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• W1956773768 abstract "Background:Breastfeeding confers health and social benefits on both mother and baby and is thus a key global public health priority, with exclusive breastfeeding for the first six months recommended. A variety of factors can influence a woman’s decision to initiate breastfeeding but a short duration of breastfeeding appears to be common in developed countries. In the UK, promotion of breastfeeding has been government policy since 1974 and gradually the incidence has increased. In Scotland in 2010 the incidence was 74% but by one week 17% of women had given up. A minority of women find that their babies attach easily at birth and more than half report problems at this time. The prevalence of exclusive breastfeeding falls sharply in the first few weeks and the introduction of formula is associated with a shorter duration. It is therefore crucial to understand what happens at this time to enable women to continue breastfeeding effectively.Study Aim:To use Social Cognitive Theory (SCT) to explore and help explain the expectations, knowledge and experiences of women and midwives with regard to breastfeeding initiation.Methods:A systematic review of qualitative studies synthesised using thematic analysis and SCT was conducted and afforded insight into what had been known before and highlighted further aspects that needed to be explored with a qualitative study.The qualitative study was comprised of five focus groups with ten antenatal women, eight postnatal women and eighteen midwives. Photographs included in a leaflet “Feeding cues at birth”, and the chart of “Feeding cues after the first few hours” were developed and used as focussing exercises during the focus groups and interviews. The focus groups and interviews were recorded, transcribed and analysed using a hybrid process of inductive and deductive thematic analysis which integrated data driven codes with theory driven codes based on SCT. Results: Twenty one studies were included in the systematic review and identified clear differences in the experiences of women when breastfeeding was going well as compared to when it was going wrong at the start. There were also differences in the midwives’ knowledge, experience and confidence when breastfeeding was going well in contrast to when it was going wrong. The synthesis did not identify any qualitative studies relevant to initiation which explored skin contact, instinctive behaviour or strategies to resolve failure to attach in the first few days after birth, from the perspectives of mothers and midwives. These topics were therefore explored in detail in the qualitative study. Few mothers recruited to my study experienced instinctive behaviour and successful attachment (in SCT enactive behaviour) at birth. The majority of mothers did not experience attachment at birth and struggled to persist and maintain their motivation to enable breastfeeding initiation in an unfamiliar environment. Midwives’ social expectations and environmental circumstances made women centred care difficult. Midwives…" @default.
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• W1956773768 date "2013-01-01" @default.
• W1956773768 modified "2023-09-27" @default.
• W1956773768 title "Confidence in Initiation of Breastfeeding" @default.
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