Alianmoghaddam Narges, Phibbs Suzanne, Benn Cheryl
School of Public Health, Massey University, New Zealand.
School of Public Health, Massey University, New Zealand.
Women Birth. 2017 Dec;30(6):e281-e291. doi: 10.1016/j.wombi.2017.05.005. Epub 2017 Jun 22.
Despite widespread consensus regarding the health benefits of breastfeeding, the prevalence of six months exclusive breastfeeding is very low in developed countries including New Zealand.
This paper aims to evaluate the role that health professionals play in promoting exclusive breastfeeding in New Zealand.
Qualitative research involving face to face postpartum interviews conducted four to six weeks after the birth with 30 new mothers who lived in New Zealand and had identified in a short antenatal questionnaire that they intended to practice exclusive breastfeeding for six months. Themes related to exclusive breastfeeding support from health professionals were extracted from the interview transcripts and interpreted using Foucault's ideas about governmentality and bio-power.
Four themes related to the quality of health care support were identified in the interview transcripts. 'Breastfeeding self-efficacy support from the community midwives', 'mothers need to know more about breastfeeding during pregnancy', 'experiencing difficulties breastfeeding' as well as 'pressure and resistance to breastfeeding'.
Most mothers in this research spoke about feeling pressured to breastfeed within the New Zealand health system. However, the participating mothers acknowledged the effective support that they had received from community midwives who respected their autonomy, strengthened their self-esteem and encouraged them to breastfeed.
Negative historical experiences related to the medicalization of infant feeding in Western countries suggests that health professionals need to provide effective skill support for breastfeeding mothers so that mothers do not consider it a form of "quiet coercion" or as an exercise of "power".
尽管对于母乳喂养对健康有益已达成广泛共识，但在包括新西兰在内的发达国家，六个月纯母乳喂养的普及率非常低。
本文旨在评估健康专业人员在促进新西兰纯母乳喂养方面所起的作用。
采用定性研究方法，在产后四至六周对30名居住在新西兰的新妈妈进行面对面访谈，这些妈妈在一份简短的产前调查问卷中表明她们打算进行六个月的纯母乳喂养。从访谈记录中提取与健康专业人员提供的纯母乳喂养支持相关的主题，并运用福柯关于治理术和生物权力的观点进行解读。
在访谈记录中确定了与医疗保健支持质量相关的四个主题。“社区助产士提供的母乳喂养自我效能支持”“母亲在孕期需要更多了解母乳喂养知识”“母乳喂养遇到困难”以及“母乳喂养面临的压力和阻力”。
本研究中的大多数母亲表示在新西兰医疗体系中进行母乳喂养感到有压力。然而，参与研究的母亲认可从尊重她们自主权、增强她们自尊并鼓励她们母乳喂养的社区助产士那里获得的有效支持。
西方国家与婴儿喂养医学化相关的负面历史经验表明，健康专业人员需要为母乳喂养的母亲提供有效的技能支持，以使母亲们不将其视为一种“隐性强制”形式或“权力”的行使。
