Schafer Ellen J, Buch Elana D, Campo Shelly, Ashida Sato
a Department of Community and Environmental Health , Boise State University College of Health Sciences , Boise , Idaho , USA.
b Department of Anthropology , University of Iowa , Iowa City , Iowa , USA.
Women Health. 2019 Apr;59(4):449-463. doi: 10.1080/03630242.2018.1487904. Epub 2018 Aug 17.
While most mothers initiate breastfeeding, many do not continue for recommended durations. This study aimed to understand the gap between breastfeeding initiation and duration through an in-depth exploration of first-time mothers' breastfeeding experiences. Contextual factors that may facilitate or deter breastfeeding maintenance were explored by identifying common turning points (significant events or periods promoting a change in thoughts/behaviors or facilitating maintenance) described by mothers with varied breastfeeding durations. In semistructured interviews conducted from March to June 2015, twenty-eight first-time mothers in Iowa were asked to describe their breastfeeding experiences from initiation through cessation. Using thematic analysis, seven turning points, consistent across varied durations and experiences were identified: breastfeeding problems, the unknowns, recurring stressors, living new life with baby, reentering social roles, special occasions, and letting go. Turning points were usually associated with stressful situations, and mothers described intrapersonal (e.g., determination) and interpersonal (e.g., social support) coping resources as facilitators of breastfeeding maintenance. These findings highlight contextual factors that may trigger turning points, representing critical intervention periods, and the importance of enhancing support networks. Interventions to facilitate longer breastfeeding durations should consider key turning points and availability of coping resources to determine strategies that best fit the mother at each point.
虽然大多数母亲开始进行母乳喂养，但许多人并未按照推荐的时长持续下去。本研究旨在通过深入探究初产妇的母乳喂养经历，了解母乳喂养开始与持续时间之间的差距。通过识别不同母乳喂养时长的母亲所描述的共同转折点（促进思想/行为改变或维持母乳喂养的重大事件或时期），探讨了可能促进或阻碍母乳喂养维持的背景因素。在2015年3月至6月进行的半结构化访谈中，爱荷华州的28位初产妇被要求描述她们从开始母乳喂养到停止的经历。通过主题分析，确定了七个在不同时长和经历中一致的转折点：母乳喂养问题、未知因素、反复出现的压力源、与宝宝一起开始新生活、重新进入社会角色、特殊场合以及放手。转折点通常与压力情境相关，母亲们将个人内部（如决心）和人际间（如社会支持）的应对资源描述为母乳喂养维持的促进因素。这些发现突出了可能引发转折点的背景因素，这些因素代表了关键的干预期，以及加强支持网络的重要性。促进更长母乳喂养时长的干预措施应考虑关键转折点和应对资源的可用性，以确定在每个阶段最适合母亲的策略。
