Nurs Womens Health. 2022 Dec;26(6):420-428. doi: 10.1016/j.nwh.2022.09.003. Epub 2022 Oct 31.
To explore the perspectives of lactation support providers delivering breastfeeding education via in-person and telehealth consultations and assess the impact of COVID-19 on the provision of breastfeeding education.
Qualitative descriptive study using purposive sampling.
Massachusetts-based lactation support providers who provided in-person and/or telehealth consultations in various practice settings (e.g., inpatient; outpatient; private practice; and the Special Supplemental Nutrition Program for Women, Infants, and Children).
Fourteen Massachusetts-based lactation support providers, ages 36 to 68 years.
Participants completed an online demographic and employment characteristics survey and virtual key informant interviews, from which six main themes were defined.
The six main themes included Common Questions Asked by Clients, Prenatal and Postpartum Consultation Topics, Facilitators for Telehealth Versus In-Person Consultations, Barriers for Telehealth Versus In-Person Consultations, Best Practices, and COVID-19 Adaptations. From participant interviews, common subthemes emerged. The primary adaptation due to COVID-19 was shifting to telehealth. Content in lactation consultations was similar via in-person and telehealth sessions. Typical content areas included breast pumping and mother's milk supply. A notable difference was the lack of physical examinations for women and newborns in telehealth sessions. Scheduling flexibility was a key facilitator of telehealth consultations, whereas the inability to provide hands-on assistance and chaotic home environments were common barriers. In-person facilitators included weighing newborns to assess feeding success and insurance billing coverage, whereas unsupportive family members were noted as a barrier. Diversity, equity, and inclusion-related barriers (e.g., language barriers, lack of reflective diversity, lack of stable Internet access) were observed in both settings. Best practices for in-person and telehealth consultations included meeting mothers where they are and focusing on mothers' goals.
Practice adaptations adopted during the pandemic and best practice recommendations may be useful for lactation support providers and other health care professionals caring for breastfeeding dyads.
探索通过面对面和远程医疗咨询为母乳喂养教育提供支持的哺乳支持提供者的观点，并评估 COVID-19 对母乳喂养教育提供的影响。
使用目的抽样的定性描述性研究。
在马萨诸塞州的哺乳支持提供者，他们在各种实践环境中提供面对面和/或远程医疗咨询（例如住院；门诊；私人诊所；以及妇女、婴儿和儿童特别补充营养计划）。
14 名在马萨诸塞州的哺乳支持提供者，年龄在 36 岁至 68 岁之间。
参与者完成了在线人口统计学和就业特征调查以及虚拟关键信息提供者访谈，从中确定了六个主要主题。
六个主要主题包括客户常问的问题、产前和产后咨询主题、远程医疗与面对面咨询的促进因素、远程医疗与面对面咨询的障碍、最佳实践和 COVID-19 适应。从参与者的访谈中，出现了常见的子主题。由于 COVID-19 而主要的适应是转向远程医疗。面对面和远程医疗咨询的内容相似。典型的内容领域包括吸乳和母乳供应。一个显著的区别是在远程医疗咨询中没有对妇女和新生儿进行身体检查。远程医疗咨询的关键促进因素是日程安排的灵活性，而无法提供实际帮助和混乱的家庭环境则是常见的障碍。面对面咨询的促进因素包括为评估喂养成功而给新生儿称重和保险计费覆盖范围，而不支持的家庭成员则是一个障碍。在这两种环境中都观察到多样性、公平性和包容性相关的障碍（例如语言障碍、缺乏反思性多样性、缺乏稳定的互联网接入）。面对面和远程医疗咨询的最佳实践包括在母亲所在的地方与她们会面，并专注于母亲的目标。
大流行期间采用的实践适应和最佳实践建议可能对哺乳支持提供者和其他照顾母乳喂养对子的医疗保健专业人员有用。
