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

Previous breastfeeding difficulties: an existential breastfeeding trauma with two intertwined pathways for future breastfeeding—fear and longing

Purpose: Experiencing breastfeeding difficulties poses a risk for early cessation of breastfeeding and decreases the likelihood of breastfeeding a future child. To further understand breastfeeding outcomes, the aim of this study is to explain the phenomenon of breastfeeding difficulties in order to understand how women’s previous experiences of breastfeeding difficulties relate to their decisions about future breastfeeding. Methods: A reflective lifeworld hermeneutical approach was adopted. The study consisted of 15 lifeworld interviews with eight women who had previously experienced difficulties with initial breastfeeding. Results: Previously experienced breastfeeding difficulties represent an existential breastfeeding trauma in an individual woman’s life, from which there are two intertwined pathways for future breastfeeding: a fear of breastfeeding, which renders the idea of future breastfeeding unthinkable, and a longing for breastfeeding, which increases the likelihood of future breastfeeding. Fear and longing are intertwined in ambiguous ways in an individual woman’s life. Conclusion: Women with previous breastfeeding difficulties may bring negative breastfeeding experiences with them, which are etched into the woman’s being as a mother as an embodied memory. A lifeworld-led caring science perspective as a foundation for care can contribute to the development of caring practices, which grasp the existential nature of the breastfeeding trauma

Vid oklara mål är kommunikation nyckeln till ett funktionellt ledarskap : En fallstudie om linjechefens upplevelser beträffande sina förutsättningar i arbetet

Att ledarskapet är viktig för medarbetarnas psykosociala arbetsmiljö och hälsa är det många studier som visar. För att den operativa linjechefen ska kunna skapa en god psykosocial arbetsmiljö och samtidigt bemästra de krav som denna position innebär, krävs goda förutsättningar i linjechefens egen arbetssituation. Studier visar att den offentliga sektorns förändringar de senaste decennierna har förändrat förutsättningarna för arbetet inom dessa organisationer. Syftet med följande studie är att skapa kunskap om hur linjechefen upplever sina förutsättningar för ledarskapet i en offentlig organisation som har förändrat styrning och organisering. Studien har sin utgångspunkt i klassisk organisationsteori som pekar på att organisationer upprätthålls av sociala relationer och kommunikation samt tidigare studier om hur offentlig sektor förändrats. Tidigare forskning visar att offentlig sektors förändring har ökat betydelsen av ledarnas kommunikativa roll och stärkt behovet av förutsättningar. Vidare visar forskningen att förändringarna påverkat kommunikationsmönstren i organisationerna, linjechefernas relationer till chefer och kollegor samt möjligheter att vara närvarande och kunna påverka. Studien baseras på en kvalitativ fallstudie med fem semistrukturerade intervjuer i en utvald vård och omsorgsförvaltning. Resultatet visar att intervjupersonerna upplever försämrade förutsättningar för ledarskapet. Arbetsrollen innefattar enligt intervjupersonernas beskrivningar orimliga krav och rollen uppfattas som gränslös. Förutsättningarna för tillitsfulla relationer till medarbetare, chefer och kollegor har enligt intervjupersonerna försämrats och möjligheten att påverka minskat. Dessa försämrade förutsättningar kan till stor del härledas till förändrad organisering och styrning som medfört försämrad kommunikation genom sociala relationer. Essentiella förutsättningar för både ledarskapet och organisationens funktion. Studien bidrar till en ökad förståelse för intervjupersonernas arbetsroll och förutsättningar att vara en kommunikativ och meningsskapande ledare. Vidare bidrar studien med förståelse för varför de förändringsmodeller som använts i offentlig sektor ofta varit negativa för organisationen och dess medlemmar

Initiating breastfeeding is an existential challenge

For most women in Sweden, breastfeeding is an essential part during the childbearing period. Nearly all women initiate breastfeeding but, due to different reasons, almost one fourth of the women stop or wean breastfeeding the first weeks or months after birth. That is often earlier than they had expected. Therefore few women follow the recommendations on breastfeeding. Until now, in-depth knowledge that aims to understand the meaning of initiating breastfeeding from women’s perspective is scantily explored. In order to develop care that enables mothers to breastfeed as recommended, or as long as they want to, it is thus necessary to complement previous research and explore breastfeeding from the percpective of the women

Kvinnors upplevelse av amning första veckan efter förlossningen

Amningen under första veckan efter förlossningen är för både mor och barn en ny ochskör process. Amning innebär för modern att hon kan ge sitt barn näringsrik ochvälanpassad mjölk men också närhet och kärlek. För barnet är amning och bröstmjölknågonting som betyder överlevnad och närhet. Sverige har internationellt sett en högamningsfrekvens under barnets första halvår. Barn som ammas under första veckan var91 % enligt siffror från år 2002. Studier som belyser kvinnors upplevelse av amning ärett fåtal både nationellt och internationellt. Syftet med studien var att undersöka hurkvinnor upplever det att amma sitt barn första veckan efter förlossningen. Studien harsin grund i metoden fenomenologi med livsvärldsansats. Det innebär att se, ta del avoch försöka förstå hur kvinnor upplever det att amma sitt barn under första veckan efterförlossningen. Intervjuer genomfördes med åtta kvinnor. Resultatet tydliggörs i feminnebördselement; fascination i det första mötet med barnet, en balansgång i det som ärokänt, att ha det yttersta ansvaret, att ge sig hän och härda ut och att söka bekräftelse idet unika. Essensen visar att kvinnorna strävar mot att bli den goda modern. Kvinnornaser amningen som en väg in i moderskapet. Strävan innebär att kvinnor vill amma ochkämpar i det längsta för att amningen skall fungera. Kvinnorna sätter sig själva i andrahand när de strävar mot att bli den goda modern. Kvinnorna underordnar sig barnet ochdess vilja och behov av amning. Strävan innebär att kvinnorna upplever en bundenhetmen också en närhet och samhörighet med barnet. Kvinnan och barnets relation växeroch stärks i och med amningen. Att bli sedd som den goda modern som strävar efter attge sitt barn det som upplevs vara bäst innebär ett bevis på dugligheten i moderskapet.För att kvinnans strävan skall upplevas som någonting positivt behöver hon bekräftelse isin unika situation. Kvinnan söker ständigt efter bekräftelse i sin nya situation.Amningen kan liknas med en pendel. Kvinnorna beskriver att när amningen fungerar så4är det häftigt och underbart att amma sitt barn men då amningen är besvärlig och intefungerar då är det stressande, outhärdligt och smärtsamt.Program: Fristående kursUppsatsnivå: D</p

Amning och existens : Moderskap, sårbarhet och ömsesidigt beroende vid inledande amning

Aim: The overall aim of the thesis is to create knowledge about what it means for women to initiate breastfeeding and what consequences these meanings have from an existential perspective. Approach and method: A lifeworld approach based on the epistemology of phenomenology and hermeneutics was used. Lifeworld interviews and meaningoriented analysis in accordance with the chosen lifeworld approach were performed. A synthesis and a philosophical analysis were carried out that facilitates an understanding of the existential meaning of initial breastfeeding and its consequences as a whole. Main findings: Initiating breastfeeding, when it functions well, entails an existential challenge, a movement from a bodily performance to an embodied relationship with the infant and with oneself as a mother. When breastfeeding is experienced as being severely difficult, it entails an existential lostness as a mother, forcing her into a constant fight with herself, the infant, and others in order to find her way into motherhood. Severe breastfeeding difficulties can evoke existential vulnerability, forcing the mother to continue breastfeeding despite the difficulties, while hoping to be confirmed as a good mother; a fear of breastfeeding may be a consequence. Existential security is a necessary condition for continued breastfeeding whilst insecurity and fear of breastfeeding can lead to ceased attempts to breastfeed when experiencing severe initial difficulties. Initial breastfeeding and motherhood are intertwined in a way that affects the woman’s existence as a mother. Conclusions: Initial breastfeeding is a complex phenomenon that is more than just a biological adaptation or a cultural issue; it touches on and evokes existential aspects of being a woman and a mother. Though anchored in both biology and culture, breastfeeding cannot be reduced to one or the other: it is both. There is a struggle between biology and culture that has existential consequences for women’s experiences of breastfeeding, the breastfeeding decision, and the women’s existence as a mother. There is a need for health professionals to look beyond the statistics of breastfeeding and consider the existential dimensions of breastfeeding-as-lived when encountering mothers wanting to breastfeed

Amning och existens : Moderskap, sårbarhet och ömsesidigt beroende vid inledande amning

Aim: The overall aim of the thesis is to create knowledge about what it means for women to initiate breastfeeding and what consequences these meanings have from an existential perspective. Approach and method: A lifeworld approach based on the epistemology of phenomenology and hermeneutics was used. Lifeworld interviews and meaningoriented analysis in accordance with the chosen lifeworld approach were performed. A synthesis and a philosophical analysis were carried out that facilitates an understanding of the existential meaning of initial breastfeeding and its consequences as a whole. Main findings: Initiating breastfeeding, when it functions well, entails an existential challenge, a movement from a bodily performance to an embodied relationship with the infant and with oneself as a mother. When breastfeeding is experienced as being severely difficult, it entails an existential lostness as a mother, forcing her into a constant fight with herself, the infant, and others in order to find her way into motherhood. Severe breastfeeding difficulties can evoke existential vulnerability, forcing the mother to continue breastfeeding despite the difficulties, while hoping to be confirmed as a good mother; a fear of breastfeeding may be a consequence. Existential security is a necessary condition for continued breastfeeding whilst insecurity and fear of breastfeeding can lead to ceased attempts to breastfeed when experiencing severe initial difficulties. Initial breastfeeding and motherhood are intertwined in a way that affects the woman’s existence as a mother. Conclusions: Initial breastfeeding is a complex phenomenon that is more than just a biological adaptation or a cultural issue; it touches on and evokes existential aspects of being a woman and a mother. Though anchored in both biology and culture, breastfeeding cannot be reduced to one or the other: it is both. There is a struggle between biology and culture that has existential consequences for women’s experiences of breastfeeding, the breastfeeding decision, and the women’s existence as a mother. There is a need for health professionals to look beyond the statistics of breastfeeding and consider the existential dimensions of breastfeeding-as-lived when encountering mothers wanting to breastfeed

Cessation of breastfeeding in mothers of preterm infants : A mixed method study

INTRODUCTION: Many women cease breastfeeding earlier than desired. This study examined the cessation of breastfeeding among mothers of preterm infants. Thus, the aim was to describe the cessation of breastfeeding in mothers of preterm infants up to 12 months after birth. METHOD: This mixed methods study used a convergent design with both qualitative data, consisting of written comments, and quantitative data, on breastfeeding status and breastfeeding satisfaction. The data were collected from questionnaires sent to the mothers at three points during the first year after birth. In total, 270 mothers of preterm infants who breastfed at the time of discharge from the neonatal unit provided data for the study. The quantitative and qualitative data were analysed separately with statistical tests and hermeneutical analysis, respectively and then together according to the convergent mixed methods design. RESULTS: Four themes of the meanings of the cessation of breastfeeding were identified in the qualitative analysis: "Desire to regain the mother's and the infant's well-being", "The mothers interpretation that the infants actively ceased breastfeeding", "The mother's body and/or the infants' signals showing the way" and "The mother's own will and perceived external obstacles". Mothers who did not breastfeed as long as they wanted were more likely to report less satisfaction with breastfeeding, a shorter breastfeeding period, and less activity when ceasing breastfeeding. In comparison, mothers who breastfed as long as they wanted were more satisfied with breastfeeding, breastfed for a longer period of time and were more active in decision making in breastfeeding cessation. CONCLUSION: Maternal passivity or activity influenced the cessation of breastfeeding in mothers of preterm infants who breastfed at the time of discharge from the neonatal unit. Passive behaviour related to breastfeeding may result in early cessation of breastfeeding, and low breastfeeding satisfaction while active behaviour may increase breastfeeding length and satisfaction

Mothers of preterm infants' experiences of breastfeeding support in the first 12 months after birth : a qualitative study

BACKGROUND: Breastfeeding support is important for breastfeeding mothers; however, it is less clear how mothers of preterm infants (&lt; 37 gestational weeks) experience breastfeeding support during the first year. Thus, the aim of this study was to describe how mothers of preterm infants in Sweden experience breastfeeding support during the first 12 months after birth. METHODS: This qualitative study used data from 151 mothers from questionnaires with open-ended questions and telephone interviews. The data were analyzed using an inductive thematic network analysis with a hermeneutical approach. RESULTS: The results exposed two organizing themes and one global theme. In the organizing theme "genuine support strengthens," the mothers described how they were strengthened by being listened to and met with respect, understanding, and knowledge. The support was individually adapted and included both practical and emotional support. In the organizing theme "inadequate support diminishes," the mothers described how health professionals who were controlling and intrusive diminished them and how the support they needed was not provided or was inappropriate. Thus, the global theme "being thrown into a lottery-dependent on the health professional who provided breastfeeding support" emerged, meaning that the support received was random in terms of knowledge and support style, depending on the individual health professionals who were available. CONCLUSION: Breastfeeding support to mothers of preterm infants was highly variable, either constructive or destructive depending on who provided support. This finding clearly shows major challenges for health care, which should make breastfeeding support more person-centered, equal, and supportive in accordance with individual needs

A qualitative study on the breastfeeding experience of mothers of preterm infants in the first 12 months after birth

Background: Being a mother of a preterm infant (&lt;37 gestational weeks) puts the mother in a vulnerable and fragile situation wherein breastfeeding is an important part of becoming a mother and bonding with the infant. Nevertheless, the breastfeeding experience of mothers during the first year after a preterm birth has not been well studied. To develop professional caring and supporting relationships, it is important to address this knowledge gap. The aim of this study was to describe the breastfeeding experience of mothers of preterm infants from birth up until 12 months after birth. Methods: The data in this qualitative study are derived from a multicentre randomized controlled trial where 270 mothers of preterm infants provided 496 written comments through questionnaires containing open-ended questions. The questionnaires were sent to the mother three times during the first 12 months after birth. A thematic network analysis based on hermeneutical philosophy was used to analyse and interpret the resulting data to describe the mothers' experiences of breastfeeding. Results: Three organizing themes, namely, "navigating smoothly," "navigating with a struggle" and "navigating in ambiguity" were revealed in the mothers' narratives regarding their breastfeeding experiences during the first 12 months after birth. These organizing themes were further interpreted as one global theme that was deemed "A journey to finding one's unique way in breastfeeding." Conclusion: Mothers of preterm infants are in an exposed and vulnerable situation when initiating breastfeeding during the first year. This situation leads to a unique journey wherein each mother navigates through breastfeeding depending on her individual situation. An awareness of the diversity of breastfeeding experiences may contribute to the provision of professional caring and supportive relationships