A Quasi-realist Synthesis Investigating Professional Breastfeeding Support Failure.

To conduct a synthesis based on a realist perspective, -investigating how professional breastfeeding support can sometimes be ineffective and/or unsatisfactory from the viewpoint of the mother and fail to address the needs of the breastfeeding dyad. An innovative, targeted "quasi-realist" -synthesis technique was used to explore the context of the interpersonal relationships through which professional breastfeeding intervention is delivered and identify any unintended mechanisms and/or consequences. Multiple expressions of failed breastfeeding support were revealed which had a negative impact on maternal empowerment, informed decision-making, and breastfeeding self-efficacy. The overarching theme, / , was elucidated by several subthemes: Mothers who experienced inadequate breastfeeding information/support often resorted to the mechanism of and withdrew from seeking or following further professional advice. Finally, unintended consequences of not breastfeeding as recommended included This was particularly true for mothers who intended to exclusively breastfeed. : The findings of this unique synthesis suggest that to sustain breastfeeding support relationships and prevent unintentional consequences of inadequate support, professionals must pay more attention to the manner in which breastfeeding intervention is provided. The findings also suggest that they must strive to provide more consistent, engaging, -sensitive, and nonjudgmental care that better meets the needs of breastfeeding dyads.