Support to breastfeeding women

Sammanfattning: Breastfeeding has important health benefits for mothers and infants in high- and low-income countries. For that reason, the World Health Organization (WHO) recommends exclusive breastfeeding for six months and partial breastfeeding for two years or longer. During pregnancy, a majority of women state that they intend to breastfeed, but they often stop earlier than they want because they face many barriers. Thus, it is important that women get the opportunity to breastfeed as long as they want. The overall aim of this thesis was to explore women’s perceptions of what assisted them in breastfeeding and their advice to healthcare professionals regarding breastfeeding support. An additional aim was to evaluate a breastfeeding support programme based on the Ten Steps to Successful Breastfeeding and the WHO’s recommendations on breastfeeding. In Paper I, an exploratory qualitative design was used based on the critical incident technique. The main finding was that supporting women to continue breastfeeding is both complex and multifaceted. In Paper II, an exploratory qualitative design illuminated that Swedish women advised healthcare professionals to provide up-to-date and evidence-based breastfeeding support in a sensitive and individualised manner to help the mothers to reach their breastfeeding goals. In Paper III, a breastfeeding training programme was evaluated using a pre-post design. The programme improved midwives’ and child healthcare nurses’ self-efficacy to provide evidence-based support in line with the Ten Steps to Successful Breastfeeding and the WHO’s recommendations on breastfeeding. Paper IV used an exploratory, longitudinal and qualitative design. Specifically, the study showed that partners who participated in the breastfeeding support programme and received structured support felt that both parents were important. They felt involved and that the family cooperated in the breastfeeding process. In conclusion, it is crucial to understand families’ perceptions and experiences of breastfeeding when supporting women to breastfeed. Midwives and child healthcare nurses have important roles to play by providing structured breastfeeding support during the breastfeeding process. The whole family must be targeted to decrease the partner’s feelings of being excluded. Both parents must be involved in a reflective dialogue, where healthcare professionals explain how breastfeeding works and how the partner can be involved without bottle-feeding the infant.