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Almeida-Hamasaki BP, Ribeiro BC, Emidio SCD, Bordignon SS, Jones DA, Carmona EV. Content validation of the nursing diagnosis "Insufficient breast milk production (00216)". Int J Nurs Knowl 2024. [PMID: 39292523 DOI: 10.1111/2047-3095.12492] [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: 07/08/2024] [Accepted: 09/03/2024] [Indexed: 09/20/2024]
Abstract
PURPOSE To review and validate the elements of the nursing diagnosis (ND) "Insufficient breast milk production" (00216) based on the literature and expert consensus, and to construct operational definitions (ODs) for its defining characteristics (DCs). METHODS It is a methodological study carried out in two phases. In the first phase, a scoping review was conducted, and in the second, a committee of experts reviewed the elements' content. Items with a Content Validity Index ≥0.8 were validated for relevance, clarity, and precision. Discussions were conducted until a consensus was reached on all items and criteria evaluated. The Ethics Committee approved the study. FINDINGS The final scoping review sample consisted of 61 articles, and 19 experts evaluated the content of the ND. All DCs were revised. Three at-risk populations, three associated conditions, and one related factor were added. Three elements had their category changed, and an element was deleted. Experts also validated ODs developed for all DCs. CONCLUSION "Insufficient breast milk production (00216)" was validated by experts. This study improved the ND through literature and expert consensus. New elements were added, and existing ones were revised. IMPLICATIONS FOR NURSING PRACTICE This study improves this ND based on scientific evidence and clinical expertise and potentially improves nurses' diagnostic accuracy through ODs.
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Affiliation(s)
| | | | | | | | - Dorothy A Jones
- Connell School of Nursing, Boston College, Boston, Massachusetts, USA
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Gabriela Alejandra GB, Ana SR, Gabriela MO, Gabriel CT, Marco Julián CO, Martha DA, Barbara V. Social representations of breastfeeding in health science students: A first step to strengthening their training. Nurse Educ Pract 2024; 78:103991. [PMID: 38823293 DOI: 10.1016/j.nepr.2024.103991] [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: 10/04/2023] [Revised: 04/29/2024] [Accepted: 05/04/2024] [Indexed: 06/03/2024]
Abstract
AIM This study aims to describe the social representations of breastfeeding among Mexican health science students. BACKGROUND Breastfeeding is a complex phenomenon involving biological, affective and sociocultural aspects. Its definition includes diverse beliefs, attitudes, traditions and myths. Being aware of the connections between biological and sociocultural concepts in the social representations of breastfeeding in health science students may facilitate our comprehension of their attitudes/behaviors towards breastfeeding. DESIGN A qualitative study was carried out based on the structuralist approach of the social representations theory. METHODS Data were collected with free-listing questionnaires with breastfeeding as an inducer word among a random sample of nutrition, medical and nursing undergraduate students (n=124). The analyses used were similitude/meanings of words, prototypical and categorical analyses. RESULTS The findings suggest that the structure of the social representation is composed of breastfeeding essentials (baby, mother, & milk), affective (attachment, love & link), biological (nutrition, breasts, & health) and sociocultural elements (taboo, responsibility, & economic). Only instrumental elements are found in the nucleus, whereas biological, affective and sociocultural elements are observed in the peripheries. Moreover, emerging thematic categories such as the "affective bond" and "feeding" introduced additional dimensions, thereby emphasizing the complexity and richness of the social representation of breastfeeding in the context of health science students. CONCLUSIONS The structure of the social representation of breastfeeding among some Mexican undergraduate health science students focuses on the instrumental aspects, emphasizing essential elements. However, they downplay more scientifically oriented elements specific to their academic training. These findings, when extrapolated to different contexts, present an opportunity that could assist the development of tailored and culturally adapted educational strategies to strengthen breastfeeding training for health students. This approach can significantly contribute to enhancing breastfeeding promotion in society by addressing practical, scientific and language-inclusive aspects in the training of health professionals.
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Affiliation(s)
- Grover-Baltazar Gabriela Alejandra
- Doctorado en Ciencias de la Salud Pública, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Colonia Independencia, Guadalajara, C.P. 44340, Jalisco, Mexico; Secretaría de Salud Jalisco, Dr. Baeza Alzaga 107, Guadalajara, C.P. 44100, Jalisco, Mexico
| | - Sandoval-Rodríguez Ana
- Instituto de Biología Molecular en Medicina, CUCS, UdeG, Sierra Mojada 950, Colonia Independencia, Guadalajara, C.P. 44340, Jalisco, Mexico
| | - Macedo-Ojeda Gabriela
- Doctorado en Ciencias de la Salud Pública, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Colonia Independencia, Guadalajara, C.P. 44340, Jalisco, Mexico; Instituto de Investigación de Ciencias Biomédicas, CUCS, UdeG, Sierra Mojada 950, Colonia Independencia, Guadalajara, C.P. 44340, Jalisco, Mexico
| | - Chavira Trujillo Gabriel
- Doctorado en Ciencias de la Salud Pública, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Colonia Independencia, Guadalajara, C.P. 44340, Jalisco, Mexico; Departamento de Epidemiología del Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Colonia Sección XVI, Alcaldía de Tlalpan, Ciudad de México, C.P. 1408, Mexico
| | | | - De Alba Martha
- Departamento de Sociología, Universidad Autónoma Metropolitana Unidad Iztapalapa, Av. San Rafael Atlixco 108, Leyes de Reforma 1ra. Sección, Iztapalapa, Ciudad de México, C.P. 09310, Mexico.
| | - Vizmanos Barbara
- Doctorado en Ciencias de la Salud Pública, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Colonia Independencia, Guadalajara, C.P. 44340, Jalisco, Mexico; Laboratorio de Evaluación del Estado Nutricio, Instituto de Nutrigenética y Nutrigenómica, CUCS, Universidad de Guadalajara, Sierra Mojada 950, Colonia Independencia, Guadalajara, C.P. 44340, Jalisco, Mexico.
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Grattan RE, London SM, Bueno GE. Perceived pressure to breastfeed negatively impacts postpartum mental health outcomes over time. Front Public Health 2024; 12:1357965. [PMID: 38638486 PMCID: PMC11024305 DOI: 10.3389/fpubh.2024.1357965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/15/2024] [Indexed: 04/20/2024] Open
Abstract
Introduction Positive maternal mental health is associated with improved outcomes for infants, and yet the consideration of maternal mental health is often neglected in breastfeeding interventions. Breastfeeding interventions typically focus on breastfeeding promotion, and do not always include supports for the mother. This may result in isolated perceived pressure to breastfeed, the mental health impacts of which are not well understood. Methods This mixed-methods, longitudinal study examined whether perceived pressure to breastfeed was associated with depression, suicide ideation, anxiety, birth trauma and stress concurrently and 4 weeks later for postpartum mothers. It also examined qualitative experiences of feeding. Results Perceived pressure to breastfeed was associated with increased anxiety, stress and birth trauma symptoms four weeks later. Thematic analysis suggested this may be due to difficulties living up to the "breast is best" ideal, believing breastfeeding was part of success as a mother, lack of choices and autonomy in feeding choices for infants and general lack of support. Discussion As such it appears we may be doing more harm than good by focusing our interventions for breastfeeding primarily on increasing pressure to breastfeed, and interventions should consider strategies for promoting positive maternal mental health alongside breastfeeding.
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Affiliation(s)
- Rebecca E. Grattan
- School of Psychology, Te Herenga Waka, Victoria University of Wellington, Wellington, New Zealand
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Meyling MMG, Frieling ME, Vervoort JPM, Feijen-de Jong EI, Jansen DEMC. Health problems experienced by women during the first year postpartum: A systematic review. Eur J Midwifery 2023; 7:42. [PMID: 38111746 PMCID: PMC10726257 DOI: 10.18332/ejm/173417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/05/2023] [Accepted: 11/15/2023] [Indexed: 12/20/2023] Open
Abstract
INTRODUCTION During pregnancy and childbirth, health issues can arise that can negatively influence women's postpartum health. Although it is imperative to identify these health problems in order to tailor care to women's needs, they often remain unrecognized. A comprehensive overview of postpartum health problems does not exist in the current literature. This systematic review aimed to explore the health problems experienced by women residing in high-income countries during the first year postpartum. METHODS Scientific databases were searched for articles on health problems experienced by women during the first year postpartum, published between January 2000 and 2 July 2021. Studies investigating the experiences of healthy women from the age of 18 years, residing in high-income countries, who gave birth to a healthy neonate, were included. Identified health issues were divided into five categories and presented in an overview. RESULTS A total of 25 articles were eligible for inclusion. In all, 83 health problems were identified and divided into five different categories (physical health problems, mental health problems, social health problems, problems related to feeding the infant, and other challenges). Common health issues postpartum were exhaustion, urinary incontinence, painful breasts, depressive symptoms, problems related to sexuality and sleep, lack of social support, and problems with breastfeeding. CONCLUSIONS This systematic review contributes to a wider understanding of postpartum health problems and can be used to adapt healthcare to women's needs. It distinguishes itself from previous studies by the wide variety of identified health problems and its specific focus on women's experiences in the postpartum period.
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Affiliation(s)
| | | | - Johanna P. M. Vervoort
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Esther I. Feijen-de Jong
- Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Midwifery Science, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Amsterdam, the Netherlands
- Midwifery Academy Amsterdam Groningen, Inholland, Groningen, the Netherlands
| | - Danielle E. M. C. Jansen
- Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Ondrušová S. Breastfeeding and Bonding: A Surprising Role of Breastfeeding Difficulties. Breastfeed Med 2023. [PMID: 37219989 DOI: 10.1089/bfm.2023.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Aims: To explore the role of breastfeeding difficulties in bonding. Background: Studies published to date yielded varying results regarding the relationship between breastfeeding and bonding. In qualitative studies, mothers often describe breastfeeding as a bonding experience and regard breastfeeding difficulties as challenging. Only one quantitative study explored the impact of breastfeeding difficulties on bonding. Methods: A cross-sectional method was used and a self-report questionnaire was administered to a convenience sample of mothers with infants aged 0-6 months. Results: We found that having problem-free breastfeeding versus breastfeeding associated with breastfeeding difficulties led to a difference in bonding quality. Experiencing any breastfeeding difficulties was associated with bonding impairment (p = 0.000, r = 0.174), especially in cases of breast engorgement (p = 0.016, r = 0.094), a nonlatching baby (p = 0.000, r = 0.179), perceived low milk supply (p = 0.004, r = 0.112), and fussing at the breast (p = 0.000, r = 0.215). We also found a difference in bonding impairment between exclusively breastfeeding and exclusively bottle-feeding mothers (p = 0.001), but only when taking into account breastfeeding difficulties. Conclusions: Breastfeeding is a complex interaction that can be associated with mother-infant bonding in various ways. We found that breastfeeding difficulties were linked to bonding impairment, whereas exclusive breastfeeding without the presence of breastfeeding difficulties was not. Strategies to help achieve exclusive breastfeeding and prevent and resolve breastfeeding difficulties may help mothers fulfill the bonding potential with their infant.
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Affiliation(s)
- Soňa Ondrušová
- Department of Psychology, Palacky University in Olomouc, Olomouc, Czech Republic
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Ulfa Y, Maruyama N, Igarashi Y, Horiuchi S. Women's experiences of breastfeeding after a cesarean section: A meta-synthesis. Jpn J Nurs Sci 2023:e12534. [PMID: 37186368 DOI: 10.1111/jjns.12534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/18/2023] [Accepted: 03/06/2023] [Indexed: 05/17/2023]
Abstract
AIM The World Health Organization and United Nations Children's Fund recommend the early initiation of breastfeeding within the first hour postpartum for successful exclusive breastfeeding. However, cesarean section is a risk factor for unsuccessful early initiation of breastfeeding. Herein, we aim to explore women's experiences of breastfeeding after a cesarean section. METHODS We used the Joanna Briggs Institute framework in this meta-synthesis. We searched articles published from 1990 to 2022 on PubMed, CINAHL, Cochrane library, PsycInfo, and EMBASE to identify qualitative studies on women's experiences of breastfeeding after a cesarean section. We used the Critical Appraisal Skills Programme checklist for qualitative studies to assess the quality of the included studies. RESULTS Seven qualitative studies from five countries met the inclusion criteria, representing the views of 194 women who underwent cesarean sections. Six new categories were integrated into the women's experiences of breastfeeding after a cesarean section as follows: (i) Perceived values of breastfeeding, (ii) Emotional vulnerability in breastfeeding, (iii) Physical difficulties in breastfeeding, (iv) Inconvenient conditions in breastfeeding, (v) Inadequate resources for breastfeeding, and (vi) Support systems to enable breastfeeding. CONCLUSIONS We provide evidence showing that knowledge of the specific breastfeeding mechanism and provision of the most appropriate postsurgical care by healthcare providers just after a cesarean section can reduce the barriers to post-cesarean breastfeeding. Moreover, effective hospital policies and family support can result in the initiation of positive breastfeeding outcomes. Future studies that consider the cultural aspects of breastfeeding practice may generate additional insights into providing optimal postpartum care.
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Affiliation(s)
- Yunefit Ulfa
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
- National Research and Innovation Agency, Central Jakarta, Indonesia
| | - Naoko Maruyama
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | - Yumiko Igarashi
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | - Shigeko Horiuchi
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
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Chambers A, Emmott EH, Myers S, Page AE. Emotional and informational social support from health visitors and breastfeeding outcomes in the UK. Int Breastfeed J 2023; 18:14. [PMID: 36882844 PMCID: PMC9990566 DOI: 10.1186/s13006-023-00551-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 02/11/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Shorter breastfeeding duration is associated with detrimental consequences for infant health/development and maternal health. Previous studies suggest social support is essential in maintaining breast/chest-feeding and helping to improve general infant feeding experiences. Public health bodies therefore work to support breastfeeding in the UK, yet UK breastfeeding rates continue to be one of the lowest globally. With this, a better understanding of the effectiveness and quality of infant feeding support is required. In the UK, health visitors (community public health nurses specialising in working with families with a child aged 0-5 years) have been positioned as one of the key providers of breast/chest-feeding support. Research evidence suggests that both inadequate informational support and poor/negative emotional support can lead to poor breastfeeding experiences and early breastfeeding cessation. Thus, this study tests the hypothesis that emotional support from health visitors moderates the relationship between informational support and breastfeeding duration/infant feeding experience among UK mothers. METHODS We ran cox and binary logistic regression models on data from 565 UK mothers, collected as part of a 2017-2018 retrospective online survey on social support and infant feeding. RESULTS Informational support, compared to emotional support, was a less important predictor of both breastfeeding duration and experience. Supportive emotional support with unhelpful or absent informational support was associated with the lowest hazard of breastfeeding cessation before 3 months. Results for breastfeeding experience followed similar trends, where positive experience was associated with supportive emotional and unhelpful informational support. Negative experiences were less consistent; however, a higher probability of negative experience was found when both types of support were reported as unsupportive. CONCLUSIONS Our findings point to the importance of health visitors providing emotional support to bolster the continuation of breastfeeding and encourage a positive subjective experience of infant feeding. The emphasis of emotional support in our results encourages increased allocation of resources and training opportunities to ensure health visitors are able to provide enhanced emotional support. Lowering health visitors caseloads to allow for personalised care is just one actionable example that may improve breastfeeding outcomes in the UK.
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Affiliation(s)
- A Chambers
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - E H Emmott
- UCL Anthropology, University College London, London, UK
| | - S Myers
- UCL Anthropology, University College London, London, UK.,BirthRites Independent Max Planck Research Group, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - A E Page
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.
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Wu JL, Jiang XM, Zheng QX, Chen XQ, Liu GH. Mothers' breastfeeding six weeks postpartum and factors influencing exclusive breastfeeding during the first six months. Health Care Women Int 2023; 44:262-275. [PMID: 34346293 DOI: 10.1080/07399332.2021.1947287] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We aimed to assess the feeding pattern and influencing factors within six weeks postpartum on exclusive breastfeeding duration among Chinese mothers. This study was conducted using 2:1 matched case-control study. Cases and controls were matched for maternal age, parity and mode of birth. A total of 210 women were included. Approximately 67.9% of women stopped exclusive breastfeeding within the first six weeks postpartum. Maternal non-exclusive breastfeeding intention, lower maternal educational level, mother-infant skin to skin contact over one hour, unsatisfied breastfeeding self-evaluation and maternal unhealthy condition within the first six weeks were risk factors for ceasing exclusive breastfeeding early.
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Affiliation(s)
- Jing-Ling Wu
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiu-Min Jiang
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Qing-Xiang Zheng
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Xiao-Qian Chen
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Gui-Hua Liu
- Department of Child Health, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
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Effects of spousal support in the early postpartum period on breastfeeding motivation in patriarchal societies. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1071483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Background and Purpose: Breastfeeding is important with regard to public health. Our aim was to examine effects of spousal support in the early postpartum period on breastfeeding motivation in patriarchal societies.
Methods: Study was descriptive, cross-sectional, correlational design. Study was conducted in a University Hospital in Inland Anatolia Region in Turkey. It included primiparous and multiparous women.
Results: Analysis showed a significant positive, moderate relation between spousal support and breastfeeding motivation in the primiparous women; spousal support accounted for 23.8% of breastfeeding motivation of the women. There was a significant, positive weak relation between spousal support and breastfeeding motivation in the multiparous women; spousal support explained 8.2% of breastfeeding motivation in these women.
Conclusion: Spousal support in the early postpartum period was found to have a positive influence on improvement of breastfeeding motivation. However, it could explain a small percentage of breastfeeding motivation. New strategies should be created to encourage spouses to get involved in breastfeeding.
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