Maternal perception of postpartal nursing support for breastfeeding offered during hospitalization

There is wide agreement that breastfeeding mothers require adequate support for their breastfeeding efforts if they are to achieve a satisfying and successful breastfeeding experience. During the critical period immediately following birth, the postpartal nurse has a significant role to play in the initiation and establishment of breastfeeding. The purpose of this research was to describe the nature of postpartal nursing support for breastfeeding in hospital and to assess the maternal perception and satisfaction with the quality of this support. House's (1981) conceptualization of social support was used to provide the framework for the study. -- This descriptive, exploratory study surveyed a non-random sample (n=40) of primiparous breastfeeding mothers at an urban hospital over a three month period. Two standardized interview schedules were developed to yield the desired information. -- The results revealed that mothers generally felt they received adequate emotional support for breastfeeding, although a substantial proportion reported that the nurses did not spend time with them during their initial breastfeeding sessions. The majority of mothers felt that they received adequate instrumental support in the area of demonstration of techniques of breastfeeding. The results indicated that the instrumental component of modifying the hospital environment to facilitate a positive breastfeeding experience was inadequate. Practices such as rooming-in, demand feeding and the early initiation of breastfeeding were not encouraged by nurses. The majority of mothers received informational support regarding various topics of breastfeeding. However, several mothers reported that they did not receive information on avoiding formula supplements and criteria for assessing the adequacy of the milk supply. Conflicting advice was a predominant source of complaint. Appraisal support behaviors by nurses were reported less frequently than the other categories of support. -- Emotional and instrumental support behaviors by nurses were found to be most helpful to the mothers' early breastfeeding experiences in hospital. Informational support tended to be more helpful to the mothers after discharge from the hospital. -- The data indicated that the large majority (95%) of mothers expressed satisfaction with the quality of nursing support received for breastfeeding in hospital. However, their satisfaction with the quality of nursing support was significantly lower when measured in the follow-up at two to three weeks. -- The findings from this study suggest that nurses need to have a clear understanding of the various types of support offered to and perceived as helpful by breastfeeding mothers. Nurses would then be able to prepare mothers for realistic breastfeeding experiences and assist those mothers who without adequate support might otherwise choose to discontinue breastfeeding prematurely

Poverty and Breastfeeding: Comparing Determinants of Early Breastfeeding Cessation Incidence in Socioeconomically Marginalized and Privileged Populations in the FiNaL Study

Purpose: Infant feeding differences are strongly tied to socioeconomic status. The goal of this study is to compare determinants of early breastfeeding cessation incidence in socioeconomically marginalized (SEM) and socioeconomically privileged (SEP) populations, focusing on birthing parents who intended to breastfeed. Methods: This cohort study includes data from 451 birthing parents in the Canadian province of Newfoundland and Labrador who reported intention to breastfeed in the baseline prenatal survey. Multivariate logistic regression techniques were used to assess the determinants of breastfeeding cessation at 1 month in both SEM and SEP populations. Results: The analysis data included 73 SEM and 378 SEP birthing parents who reported intention to breastfeed at baseline. At 1 month, 24.7% (18/73) in the SEM group had ceased breastfeeding compared to 6.9% (26/378) in the SEP group. In the SEP population, score on the Iowa Infant Feeding Attitude Scale (IIFAS) (odds ratio [OR] 3.33, p=0.01) was the sole significant determinant. In the SEM population, three significant determinants were identified: unpartnered marital status (OR 5.10, p=0.05), <1 h of skin-to-skin contact after birth (OR 11.92, p=0.02), and negative first impression of breastfeeding (OR 11.07, p=0.01). Conclusion: These results indicate that determinants of breastfeeding cessation differ between SEM and SEP populations intending to breastfeed. Interventions intended on improving the SEM population's postpartum breastfeeding experience using best practices, increasing support, and ensuring at least 1 h of skin–skin contact may increase breastfeeding rates