Does Continuity of Care by Well-Trained Breastfeeding Counselors Improve a Mother's Perception of Support?

Authors

  • Anette Ekström RNM, PhD,

    Corresponding author
    1. Anette Ekström and Eva Nissen are Senior Lecturers at the School of Life Sciences, University of Skövde, Skövde, and Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm; and Ann-Marie Widström is Associate Professor in the Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Sweden.
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  • Ann-Marie Widström RNMTD,

    1. Anette Ekström and Eva Nissen are Senior Lecturers at the School of Life Sciences, University of Skövde, Skövde, and Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm; and Ann-Marie Widström is Associate Professor in the Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Sweden.
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  • Eva Nissen RNMTD, PhD

    1. Anette Ekström and Eva Nissen are Senior Lecturers at the School of Life Sciences, University of Skövde, Skövde, and Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm; and Ann-Marie Widström is Associate Professor in the Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Sweden.
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  • This study was supported by the Skaraborg Institute for Research and Development, School of Life Sciences of the University of Skövde, the Primary Care Unit in Skaraborg and the Science Committee, Central Hospital, Skövde, and the Board of Research for Health and Caring Sciences, Swedish Research Council, Sweden (grants K1999-27P-13085-01A, and K2001-27P-13085-036).

* Anette Ekström, RNM, School of Life Sciences, University of Skövde, Box 408, SE 541 28 Skövde, Sweden.

Abstract

Abstract: Background:Social support has been shown to be greatly important for breastfeeding success. The objective of this study was to investigate if mothers who were attended by midwives and nurses specially trained in breastfeeding counseling perceived better continuity of care and emotional and informative breastfeeding support than mothers who received only routine care. Method:Ten municipalities, each with an antenatal center and child health center, in southwest Sweden were randomized either to intervention or control municipalities. The intervention included a process-oriented training in breastfeeding counseling and continuity of care at the antenatal and child health centers. Primiparas were asked to evaluate the care given, and those living in the control municipalities were divided into control groups A and B. Data collection took place at different points in time for the two control groups. The 540 mothers responded to 3 questionnaires at 3 days and at 3 and 9 months postpartum. The perception of support provided by the health professionals and from the family classes was rated on Likert scales. Results:Intervention group mothers rated the breastfeeding information given during the family class as significantly better during pregnancy than both control groups, and better than control group B mothers at 3 months postpartum; compared with both control groups, intervention group mothers perceived that they received significantly better overall support and that postnatal nurses provided better information about breastfeeding and the baby's needs. At 9 months, intervention group mothers were more satisfied with knowledge about social rights, information about the baby's needs, and their social network than control group B mothers. Both intervention group and control group B mothers perceived better overall support than control group A during pregnancy. At 3 and 9 months, intervention group mothers perceived that postnatal nurses were more sensitive and understanding compared with both control groups. Conclusions:After implementation of a process-oriented breastfeeding training program for antenatal midwives and postnatal nurses that included an intervention guaranteeing continuity of care, the mothers were more satisfied with emotional and informative support during the first 9 months postpartum. The results lend support to family classes incorporating continuity of care. (BIRTH 33:2 June 2006)

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