1 Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA.
2 Yale School of Nursing, Orange, CT, USA.
J Hum Lact. 2018 Feb;34(1):51-67. doi: 10.1177/0890334417726305. Epub 2017 Aug 18.
Addressing suboptimal breastfeeding initiation and duration rates is a priority in the United States. To address challenges to improving these rates, the voices of the providers who work with breastfeeding mothers should be heard. Research aim: The purpose of this study was to explore lactation consultants' perceived barriers to managing early breastfeeding problems.
This qualitative study was conducted with a grounded theory methodological approach. In-depth interviews were conducted with 30 International Board Certified Lactation Consultants across Florida. Lactation consultants were from a range of practice settings, including hospitals, Special Supplemental Nutrition Program for Women, Infants, and Children clinics, private practice, and pediatric offices. Data were digitally recorded, transcribed, and analyzed in Atlas.ti.
A range of barriers was identified and grouped into the following categories/themes: indirect barriers (social norms, knowledge, attitudes); direct occupational barriers (institutional constraints, lack of coordination, poor service delivery); and direct individual barriers (social support, mother's self-efficacy). A model was developed illustrating the factors that influence the role enactment of lactation consultants in managing breastfeeding problems.
Inadequate support for addressing early breastfeeding challenges is compounded by a lack of collaboration among various healthcare providers and the family. Findings provide insight into the professional management issues of early breastfeeding problems faced by lactation consultants. Team-based, interprofessional approaches to breastfeeding support for mothers and their families are needed; improving interdisciplinary collaboration could lead to better integration of lactation consultants who are educated and experienced in providing lactation support and management of breastfeeding problems.
解决母乳喂养启动和持续时间不理想的问题是美国的优先事项。为了解决提高这些比率所面临的挑战,应该听取与母乳喂养母亲合作的提供者的意见。研究目的:本研究的目的是探讨哺乳顾问在管理早期母乳喂养问题时所感知的障碍。
本定性研究采用扎根理论方法进行。在佛罗里达州,对 30 名国际认证哺乳顾问进行了深入访谈。哺乳顾问来自各种实践环境,包括医院、妇女、婴儿和儿童特别补充营养计划诊所、私人诊所和儿科办公室。数据以数字形式记录、转录,并在 Atlas.ti 中进行分析。
确定并分为以下几类/主题的一系列障碍:间接障碍(社会规范、知识、态度);直接职业障碍(制度约束、缺乏协调、服务提供不善);直接个人障碍(社会支持、母亲的自我效能感)。开发了一个模型,说明影响哺乳顾问在管理母乳喂养问题中的角色表现的因素。
由于各种医疗保健提供者和家庭之间缺乏协作,解决早期母乳喂养挑战的支持不足,情况更加复杂。研究结果深入了解了哺乳顾问在管理早期母乳喂养问题方面面临的专业管理问题。需要采取基于团队的、跨专业的方法来支持母亲及其家庭的母乳喂养;改善跨学科合作可以更好地整合接受过提供母乳喂养支持和管理母乳喂养问题方面的教育和经验的哺乳顾问。