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Boss M, Saxby N, Pritchard D, Pérez-Escamilla R, Clifford R. Interventions supporting medical practitioners in the provision of lactation care: A systematic review and narrative analysis. MATERNAL AND CHILD NUTRITION 2021; 17:e13160. [PMID: 33590635 PMCID: PMC8189190 DOI: 10.1111/mcn.13160] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 12/13/2022]
Abstract
Most children globally are not breastfed to recommendations. Medical practitioners are frequently visited in the first 6 months post‐partum, and the interaction at such visits significantly influences subsequent infant feeding decisions. Medical practitioners report that clinical practice in lactation is often disproportionately reliant on personal experience. This systematic review synthesises the literature on lactation health interventions used to support clinical decision making by medical practitioners. MEDLINE, Embase, PsycINFO, Scopus and Cochrane Library databases were searched for peer‐reviewed empirical studies published after 2000. Two reviewers independently screened and then assessed full‐text articles against inclusion criteria. Quality of reporting and risk of bias were independently assessed using three validated tools. No conclusions can be made regarding the success or failure of implementation strategies used or the outcomes of putting them into effect due to problems with study methodology, intervention reporting and risk of bias. Good‐quality research, which follows proven implementation frameworks, is needed to guide and sustain the incorporation of evidence‐based decision support into medical practitioners' care of breastfeeding mothers and infants.
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Affiliation(s)
- Melinda Boss
- School of Allied Health, Division of Pharmacy, The University of Western Australia, Crawley, Western Australia, Australia
| | - Nicole Saxby
- Women's and Children's Services, Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Douglas Pritchard
- School of Medicine, Division of General Practice, The University of Western Australia, Crawley, Western Australia, Australia
| | - Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Rhonda Clifford
- School of Allied Health, Division of Pharmacy, The University of Western Australia, Crawley, Western Australia, Australia
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Boss M, Hartmann P, Turner J, Pritchard D, Pérez-Escamilla R, Clifford R. Development of LactaPedia: A lactation glossary for science and medicine. MATERNAL AND CHILD NUTRITION 2020; 16:e12969. [PMID: 32032481 PMCID: PMC7296804 DOI: 10.1111/mcn.12969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 01/13/2023]
Abstract
During the last decade, there have been several publications highlighting the need for consistent terminology in breastfeeding research. Standard terms and definitions are essential for the comparison and interpretation of scientific studies that, in turn, support evidence‐based education, consistency of health care, and breastfeeding policy. Inconsistent advice is commonly reported by mothers to contribute to early weaning. A standard language is the fundamental starting point required for the provision of consistent advice. LactaPedia (www.lactapedia.com) is a comprehensive lactation glossary of over 500 terms and definitions created during the development of LactaMap (www.lactamap.com), an online lactation care support system. This paper describes the development of LactaPedia, a website that is accessible free of charge to anyone with access to the Internet. Multiple methodological frameworks were incorporated in LactaPedia's development in order to meet the needs of a glossary to support both consistent health care and scientific research. The resulting LactaPedia methodology is a six‐stage process that was developed inductively and includes framework to guide vetting and extension of its content using public feedback via discussion forums. The discussion forums support ongoing usability and refinement of the glossary. The development of LactaPedia provides a fundamental first step towards improving breastfeeding outcomes that are currently well below World Health Organisation recommendations globally.
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Affiliation(s)
- Melinda Boss
- School of Allied Health, Division of Pharmacy, The University of Western Australia, Perth, Western Australia, Australia
| | - Peter Hartmann
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Jennifer Turner
- School of Allied Health, Division of Pharmacy, The University of Western Australia, Perth, Western Australia, Australia
| | - Douglas Pritchard
- School of Medicine, Division of General Practice, The University of Western Australia, Perth, Western Australia, Australia
| | - Rafael Pérez-Escamilla
- Department of Social and Behavioural Sciences, Yale School of Public Health, New Haven, Connecticut
| | - Rhonda Clifford
- School of Allied Health, Division of Pharmacy, The University of Western Australia, Perth, Western Australia, Australia
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Radwan H, Sapsford R. Maternal Perceptions and Views About Breastfeeding Practices Among Emirati Mothers. Food Nutr Bull 2016; 37:73-84. [PMID: 26793991 DOI: 10.1177/0379572115624289] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Understanding women's breastfeeding perceptions and experiences is increasingly recognized as a vital tool to provide effective support that would encourage the extension of the breastfeeding period. OBJECTIVE To identify and explore the perceptions and views that influence the feeding and weaning decisions of Emirati mother. METHODS A qualitative study using indepth interviews was undertaken with a convenience sample of 45 Emirati mothers who had infants aged between 6 months and 2 years. Participants were interviewed in the health centers in 3 cities in United Arab Emirates. Data were recorded through field notes and analyzed thematically using grounded theory analysis. RESULTS The following themes emerged: influences of others on the decisions to breastfeed, sources of information, infants' behavior and participants' views and decisions about when to introduce supplementary feeding, knowledge of and attitudes toward current World Health Organization recommendations, and mothers' perception of the benefits of breastfeeding. Grandmothers in this study played an important role in the breastfeeding practices of Emirati mothers. They supported breastfeeding, however, some encouraged giving the infants prelacteal feeds for a variety of reasons: colic, hunger, promoting growth, and hydration. Fathers, according to the mothers, either supported or ignored breastfeeding practices. CONCLUSION Health promotions and health care facilities failed to deliver the message of exclusive breastfeeding. Mothers in our study were resorting to the expertise of the grandmothers and receiving information and advice about child feeding from them. The findings highlight the need for successful intervention programs to be implemented for mothers and grandmothers through health care providers.
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Affiliation(s)
- Hadia Radwan
- Clinical Nutrition and Dietetics Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Avni-Barron O, Gupta R. The effect of having multiple providers on antidepressant discontinuation in pregnancy: a case report. Arch Womens Ment Health 2012; 15:317-9. [PMID: 22588509 DOI: 10.1007/s00737-012-0284-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Accepted: 04/23/2012] [Indexed: 10/28/2022]
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Hauck YL, Fenwick J, Dhaliwal SS, Butt J, Schmied V. The association between women's perceptions of professional support and problems experienced on breastfeeding cessation: a Western Australian study. J Hum Lact 2011; 27:49-57. [PMID: 21177989 DOI: 10.1177/0890334410386956] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A cross-sectional survey was used to determine the association among women's breastfeeding problems, their perceptions of support from midwives and child health nurses, and breastfeeding cessation in the first 10 weeks postbirth in a sample of Western Australian women (N = 2669). Primiparous women (75.8%) experienced significantly more problems that multiparous women (52.6%). Although 78.8% of all women agreed or strongly agreed that staff were helpful with feeding, 53.4% confirmed that different midwives offered different feeding advice; however, receiving different advice from midwives around feeding was not associated with breastfeeding cessation. Differences in breastfeeding cessation were associated with parity. Primiparous women's cessation was associated with experiencing any breastfeeding problems, unhelpful hospital midwives, and unhelpful information from child health nurses, whereas for multiparous women, this included 2 or more breastfeeding problems, not being able to choose when to feed, and unhelpful information from child health nurses.
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Affiliation(s)
- Yvonne L Hauck
- School of Nursing and Midwifery at Curtin University and King Edward Memorial Hospital for Women in Perth, Western Australia
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Sherriff N, Hall V, Pickin M. Fathers' perspectives on breastfeeding: ideas for intervention. ACTA ACUST UNITED AC 2009. [DOI: 10.12968/bjom.2009.17.4.41670] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Nigel Sherriff
- International Health Development Research Centre (IHDRC), University of Brighton
| | - Valerie Hall
- Centre for Nursing and Midwifery Research, University of Brighton
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Abstract
AIM This paper is a report of a synthesis of mothers' and healthcare professionals' experiences and perceptions of breastfeeding support. BACKGROUND Despite increasing knowledge, breastfeeding rates remain relatively static and mothers continue to report dissatisfaction with their experiences of breastfeeding. Greater understanding of breastfeeding may be achieved through rigorous qualitative research, and there has been a recent increase in such studies. DATA SOURCES Electronic databases and citation lists of published papers were searched for articles listed between 1990 and 2005 and updated in May 2007. Studies were included if they used qualitative methods, were published in English, explored an aspect of breastfeeding and were based in a westernized country. REVIEW METHODS Papers were included if they reported studies using qualitative methods to explore breastfeeding and were published in English and based in a westernized country. Each study was reviewed and assessed independently, key themes extracted and grouped, and secondary thematic analysis used to explore key concepts. RESULTS From the 1990-2005 search, five themes emerged in health service support of breastfeeding: the mother-health professional relationship, skilled help, pressures of time, medicalization of breastfeeding and the ward as a public place. Social support had two themes: compatible and incompatible support. One additional theme emerged from the update to 2007: health professional relationships. CONCLUSION Mothers tended to rate social support as more important than health service support. Health service support was described unfavourably with emphasis on time pressures, lack of availability of healthcare professionals or guidance, promotion of unhelpful practices and conflicting advice. Changes are required within the health services to address the needs of both mothers and staff.
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Manhire KM, Hagan AE, Floyd SA. A descriptive account of New Zealand mothers’ responses to open-ended questions on their breast feeding experiences. Midwifery 2007; 23:372-81. [PMID: 17126458 DOI: 10.1016/j.midw.2006.01.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2005] [Revised: 01/30/2006] [Accepted: 01/31/2006] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the breast feeding experiences of mothers in New Zealand. DESIGN Descriptive, qualitative study. After a previous quantitative analysis of a questionnaire, the open-ended responses by the women were examined using a thematic analysis approach. SETTING Hawke's Bay, New Zealand. PARTICIPANTS 153 primiparous and multiparous breast feeding women aged between 20 and 49 years, who had had a caesarean section or vaginal birth between 4 months and 3 years previously. FINDINGS Themes identified during the data analysis are as follows: persistence, determination, confidence and satisfaction; pain and limitation of mothering activities; conflicting advice and professionalism; and others' expectations. CONCLUSIONS Breast feeding experience could be detrimentally affected by physical factors, inconsistent health-professional support and others' expectations. Negative influences, however, were likely to be overcome by persistence, determination, confidence and satisfaction. IMPLICATIONS FOR PRACTICE Implications for midwifery practice from the study iterate the importance of consistency of advice and skills of health professionals, of listening and understanding women's responses to early breast feeding assistance and giving continuous encouragement and support throughout their breast feeding experience. To meet these recommendations, breast feeding education for health professionals needs to include technical expertise and communication skills. Recommendations for further research from this study include investigations into why women commit to breast feeding and an exploration of women's perceptions of midwives' breast feeding support.
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Affiliation(s)
- Kathleen M Manhire
- Eastern Institute of Technology, Napier, 162 Waghorne St, Napier, New Zealand.
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Abstract
AIM This paper is a report of a study to describe the meaning and significance of common, essential elements of inconsistent professional breastfeeding support as revealed through the experiences of maternal-newborn nurses in a hospital. BACKGROUND Professional breastfeeding support has been found to have a beneficial effect on breastfeeding, although mothers also report that inconsistent professional breastfeeding support has a negative influence on their breastfeeding efforts. METHOD An existential-phenomenological approach was used, and interviews were conducted with 12 maternal-newborn nurses between October 2005 and January 2006. Interview transcripts were subjected to thematic analysis. FINDINGS Inconsistency in professional breastfeeding support was directly related to the fact that 'supporting' breastfeeding is a dynamic, multidimensional process with relational, contextual and situational components. Eight themes were identified: Inconsistencies still exist but things are changing; A need for 'buy in'; There is no escaping personal experience; What works for one does not work for all; Time impacts recommendations; We have a privileged vantage point; 'My job': what it is and what it is not and After all, breastfeeding is a maternal 'choice'. CONCLUSION Addressing inconsistent professional breastfeeding support involves understanding the multiple institutional and personal factors that influence this phenomenon. Because multiple practitioners assist each mother-infant dyad in learning to breastfeed, fostering strong collaborative relationships within this support team is essential. Regular opportunities for all team members to dialogue and actively participate in the updating of breastfeeding policies may increase 'buy in', promote greater collaboration and decrease both conflict and inconsistencies.
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Affiliation(s)
- Antonia M Nelson
- Department of Nursing, University of Connecticut, Storrs, Connecticut, USA.
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Hall WA, Hauck Y. Getting it right: Australian primiparas’ views about breastfeeding: A quasi-experimental study. Int J Nurs Stud 2007; 44:786-95. [PMID: 16581077 DOI: 10.1016/j.ijnurstu.2006.02.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2005] [Revised: 12/18/2005] [Accepted: 02/14/2006] [Indexed: 11/25/2022]
Abstract
BACKGROUND The study documented Australian primigravidas' perceptions about breastfeeding. OBJECTIVES To examine women's perspectives of their breastfeeding experiences during the first 12 weeks postpartum. DESIGN A Journal was introduced to an intervention group (n=149) attending prenatal classes at a private hospital at 36 antenatal weeks. Using quantitative data at two days and 12 weeks postpartum, the intervention group was compared with a control group (n=154) that delivered at the same hospital. Qualitative data were also collected about the women's perceptions about breastfeeding to further illuminate their experience. Qualitative data from 203 women at two days postpartum and 252 women at 12 weeks postpartum represented the combined comments from the intervention and control groups. PARTICIPANTS Participants were recruited as part of a randomised controlled trial of the effects of a Breastfeeding Journal on breastfeeding prevalence, self-efficacy, support, and influence from conflicting advice. The convenience sample of middle class, well-educated primiparous women from a Western Australian hospital had given birth to a singleton infant that was greater than 34 weeks gestation. METHODS An open-ended question on a questionnaire sought mothers' comments about their breastfeeding experiences. Data were analysed using inductive content analysis. FINDINGS These mothers described trying to 'get breastfeeding right'. Getting it right included enhancing factors, factors with mixed effect, and negative factors. CONCLUSIONS Middle class mothers share breastfeeding perceptions with women in more vulnerable groups, including encountering conflicting and unhelpful advice and feeding pressures from health care professionals, family, and community members.
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Affiliation(s)
- Wendy A Hall
- School of Nursing, University of British Columbia, T. 201 2211 Wesbrook Mall, Vancouver, British Columbia, Canada, V6T 2B5.
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McInnes RJ, Wright C, Haq S, McGranachan M. Who's keeping the code? Compliance with the international code for the marketing of breast-milk substitutes in Greater Glasgow. Public Health Nutr 2007; 10:719-25. [PMID: 17381952 DOI: 10.1017/s1368980007441453] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To evaluate compliance with the World Health Organization's International Code of Marketing of Breast-milk Substitutes in primary care, after the introduction of strict local infant feeding guidelines. DESIGN An audit form was sent to all community-based health professionals with an infant feeding remit. Walking tours were conducted in a random sample of community care facilities. SETTING Greater Glasgow Primary Care Division. SUBJECTS (1) Primary-care staff with an infant feeding remit; (2) community health-care facilities. MAIN OUTCOME MEASURES Contact with manufacturers of breast-milk substitutes (BMS) and BMS company personnel, free samples or incentives, and advertising of BMS. RESULTS Contact with company personnel was minimal, usually unsolicited and was mainly to provide product information. Free samples of BMS or feeding equipment were rare but childcare or parenting literature was more prevalent. Staff voiced concerns about the lack of relevant information for bottle-feeding mothers and the need to support the mother's feeding choice. One-third of facilities were still displaying materials non-compliant with the Code, with the most common materials being weight conversion charts and posters. CONCLUSIONS Contact between personnel from primary care and BMS companies was minimal and generally unsolicited. The presence of materials from BMS companies in health-care premises was more common. Due to the high level of bottle-feeding in Glasgow, primary-care staff stated a need for information about BMS.
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Affiliation(s)
- Rhona J McInnes
- Nursing, Midwifery and Allied Health Professions Research Unit, Iris Murdoch Building, University of Stirling, Stirling FK9 4LA, and Royal Hospital for Sick Children, Glasgow, UK.
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Berridge K, McFadden K, Abayomi J, Topping J. Views of breastfeeding difficulties among drop-in-clinic attendees. MATERNAL & CHILD NUTRITION 2005; 1:250-62. [PMID: 16881907 PMCID: PMC6860950 DOI: 10.1111/j.1740-8709.2005.00014.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Breast-milk is the optimum form of nutrition for the first 6 months of life. However, breastfeeding rates in the UK are low and static compared to other European countries and those in the North-west of England in the UK are even lower. Of the women who initiate breastfeeding, many cease in the first month following the birth for reasons that might be avoided. To try and prevent this, UNICEF Baby Friendly Hospital Initiative (BFHI) 'Ten Steps to Successful Breastfeeding' state that maternity facilities should foster the development of support groups for breastfeeding women. The aim of the present study was to describe breastfeeding difficulties reported by women who attended the infant feeding clinic at a Women's Hospital in the North-west of England. During the study period, the clinic was attended mainly by primiparous mothers who were educated beyond 18 years of age and of higher socio-economic status. They presented with a variety of problems including baby not latching on, concerns about baby's weight gain/loss, sore nipples and advice about expressing milk in preparation for return to work. The women highlighted the importance of meeting other mothers and having someone to talk to who understood what they were going through. Inconsistent information/lack of detailed knowledge from health professionals was cited as contributing to breastfeeding difficulties. A number of women reported that expert hands-on, one-to-one support, was invaluable and many felt they were able to continue breastfeeding but without the support, they may have given up.
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Affiliation(s)
- Kirstin Berridge
- School of the Outdoors, Leisure & Food, Liverpool John Moores University, Liverpool, UK.
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