Lyons Stephanie, Currie Sinead, Peters Sarah, Lavender Dame Tina, Turnbull Emilie, Bhatia Ria, Khan Zaynab, Smith Debbie M
Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK.
Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, UK.
Int Breastfeed J. 2025 Apr 10;20(1):29. doi: 10.1186/s13006-025-00720-w.
Breastfeeding has many health benefits for both mother and child, but rates of initiation and duration amongst women with a BMI ≥ 30 kg/m are low. Few interventions aiming to increase breastfeeding in this group have been successful; likely because existing interventions do not target psychological factors. Therefore, this study aimed to design and explore the acceptability of a newly developed psychological intervention to increase breastfeeding initiation and duration in women with a BMI ≥ 30 kg/m.
The Medical Research Council's Complex Intervention Development Framework was followed to design the intervention. A 'breastfeeding workbook' was developed, based on literature and psychological theory, and filled with tailored information and activities. A Patient and Public Involvement group of women with a BMI ≥ 30 kg/m who had breastfed, health professionals and researchers were consulted throughout the process, selecting the intervention content, format and delivery methods. Thirteen women with a BMI ≥ 30 kg/m then reviewed the workbook and took part in in-depth qualitative interviews to assess its acceptability. Thematic analysis was conducted, informed by the Theoretical Framework of Acceptability version 2.
The findings reveal the intervention is acceptable to the target population; women believe the intervention shows promise for increasing breastfeeding initiation and duration, is representative of their experiences, is accessible, and aligns with their belief system. They valued that the intervention provided realistic expectations of breastfeeding, options to overcome the challenges of breastfeeding in the real-world and supported them to breastfeed without inducing stigma or shame regarding their weight or infant feeding practices. Suggestions for improvement are also included, such as incorporating audio and video content as alternatives to written text and translation options.
An acceptable, psychological intervention was developed to increase breastfeeding initiation and duration in women with BMIs ≥ 30 kg/m. These findings can inform maternity and breastfeeding care, future research directions and intervention development.
母乳喂养对母亲和孩子都有诸多健康益处，但体重指数（BMI）≥30kg/m²的女性的母乳喂养起始率和持续时间较低。旨在提高该群体母乳喂养率的干预措施很少取得成功；可能是因为现有的干预措施没有针对心理因素。因此，本研究旨在设计并探索一种新开发的心理干预措施对BMI≥30kg/m²的女性增加母乳喂养起始率和持续时间的可接受性。
遵循医学研究理事会的复杂干预开发框架来设计干预措施。基于文献和心理学理论编制了一本“母乳喂养工作手册”，其中包含量身定制的信息和活动。在整个过程中咨询了一个由BMI≥30kg/m²且有过母乳喂养经历的女性、健康专业人员和研究人员组成的患者及公众参与小组，以选择干预内容、形式和实施方法。然后，13名BMI≥30kg/m²的女性对该工作手册进行了评估，并参与了深入的定性访谈以评估其可接受性。采用可接受性理论框架第2版进行主题分析。
研究结果表明该干预措施为目标人群所接受；女性认为该干预措施有望提高母乳喂养起始率和持续时间，代表了她们的经历，易于获取，并且与她们的信仰体系相符。她们重视该干预措施对母乳喂养提供了现实的期望，提供了在现实世界中克服母乳喂养挑战的选择，并支持她们进行母乳喂养，而不会因体重或婴儿喂养方式而产生耻辱感或羞愧感。还包括改进建议，例如纳入音频和视频内容作为书面文本的替代形式以及翻译选项。
开发了一种可接受的心理干预措施，以提高BMI≥30kg/m²的女性的母乳喂养起始率和持续时间。这些研究结果可为孕产和母乳喂养护理、未来研究方向及干预措施开发提供参考。
