Breastfeeding in South Gloucestershire: Mothers' early experiences of infant feeding

Abstract

Executive SummaryIntroduction• This research about mothers’ early experiences of infant feeding was developed following discussions about South Gloucestershire’s public health priorities for breastfeeding; current services supporting breastfeeding; and relatively low breastfeeding continuation rates.Background and context• Breastfeeding is recognised as the optimal way to feed infants from birth and exclusive breastfeeding is recommended until about six months of age, with the introduction of complementary feeding when babies are developmentally ready, usually around six months. • The support, promotion and protection of breastfeeding is a national and local priority. In 2014/15, initiation of breastfeeding in South Gloucestershire, was 77.1% while continuation was 47.8%. The Joint Strategic Needs Assessment in 2016, highlighted the need to obtain the views of mothers on their experience of support for breastfeeding. Research question• The research question was: What are the experiences of mothers (with a focus on support) in South Gloucestershire in relation to infant feeding in the first 6-8 weeks? Methods• The research design adopted a purposive sampling strategy, based on criteria sampling, with mothers that had; experience of breastfeeding in the first 6-8 weeks of their baby’s life, a baby up to 6 months of age and were engaged with a Children’s Centre. We recruited mothers who met all three criteria. • Support for the research was obtained from Midwifery, Health Visiting and Children’s Centres managers. Baby and Me groups were visited to invite participation; 53 mothers expressed an interest and 24 mothers selected randomly were interviewed. An information sheet, consent form and interview schedule were developed.• NVivo was used to support data management and analysis in which themes were identified. Data protection requirements were adhered to throughout the research. The research had ethical approval from both South Gloucestershire Council and the University of the West of England. The findingsFindings from this project suggest that there are three ‘critical stages’ in supporting a mother to breastfeed and in her experience of breastfeeding; within these the main themes emerging from this research are discussed: • Support before birth: o Preparation antenatally for breastfeeding does not prepare women for the reality.o Many mothers would have liked information about expressing milk and bottle-feeding before they become mothers. • Support around the time of the birth:o In hospital, after the birth, some mothers receive conflicting messages and don’t always feel supported.o Birth experience can influence early experiences of breastfeeding.• Support once at home:o On return home, Health Visitors are generally perceived as supportive although contact can be minimal.o Breastfeeding support groups suit some women but are not available when needed.o Family, friends and other networks are a key source of support and advice for many motherso Many women seek support from other sources including online groups and apps although telephone helplines were not much used.Recommendations A number of recommendations are made; these are mainly directed towards South Gloucestershire Council but are also of relevance to the wider partnership of health and community and voluntary sector agencies. Recommendations concern the promotion and protection of breastfeeding; the mental and emotional health and wellbeing of women; consistent evidence-based personal and timely support; mothers awareness of differing professional roles; evaluation of breastfeeding groups and; consistent approach to signposting women to websites, apps and social media; and quality assurance of resources and workforce development