Centre of Expertise Health Innovation, UCLL Research & Expertise, University Colleges Leuven-Limburg.
Centre of Expertise Health Innovation, UCLL Research & Expertise, University Colleges Leuven-Limburg; Department of Development and Regeneration, KU Leuven, Belgium; Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Belgium.
Midwifery. 2019 Nov;78:50-57. doi: 10.1016/j.midw.2019.07.016. Epub 2019 Jul 15.
In Flanders, Belgium, 78.2% of the women exclusively breastfeed their babies following birth. However, after three months just one third of those babies is breastfed exclusively. This is in contrast with the WHO recommendations of a minimum of six months. Studies reveal that women are not always satisfied with the breastfeeding support they receive from their midwives, which can lead to early cessation of breastfeeding. The general aim of this study is to gain an in-depth understanding of the supporting role of midwives in breastfeeding support during the first two weeks after birth and compare it to the needs of the breastfeeding women.
A qualitative approach was used with an observational design and a focus group study. Two researchers performed non-participative observations in both hospital and primary healthcare settings. Midwife-mother interactions during breastfeeding support (midwives, n = 21; mothers, n = 59) were observed. Analysis of the data gathered from two focus groups with midwives (n = 10) and two focus groups with mothers (n = 9) provides an in-depth understanding of the supporting role of midwives during breastfeeding and helps to investigate whether that role corresponds to the mothers' needs both from the mothers' and the midwives' perspective. Observations and focus groups were analyzed using thematic analysis.
The analysis showed that both midwives and mothers want the breastfeeding to be a success. Generally, the production of breastmilk is a priority, for both the midwives and the mothers. Overall a hands-on approach regarding breastfeeding support was observed, mainly in the hospital settings when compared with the findings from the primary healthcare settings. A hands-on approach often occurs without asking the mother's consent. During the breastfeeding support, a professional relationship between the midwife and the mother is fostered. In primary healthcare there is one - to - one support which is contrary to hospital care, resulting in a personalized relationship. Breastfeeding support is influenced by personal (e.g. negative belief in breastfeeding policies) and external context factors (e.g. time restraints).
The research data revealed three topics on breastfeeding support by the midwife which were the focus, the approach and the relationship between the midwife and the mothers. The way the midwife provides this support varies due to the setting (hospital or primary health care) and due to personal convictions of midwives and mothers. The study shows the importance of providing breastfeeding support which is tailored to individual needs of the mother.
在比利时的弗兰德斯地区，78.2%的女性在产后完全母乳喂养婴儿。然而，仅仅三个月后，只有三分之一的婴儿仍在接受纯母乳喂养。这与世界卫生组织（WHO）建议的至少 6 个月母乳喂养时间相去甚远。研究表明，女性对产褥期保健护士提供的母乳喂养支持并不总是满意，这可能导致母乳喂养过早停止。本研究的总体目的是深入了解产褥期保健护士在产后头两周内对母乳喂养的支持作用，并将其与母乳喂养女性的需求进行比较。
采用定性研究方法，设计为观察性研究和焦点小组研究。两名研究人员在医院和基层医疗保健机构中进行了非参与式观察。观察了产褥期保健护士在母乳喂养支持期间与母亲的互动（护士 21 名，母亲 59 名）。对来自两个护士焦点小组（n=10）和两个母亲焦点小组（n=9）的数据分析提供了对产褥期保健护士支持作用的深入了解，并有助于从母亲和护士的角度调查该角色是否符合母亲的需求。观察和焦点小组的分析采用主题分析。
分析表明，护士和母亲都希望母乳喂养取得成功。一般来说，产奶量是护士和母亲的首要任务。总的来说，在医院环境中，观察到了一种对母乳喂养支持的积极方法，与基层医疗保健环境中的发现相比。这种积极的方法往往在未经母亲同意的情况下发生。在母乳喂养支持期间，护士和母亲之间建立了一种专业关系。在基层医疗保健中，存在一对一的支持，与医院护理相反，从而形成了一种个性化的关系。母乳喂养支持受到个人（例如对母乳喂养政策的负面信念）和外部环境因素（例如时间限制）的影响。
研究数据揭示了产褥期保健护士母乳喂养支持的三个重点：关注、方法和护士与母亲之间的关系。护士提供这种支持的方式因环境（医院或基层医疗保健）以及护士和母亲的个人信念而异。研究表明，提供量身定制的母乳喂养支持非常重要，以满足母亲的个人需求。
