How breastfeeding can be an emotional rollercoaster A
How breastfeeding can be an emotional rollercoaster: A qualitative study of primigravid women in Lincolnshire Kathryn Hinsliff-Smith Rachel Spencer Denis Walsh School of Nursing, Midwifery and Physiotherapy Academic Division of Midwifery 1
Background • Breastfeeding is a key public health priority • WHO 2011 - optimal way to feed infants up to 6 months • Improving health outcomes, via improved breastfeeding rates, has the potential to save NHS funds (Renfrew et al. 2012)
Local context • Breastfeeding initiation per PCT 2009/2010 England 72. 7%, East Midlands 72%, Lincolnshire 71. 8% • Breastfeeding rates at 6 – 8 weeks England 49%, East Midlands 45%, Lincolnshire 40% • Lincolnshire Hospital Trust BFI level 2 accredited • Lincolnshire PCT commission 2012, 12 month project 12/16/2021 Event Name and Venue 3
Research aim To develop an understanding of primiparous women’s experiences “ and challenges of breastfeeding in the early postpartum period (6 -8 weeks) 4
Methods Recruitment (May until August) Primigravid women over 34 weeks Information letter and consent form Planned birth at Boston, Grantham, Lincoln Antenatal and postnatal care in Lincolnshire Data collection – Written diaries returned from 22 women for the first 6 weeks after birth – A sub-sample of 13 women agreed to an in-depth face to face interview conducted in their home at 6/8 weeks – Overall 26 women shared their infant feeding experience
Findings 6
Emotional rollercoaster of infant feeding Professionals: notions of expertise, communication and impact Dimensions of public feeding maternal guilt perceived power of ‘experts’ feeding in front of family and friends unpreparedness for breastfeeding communication and support using private facilities in public spaces unrealistic expectations feeding ‘where ever and when ever’ 7
Table 1 – Infant feeding outcome of 26 participants Feeding at hospital discharge Breastfeeding including EBM 18 Formula Mixed 7 1 Total 26 Feeding pattern at 6 weeks 10 16 0 26 8
Emotional rollercoaster of infant feeding Resear chers m etapho r maternal guilt Breastfeeding most of today, he has barely left my chest (p 19 diary) He feeds every two hours and I find this difficult (p 42 diary) unpreparedness for breastfeeding unrealistic expectations I was not expecting it to be like this (constant feeding) (p 32 diary) He never went more than an hour between feeds at night (p 25 diary) 9
Professionals: notions of expertise, communication and impact perceived power of ‘experts’ She (midwife) came in and said you are doing it wrong, you do not look like you are sat right, and you don’t look comfortable (p 10 diary) She (midwife) was not helpful at all. When I was hand expressing she said, that is not worth giving it to him, and she put it in the sharps bin. I was so mad (p 30 interview) Day 11 My health visitor told me off. She said I was confusing him [baby]. I don’t know what to do, either try him on my boob again and see how it goes or keep him on a bottle now. I feel so bad (p 36 diary). breastfeeding communication and support 10
Dimensions of public feeding in front of family and friends using private facilities in public spaces feeding ‘where ever and when ever’ 11
- Final Report with findings, conclusions and recommendations submitted to NHS Lincolnshire December 2012 - 2013 Report reviewed and approval gained for dissemination - Lincolnshire Infant Feeding Strategy 2013 – 2016 currently under review 12
Key Messages • In preparing women for the realities of breastfeeding their newborn there is a need to include the difficulties that mothers may experience and should be explicitly included in antenatal preparation • Predictable, scheduled, ongoing support, both on the postnatal ward and throughout the early postnatal period when discharged home is recommended. Breastfeeding support should be proactive rather than reactive. • Approaches need to be taken that promote breastfeeding as the ‘norm’ and that continue to provide supportive environments for breastfeeding mothers. 13
Key Message – data collection • Diaries provide a useful means of collecting data that enables mothers to describe and reflect upon their infant feeding journey, providing researchers with useful contemporaneous data of mothers lived experiences. 14
Thank you Please feel free to take a copy of the report or request an electronic copy kathryn. hinsliff-smith@nottingham. ac. uk 15
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