Maternal and Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, Preston, UK.
School of Education, Health and Social Studies, Dalarna University, Högskolegatan 2, Falun, Sweden.
BMC Pregnancy Childbirth. 2020 Sep 29;20(1):569. doi: 10.1186/s12884-020-03245-8.
A lack of perceived social support influences women's infant feeding behaviours. The Infant Feeding Genogram is a visual co-constructed diagram which details people/services that can provide support to women and can facilitate a connection between mothers and their existing assets landscape. The aim of this study is to explore women's and infant feeding helpers' experiences and use of an infant feeding genogram delivered to the intervention group of the "Assets-based infant feeding help Before and After birth (ABA)" randomised feasibility trial.
103 primiparous mothers aged 16+ years were recruited to the trial (trial registration number) in two sites (Site A and Site B) with low breastfeeding prevalence in the UK. Infant feeding helpers (IFHs) co-constructed a genogram at the first antenatal meeting for the intervention group (n = 50), and then provided proactive, woman-centered support from ~ 32 weeks gestation to up to 5 months postnatal. Infant feeding helpers' and women's experiences of the infant feeding genogram were collected via interviews or focus groups. Completed genograms were shared with researchers. Content analysis of the genograms and qualitative data from the interviews and focus groups were analysed thematically.
Data comprised 32 completed genograms, and qualitative insights from all 13 infant feeding helpers (two focus groups; 4 interviews) and interviews with a purposive sample of 21 of 50 intervention group women between 4 and 21 weeks after birth. Content analysis of the genograms highlighted variations, with more personal, individualised genograms completed at Site B compared to Site A. The perceived impact of the genogram was related to the IFHs' application of the tool. The genogram was either used as intended to raise women's awareness of available assets and motivate help-seeking behaviour, or as a data collection tool with limited perceived utility. Negative and positive unintended consequences of genogram use were highlighted.
The genogram has the potential to offer a woman, family and community-centred approach that focusses on building assets for infant feeding. However, variations in genogram application indicate that revised training is required to clarify the purpose and ensure it is used as intended.
ISRCTN ISRCTN14760978 ; Registered 30 January 2017.
感知到的社会支持不足会影响妇女的婴儿喂养行为。婴儿喂养系谱图是一种直观的共同构建图表，详细描述了可以为妇女提供支持的人员/服务，并可以促进母亲与其现有资产环境之间的联系。本研究的目的是探讨妇女和婴儿喂养助手在“基于资产的婴儿喂养帮助（Assets-based infant feeding help）”随机可行性试验干预组中使用婴儿喂养系谱图的经验。
在英国母乳喂养率较低的两个地点（A 点和 B 点），招募了 103 名 16 岁以上的初产妇参加该试验（试验注册号）。干预组的婴儿喂养助手（IFH）在第一次产前会议上共同构建系谱图，然后从大约 32 周妊娠开始提供积极主动、以妇女为中心的支持，直到产后 5 个月。通过访谈或焦点小组收集婴儿喂养助手和妇女对婴儿喂养系谱图的经验。完成的系谱图与研究人员共享。对系谱图进行内容分析，并对访谈和焦点小组的定性数据进行主题分析。
数据包括 32 份完成的系谱图，以及 13 名婴儿喂养助手（两个焦点小组；4 次访谈）的全部定性见解，以及在产后 4 至 21 周之间对 50 名干预组妇女的有针对性样本进行的 21 次访谈。系谱图的内容分析突出了差异，B 点完成的系谱图更加个人化、个性化，而 A 点完成的系谱图则更少。系谱图的感知影响与 IFH 对工具的应用有关。系谱图的使用目的可以是提高妇女对可用资产的认识并激发寻求帮助的行为，也可以是作为数据收集工具，其感知效用有限。系谱图使用的负面和正面意外后果也被突出显示。
系谱图有可能提供以妇女、家庭和社区为中心的方法，侧重于为婴儿喂养建立资产。然而，系谱图应用的差异表明，需要进行修订培训以澄清目的并确保其按预期使用。
ISRCTN ISRCTN14760978；注册日期：2017 年 1 月 30 日。
