Background: Provisions of sympathetic, informed counseling can make a difference in successful breastfeeding.

Subjects: Study participants were public health department clients, Anglo-American and African-American women, and economically disadvantaged. The study also included health department staff, perinatal hospital staff, lactation consultants, and nutritionists from the same geographical area.

Study Design: Client subjects were divided into 35 focus groups ranging in size from 4 to 10 persons. Discussions were conducted with group members. The groups were separated according to age, parity, geographic residence, and infant feeding method. Six focus groups were formed with the health care personnel. Twenty-two in-depth interviews were performed with members of the health care staff. Some topics for discussion included beliefs and attitudes about breastfeeding, influencing factors, expectations of and perceived problems with counselors, and recommendations for improvement. Focus groups and interviews were transcribed verbatim, coded, and sorted with computer programs. Thematic categories were developed according to results.

Findings: Although results varied, data collected from both the clients and the providers reinforced earlier research findings. Clients believed there was a lack of preparation for what to expect during the entire lactation process. They also received contradicting information from different health care workers. Providers felt that lack of time contributed to the poor teaching outcomes. Many admitted to being unfamiliar with proper technique or exact physiology. A general consensus concurred that a gap exists in the support services offered between hospital discharge and the first postpartum visit, one to two weeks after discharge.

Research reviewed by Suzanne Winder, RN, while a student at Virginia Commonwealth University, School of Nursing, in Richmond, VA.

Abstract 2:

Premise: Support density is an important factor in breastfeeding success.

Research Question: How does the amount of perceived support relate to a woman’s feelings of breastfeeding success? Are certain types of support more related to a woman’s feelings of success? Is the makeup of a woman’s support network structure related to her lactation outcomes?

Subjects: A convenience sample of 45 first-time mothers giving birth at a small community in southeastern Connecticut. All communicated in English and expressed a desire to breastfeed. All participants had to have normal vaginal deliveries and the birth of one term infant with 5-minute Apgar scores of 7 or greater. The selected women were informed about the study and invited to participate between 24 and 72 hours post-birth.

Study Design: Subjects were divided into two groups, depending on their response to questions regarding breastfeeding satisfaction. Informed consent was obtained. Questionnaires were mailed to the participants four to six weeks after discharge. Thirty-eight out of 45 participants returned the questionnaires, which included thoughts and feelings regarding breastfeeding. The subjects were also asked to identify their support networks. Demographic and social variables were similar between the two groups.

Findings: Results indicated that women who were satisfied with their breastfeeding experience had double the number of informational support providers compared to women who were dissatisfied. It was also found that, as women increased their informational network, the number of people providing emotional support also increased. No difference was identified between perceived support and lactation outcomes, possibly due to factors such as research design and sample selection. Researchers suggested that women should select or be directed to appropriated and qualified support networks to enhance lactation satisfaction.

Research reviewed by Suzanne Winder, RN, while a student at Virginia Commonwealth University, School of Nursing, in Richmond, VA.

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Abstract 3:

Wright, A., & Rice, S. (1996). Changing hospital practice to increase duration of breastfeeding. Pediatrics, 97(5), 669-675.

Premise: Adopting the Baby Friendly Hospital Initiative

LINK: http://www.naturalchild.com/advocacy/worldwide/baby-friendly_hospital.html

(BFHI) in Tucson, AZ, had a positive effect on breastfeeding outcomes.

Research Synopsis: Current health care practices undermine mothers’ attempts to breastfeed exclusively and impact their long-term breastfeeding success. Research was developed to assess the impact of hospital practices on duration of breastfeeding for mothers in a university teaching hospital after changes were made in accordance with the BFHI-recommended Ten Steps to Successful Breastfeeding.

Background: The potential lifelong benefits of breastfeeding infants make breastfeeding the optimal feeding method.

Study Design: Variables included health care practices including, but not limited to, breastfeeding guidance from staff, rooming in, formula supplementation, and referring mothers to support groups. Confounding variables included breastfeeding plans, native language, and maternal education. Research entailed a study of existing practices and outcomes before and after adoption of the BFHI. An initial baseline study was conducted in 1990 through an interview process with a limited questionnaire. During a one-month period, 192 of the 325 women that gave birth were questioned prior to their discharge from the hospital. The evaluation after the BFHI was conducted in 1993. It included a questionnaire similar to the baseline study with additional questions related to the new policies and procedures. Out of 720 mothers that gave birth over a two-month period, 392 were interviewed during their hospital stay. A follow-up telephone interview was conducted on breastfeeding mothers when their infants were 4 months old.

Findings: Among the findings, more women were offered help with breastfeeding by hospital staff (81.9% in 1993 vs. 61.3% [p< .00001] in 1990). As a result of the new policy implementation, 38.4% of mothers in 1993 were referred to breastfeeding support groups prior to discharge. Multivariate analysis indicated the duration of breastfeeding at one and four months was also found to be associated with the implementation of multiple practices.

Research reviewed by Suzanne Winder, RN, while a student at Virginia Commonwealth University, School of Nursing, in Richmond, VA.