School of Pharmacy and Health Sciences, Creighton University, Omaha, NE, USA.
Center for the Child & Community, Children's Hospital & Medical Center, Lincoln, NE, USA.
Int Breastfeed J. 2021 Jul 12;16(1):52. doi: 10.1186/s13006-021-00401-4.
Early breastfeeding cessation is a societal concern given its importance to the health of mother and child. More effective interventions are needed to increase breastfeeding duration. Prior to developing such interventions more research is needed to examine breastfeeding supports and barriers from the perspective of breastfeeding stakeholders. One such framework that can be utilized is the Socio-Ecological Model which stems from Urie Broffenbrenner's early theoretical frameworks (1973-1979). The purpose of this study was to examine supports and barriers to breastfeeding across environmental systems.
A total of 49 representatives participated in a telephone interview in Nebraska, USA in 2019. Interviewees represented various levels of the model, based on their current breastfeeding experience (i.e., mother or significant other) or occupation. A direct content analysis was performed as well as a constant comparative analysis to determine differences between level representatives.
At the Individual level, breastfeeding is a valued behavior, however, women are hindered by exhaustion, isolation, and the time commitment of breastfeeding. At the Interpersonal level, social media, peer-to-peer, and family were identified as supports for breastfeeding, however lack of familial support was also identified as a barrier. At the community level, participants were split between identifying cultural acceptance of breastfeeding as support or barrier. At the organizational level, hospitals had supportive breastfeeding friendly policies in place however lacked enough personnel with breastfeeding expertise. At the policy level, breastfeeding legislation is supportive, however, more specific breastfeeding legislation is needed to ensure workplace breastfeeding protections.
Future efforts should target hospital-community partnerships, family-centered education, evidence-based social media strategies and improved breastfeeding legislation to ensure breastfeeding women receive effective support throughout their breastfeeding journey.
鉴于母乳喂养对母婴健康的重要性，早期停止母乳喂养是一个社会关注的问题。需要更有效的干预措施来延长母乳喂养时间。在开发此类干预措施之前，需要更多的研究从母乳喂养利益相关者的角度来检查母乳喂养的支持和障碍。可以利用的一个这样的框架是社会生态模型，它源自 Urie Broffenbrenner 的早期理论框架（1973-1979 年）。本研究的目的是检查整个环境系统中的母乳喂养支持和障碍。
2019 年，共有 49 名代表参加了在美国内布拉斯加州的电话访谈。根据他们目前的母乳喂养经验（即母亲或重要他人）或职业，受访者代表了模型的各个层次。进行了直接内容分析和恒定比较分析，以确定不同层次代表之间的差异。
在个人层面上，母乳喂养是一种有价值的行为，但女性会因疲惫、孤立和母乳喂养的时间投入而受到阻碍。在人际层面上，社交媒体、同伴对同伴和家庭被确定为母乳喂养的支持，但也发现缺乏家庭支持是一个障碍。在社区层面上，参与者对文化上接受母乳喂养是支持还是障碍存在分歧。在组织层面上，医院已经制定了支持母乳喂养的友好政策，但缺乏具有母乳喂养专业知识的足够人员。在政策层面上，母乳喂养立法是支持的，但需要更具体的母乳喂养立法来确保工作场所的母乳喂养保护。
未来的工作应针对医院-社区伙伴关系、以家庭为中心的教育、基于证据的社交媒体策略和改善母乳喂养立法，以确保母乳喂养的女性在整个母乳喂养过程中得到有效的支持。
