Severe breastfeeding difficulties: Existential lostness as a mother—Women's lived experiences of initiating breastfeeding under severe difficulties

A majority of women in Sweden initiate breastfeeding but almost a quarter stop or wean the infant in the first few weeks after birth because of difficulties. In order to develop care that facilitates initiation of breastfeeding and enables mothers to realize their expectations concerning breastfeeding, it is necessary to understand what having severe breastfeeding difficulties means for women who experience them. The aim of this study is to describe the lived experiences of initiating breastfeeding under severe difficulties. A reflective lifeworld research design was used. Eight women, seven primiparous and one multipara, were interviewed within 2 months of giving birth. The essential meaning of the phenomenon is described as “Existential lostness as a mother forcing oneself into a constant fight”. This pattern is further explicated through its constituents; shattered expectations, a lost time for closeness, being of no use to the infant, being forced to expose oneself, and gaining strength through sharing. The results show that mothers with severe breastfeeding difficulties feel alone and exposed because of their suffering and are lost in motherhood. Thus, adequate care for mothers should enhance the forming of a caring relationship through sharing rather than exposing

Education and training of healthcare staff in the knowledge, attitudes and skills needed to work effectively with breastfeeding women:a systematic review

BACKGROUND: Current evidence suggests that women need effective support to breastfeed, but many healthcare staff lack the necessary knowledge, attitudes and skills. There is therefore a need for breastfeeding education and training for healthcare staff. The primary aim of this review is to determine whether education and training programs for healthcare staff have an effect on their knowledge and attitudes about supporting breastfeeding women. The secondary aim of this review was to identify whether any differences in type of training or discipline of staff mattered. METHODS: A systematic search of the literature was conducted using the Cochrane Pregnancy and Childbirth Group’s trial register. Randomised controlled trials comparing breastfeeding education and training for healthcare staff with no or usual training and education were included if they measured the impact on staff knowledge, attitudes or compliance with the Baby Friendly Hospital Initiative (BFHI). RESULTS: From the 1192 reports identified, four distinct studies were included. Three studies were two-arm cluster-randomised trials and one was a two-arm individual randomised trial. Of these, three contributed quantitative data from a total of 250 participants. Due to heterogeneity of outcome measures meta-analysis was not possible. Knowledge was included as an outcome in two studies and demonstrated small but significant positive effects. Attitudes towards breastfeeding was included as an outcome in two studies, however, results were inconsistent both in terms of how they were measured and the intervention effects. One study reported a small but significant positive effect on BFHI compliance. Study quality was generally deemed low with the majority of domains being judged as high or unclear risk of bias. CONCLUSIONS: This review identified a lack of good evidence on breastfeeding education and training for healthcare staff. There is therefore a critical need for research to address breastfeeding education and training needs of multidisciplinary healthcare staff in different contexts through large, well-conducted RCTs

Perinatal THC exposure via lactation induces lasting alterations to social behavior and prefrontal cortex function in rats at adulthood

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