem to impact infant feeding choices. The present study employed an online (N = 396) experimental pretest-posttest design set to examine whether a mere exposure effect of briefly viewing and rating the valence of four different images of public breastfeeding (i.e., mother and baby alone, females in background, males in background, and females and males in background) would impact on participants' attitudes toward a mother breastfeeding in public. There was a marginal increase in the positive attitudes toward public breastfeeding at Time 2 when compared with Time 1 following exposure to the four images. These findings support a potential positive mere exposure effect in enhancing attitudes toward breastfeeding in public. This suggests a greater use of promotional material using visual stimuli may improve societal acceptance of breastfeeding in public.
Collapse
Affiliation(s)
| | - Emily Sandoz
- Department of Psychology, University of Louisiana at Lafayette
| | - Ian Tyndall
- Department of Psychology, University of Chichester
| |
Collapse
|
8
|
Factors affecting attitude towards breastfeeding in public: a cross-sectional web-based study on Polish women. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01320-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Abstract
Aim
Breastfeeding is believed to be beneficial to both mother and child. Although the percentage of Polish mothers who start breastfeeding after childbirth is relatively high, most of them finish after 8–12 weeks. Many factors are involved in the decision to stop, including an unfavourable social attitude towards breastfeeding in public. Our cross-sectional web-based study was conducted to identify the factors predicting negative attitudes towards public breastfeeding among Polish women.
Subjects and methods
A population-based internet-administered public opinion survey was conducted among 663 women aged 19 to 50 years old regarding their attitude towards breastfeeding in public. The participants completed a questionnaire concerning demographic data, general beliefs about breastfeeding and attitudes towards breastfeeding in public.
Results
Overall, 46.6% of respondents had a negative attitude towards breastfeeding in public. Multivariable logistic regression analysis found that the beliefs that breastfeeding is not a natural activity [adjusted odds ratio (AOR) = 17.54; 95% CI = 1.44–21.95] and that breastfeeding is not emotionally moving (AOR = 8.73; 95% CI = 3.950–19.30) or not having any opinion (AOR = 2.31; 95% CI: 1.18–4.50) to play the most significant roles in shaping a negative attitude, as well as breastfeeding their own child for < 6 months (AOR = 13.93; 95% CI = 0.14–20.24).
Conclusions
As women’s beliefs about breastfeeding play a key role in choosing to breastfeed in public, there is a need to further explore attitudes regarding this activity.
Collapse
|
9
|
Hirani SAA. Breastfeeding in Public: Challenges and Evidence-Based Breastfeeding-Friendly Initiatives to Overcome the Barriers. CLINICAL LACTATION 2021. [DOI: 10.1891/clinlact-d-21-00010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
IntroductionBreastfeeding is the safest mode of infant feeding that is readily available at the right temperature and does not require supplies for its preparation. Despite the many benefits of breastfeeding, it is often challenging for breastfeeding mothers to breastfeed in public.MethodsA review of the literature was undertaken to explore challenges hindering breastfeeding in public and ascertain evidence-based breastfeeding-friendly strategies to overcome those barriers.ResultsMajor barriers to breastfeeding in public include negative public perceptions of breastfeeding, sociocultural barriers, embarrassment/lack of comfort, stigmatization, sexualization of breast, and nonconducive environment in public spaces. Evidence-based strategies to support breastfeeding in public include normalization of breastfeeding in public, increasing the visibility of breastfeeding through social media and public events, empowerment of breastfeeding mothers, positive role modeling, social support, and environmental modifications.ConclusionImplementation of evidence-based and innovative breastfeeding-friendly initiatives are essential to combat challenges surrounding breastfeeding in public spaces.
Collapse
|
10
|
Nguyen NT, Do HT, Pham NTV. Barriers to exclusive breastfeeding: A cross-sectional study among mothers in Ho Chi Minh City, Vietnam. BELITUNG NURSING JOURNAL 2021; 7:171-178. [PMID: 37469344 PMCID: PMC10353628 DOI: 10.33546/bnj.1382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/23/2021] [Accepted: 05/03/2021] [Indexed: 07/21/2023] Open
Abstract
Background Exclusive breastfeeding provides numerous benefits to the health of infants, mothers, economics, and the environment. However, during the exclusive breastfeeding period, the mothers face many barriers. Objective This study aimed to describe the perceived barrier of breastfeeding and compare its differences among mothers in Vietnam according to demographic and individual characteristics. Methods A cross-sectional study was conducted among 246 women in Ho Chi Minh City, Vietnam. Data were derived from the original survey using a self-administered questionnaire asking about the barriers of breastfeeding in three aspects: maternal, infant, and socio-environment. Descriptive statistics, Independent t-test, and ANOVA were used to describe the mothers' characteristics and the breastfeeding barriers. Results The barrier from the infants was the most noticeable, followed by socio-environment and maternal barriers, respectively. Breastfeeding in public places (M = 2.93, SD = 0.92), baby's illness (M = 2.74, SD = 0.99), and insufficient milk supply (M = 2.70, SD =0.99) were considered as major barriers to six-month exclusive breastfeeding among mothers in Ho Chi Minh City, Vietnam. Among the age groups, mothers who were more than 35 years old perceived had lower breastfeeding barriers than the younger mothers (F = 3.67, p = 0.03). Conclusion The investigation of the barriers against exclusive breastfeeding practice can help nurses and midwives develop breastfeeding promotion programs to promote exclusive breastfeeding rate for women in Vietnam.
Collapse
Affiliation(s)
- Nhan Thi Nguyen
- Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
| | - Huong Thi Do
- Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
| | - Nhu Thi Van Pham
- Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
| |
Collapse
|
11
|
Grant A. Breasts and the city: an urban ethnography of infant feeding in public spaces within Cardiff, United Kingdom. Int Breastfeed J 2021; 16:37. [PMID: 33926506 PMCID: PMC8082607 DOI: 10.1186/s13006-021-00384-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Internationally, women report challenges breastfeeding in public spaces. This study aimed to investigate the social-spatial aspects of public spaces in one UK city, Cardiff, in order to suggest possible barriers and facilitators to breastfeeding in public spaces. METHODS The study observation location guide prioritised places that had been reported as hostile to breastfeeding or breastfeeding friendly in the existing literature. Data were collected between April and September 2018 at various times of day, in several areas of the city, and included transport (n = 4), transport hubs (n = 3), high streets (n = 4), cafes (n = 2), a large city centre shopping complex, comprising of three joined shopping malls and a large city centre department store containing a third café. Low inference field notes were written on an encrypted smart phone and expanded soon after. Data were analysed thematically using deductive codes based on the observation schedule. Additional inductive codes relating to places were added. RESULTS Overall, public transport and the city centre were inhospitable environments for those who might need to breastfeed, and even more so for those who need to express breastmilk. The core barriers and facilitators across locations were the availability of appropriate seating coupled with either high privacy or politely unimposing strangers (civil inattention). The one variation to this model arose from the department store café, where civil inattention was not performed and there was low privacy, but breastfeeding occurred anyway. CONCLUSIONS This research highlights the physical and social barriers to breastfeeding within one urban city centre in the UK and its associated transport links. It is clear that there is an urgent need for change in urban city centres and public transport if countries are to meet their aims in relation to increasing breastfeeding rates. Interventions will need to be multifaceted, accounting for social norms relating to infant feeding as well as changes to the physical environment, policy and potentially legal change. Further research should be undertaken in other countries to examine the extent to which hostile environments exist, and if correcting these could facilitate breastfeeding and reduce gender-based violence.
Collapse
Affiliation(s)
- Aimee Grant
- Centre for Lactation, Infant Feeding and Translational Research, Swansea University, Swansea, UK.
| |
Collapse
|
12
|
Abstract
BACKGROUND Negative attitudes toward breastfeeding in public have consistently been identified as a key barrier to breastfeeding continuation. In order to design effective social marketing campaigns to improve public attitude toward breastfeeding in public, it is critical to identify segments of the population who are less likely to support this activity, their underlying reasons, and the medium through which they can be reached. RESEARCH AIM The aims were to (a) identify the underlying dimensions that drive acceptance or opposition to breastfeeding in public, (b) test whether specific population segments were more or less likely to support breastfeeding in public, and (c) identify suitable media outlets to reach them. METHODS A cross-sectional survey testing agreement with 60 statements was administered online between May 2016 and May 2017 and was completed by 7190 respondents. Exploratory factor analysis was used to identify 12 dimensions driving acceptance or opposition to breastfeeding in public. The influence of demographics and media consumption on attitudes toward breastfeeding in public was tested using Welch's t tests and one-way analyses of variance (ANOVAs). RESULTS Acceptance of breastfeeding in public was found to differ with gender, age, religion, and parental and breastfeeding status, but not household income. Support for breastfeeding in public also varied with media consumption habits. CONCLUSIONS This work lays the foundation to design effective social marketing campaigns aimed at increasing public support for breastfeeding in public.
Collapse
Affiliation(s)
- Cecile Morris
- Food and Nutrition Group, Sheffield Business School, Sheffield Hallam University, Sheffield, UK
| | - Peter Schofield
- Department of Service Sector Management, Sheffield Business School, Sheffield Hallam University, Sheffield, UK
| | - Craig Hirst
- Food and Nutrition Group, Sheffield Business School, Sheffield Hallam University, Sheffield, UK
| |
Collapse
|
13
|
Women's experiences with breastfeeding in public: An integrative review. Women Birth 2020; 34:e217-e227. [PMID: 32402811 DOI: 10.1016/j.wombi.2020.04.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Much evidence around public breastfeeding does not reflect experiences of the key stakeholder, the breastfeeding woman, and focuses upon the audience. Selective evidence has explored breastfeeding experiences revealing challenges with public breastfeeding as a serendipitous finding. Although women's experiences have been explored in specific contexts, insight into commonalities reflective of an international perspective is unknown. OBJECTIVE to explore, review and synthesise published literature on women's experience with public breastfeeding. METHODS An integrative review allows inclusion of findings beyond empirical evidence. Whittemore and Knafl's approach was used to capture and analyse evidence from varied sources to provide understanding of a phenomenon from diverse methodologies. PubMed, Medline, Ovid emBase, Scopus, Science Direct, the Cumulative Index of Nursing and Allied Health Literature and PsychINFO were searched. Inclusion criteria included publications in English after 2005 offering descriptions of women's experiences. Data evaluation included assessment of literature quality. A constant comparison approach involved comparing, analysing and drawing similar concepts into themes. FINDINGS Integration of women's experience with public breastfeeding from 27 publications covering 12 countries revealed two key themes, what women shared as 'enhancing' and 'challenging'. Challenges included four subthemes: 'drawing attention', 'sexualisation of breasts', 'awareness of others' discomfort', and 'efforts not to be seen'. Enhancing incorporated subthemes: 'supportive audience' and 'confidence'. CONCLUSION Challenges confirm an international commonality that women encounter during public breastfeeding suggesting a multilayered approach addressing community and societal behaviours is required. Insight to enhance public breastfeeding experiences offers direction to improve support.
Collapse
|
14
|
Abstract
Background Decisions about infant feeding are embedded and are continuously made within a woman's social and cultural context. Despite the benefits of breastfeeding to both women and infants, and government policies and laws to protect and promote breastfeeding, breastfeeding in public remains a controversial issue. The purpose of this paper is to present findings from an Australian study that explored the perceptions and beliefs held by first time expectant mothers and their family and social networks towards breastfeeding in public. Methods This study collected data through fifteen family conversations to explore the views and beliefs of first time mothers and those in her social network towards breastfeeding. Breastfeeding in public was discussed in nine of the family conversations with 50 individual people contributing. We used a process of a descriptive contextual analysis drawing out specific elements of the family conversations to identify an underlying ideology around breastfeeding in public within these groups. Results The analysis focused on four key elements of the conversations. These included the descriptions of the event, the actions, the locations and feelings of the dominant players. Descriptions of the event outlined different beliefs and feelings related to breastfeeding in public and whether it should occur at all. Suggestions for not breastfeeding in public were timing your outings so feeding could take place at home, expressing breastmilk or using the dummy. When breastfeeding in public was considered acceptable, there were requisite social norms. Breastfeeding in public requires women to be discrete and covered-up, so as not to expose her breast. She is also required to feed in an appropriate place to avoid discomforting others, guard against judgement, and to protect herself from the unwanted male gaze. Conclusions Our findings suggest that controversy remains as to whether breastfeeding should occur in public at all. Even where breastfeeding in public is seen as a woman's choice, there are social rules that govern how it should be undertaken to make it an 'appropriate' activity. As a result, women need to take responsibility for others feelings, minimise the discomfort of others and 'keep themselves safe' if and when they breastfeed in public spaces.
Collapse
Affiliation(s)
- Athena Sheehan
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Karleen Gribble
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Virginia Schmied
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| |
Collapse
|
15
|
|
16
|
Chinese women's experiences, emotions and expectations of breast-feeding in public: a qualitative study. Public Health Nutr 2018; 21:1565-1572. [PMID: 29386081 DOI: 10.1017/s1368980017003937] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To explore Chinese mothers' experiences, emotions and expectations of breast-feeding in public places. DESIGN Exploratory qualitative study. Purposive sampling was used to recruit participants and face-to-face interviews were conducted. Themes were identified by content analysis. SETTING Two different geographical communities in Wuhan, Hubei Province, central China, March-May 2016. SUBJECTS A total of twenty-seven mothers aged 23-33 years, who had one child under 3 years of age and had experience of breast-feeding in public places. RESULTS Seven themes emerged from the interviews: struggling to balance infant's needs and personal feelings; embarrassed or natural emotion regarding breast-feeding in public places; effect of cultural and social norms; internalized concerns going beyond actual social reaction; measures to make breast-feeding in public places easier; desire for more public facilities; and expecting emotional support from society members. CONCLUSIONS More positive social support, favourable policies and necessary facilities were desired to enable mothers to breast-feed in an appropriate public location. Women expected increased public acceptance of breast-feeding practices and support from government health officials to ensure women's success in breast-feeding in public settings.
Collapse
|
17
|
Pahlevan Sharif S. Development and psychometric evaluation of the breast size satisfaction scale. Int J Health Care Qual Assur 2017; 30:717-727. [PMID: 28958201 DOI: 10.1108/ijhcqa-12-2016-0190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose The purpose of this paper is to develop and evaluate psychometrically an instrument named the Breast Size Satisfaction Scale (BSSS) to assess breast size satisfaction. Design/methodology/approach The present scale was developed using a set of 16 computer-generated 3D images of breasts to overcome some of the limitations of existing instruments. The images were presented to participants and they were asked to select the figure that most accurately depicted their actual breast size and the figure that most closely represented their ideal breast size. Breast size satisfaction was computed by subtracting the absolute value of the difference between ideal and actual perceived size from 16, such that higher values indicate greater breast size satisfaction. Findings Study 1 ( n=65 female undergraduate students) showed good test-retest reliability and study 2 ( n=1,000 Iranian women, aged 18 years and above) provided support for convergent validity using a nomological network approach. Originality/value The BSSS demonstrated good psychometric properties and thus can be used in future studies to assess breast size satisfaction among women.
Collapse
|