School of Nursing and Midwifery, University of Western Sydney, New South Wales, Australia.
Birth. 2011 Mar;38(1):49-60. doi: 10.1111/j.1523-536X.2010.00446.x. Epub 2010 Dec 23.
Both peer and professional support have been identified as important to the success of breastfeeding. The aim of this metasynthesis was to examine women's perceptions and experiences of breastfeeding support, either professional or peer, to illuminate the components of support that they deemed "supportive."
The metasynthesis included studies of both formal or "created" peer and professional support for breastfeeding women but excluded studies of family or informal support. Qualitative studies were included as well as large-scale surveys if they reported the analysis of qualitative data gathered through open-ended responses. Primiparas and multiparas who initiated breastfeeding were included. Studies published in English, in peer-reviewed journals, and undertaken between January 1990 and December 2007 were included. After assessment for relevance and quality, 31 studies were included. Meta-ethnographic methods were used to identify categories and themes.
The metasynthesis resulted in four categories comprising 20 themes. The synthesis indicated that support for breastfeeding occurred along a continuum from authentic presence at one end, perceived as effective support, to disconnected encounters at the other, perceived as ineffective or even discouraging and counterproductive. A facilitative approach versus a reductionist approach was identified as contrasting styles of support that women experienced as helpful or unhelpful.
The findings emphasize the importance of person-centered communication skills and of relationships in supporting a woman to breastfeed. Organizational systems and services that facilitate continuity of caregiver, for example continuity of midwifery care or peer support models, are more likely to facilitate an authentic presence, involving supportive care and a trusting relationship with professionals.
同伴支持和专业支持都被认为对母乳喂养的成功至关重要。本元分析旨在考察女性对母乳喂养支持（无论是专业支持还是同伴支持）的看法和体验，以阐明她们认为“支持性”的支持组成部分。
该元分析包括对母乳喂养女性的正式或“创建”同伴和专业支持的研究，但不包括对家庭或非正式支持的研究。纳入了定性研究以及大规模调查，如果它们报告了通过开放式回答收集的定性数据分析。纳入了初产妇和经产妇，她们都开始母乳喂养。纳入了发表在同行评议期刊上的英语研究，研究时间在 1990 年 1 月至 2007 年 12 月之间。在评估相关性和质量后，纳入了 31 项研究。使用元民族学方法确定类别和主题。
元分析结果得出了四个类别，包含 20 个主题。综合结果表明，母乳喂养支持沿着从真实存在（被认为是有效支持）到脱节相遇（被认为是无效甚至令人沮丧和适得其反）的连续体发生。确定了促进方法与简化方法，这是女性体验到的两种有帮助或无帮助的支持风格。
研究结果强调了以人为主导的沟通技巧和人际关系在支持女性母乳喂养方面的重要性。组织系统和服务，例如促进护理人员连续性的系统和服务，例如助产士护理连续性或同伴支持模式，更有可能促进真实存在，包括支持性护理和与专业人员的信任关系。
