Women’s Perceptions and Experiences of Breastfeeding Support: A Metasynthesis

Authors

  • Virginia Schmied PhD, MA (Hons), RM,

    1. Virginia Schmied is an Associate Professor (Maternal and Child Health) in the School of Nursing and Midwifery, University of Western Sydney, New South Wales, Australia; Sarah Beake is a Research Associate in the Florence Nightingale School of Nursing and Midwifery, Kings College, London, United Kingdom; Athena Sheehan is a Senior Lecturer in the Faculty of Nursing and Health, Avondale College, and Adjunct Fellow in the School of Nursing and Midwifery, University of Western Sydney, New South Wales, Australia; Christine McCourt is a Professor of Maternal and Child Health in the City University, London, United Kingdom; and Fiona Dykes is a Professor of Maternal and Infant Health and Director of Maternal and Infant Nutrition and Nurture Unit, School of Public Health and Clinical Sciences, University of Central Lancashire, United Kingdom, and Adjunct Professor, University of Western Sydney, New South Wales, Australia.
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  • Sarah Beake MA, RM, RN,

    1. Virginia Schmied is an Associate Professor (Maternal and Child Health) in the School of Nursing and Midwifery, University of Western Sydney, New South Wales, Australia; Sarah Beake is a Research Associate in the Florence Nightingale School of Nursing and Midwifery, Kings College, London, United Kingdom; Athena Sheehan is a Senior Lecturer in the Faculty of Nursing and Health, Avondale College, and Adjunct Fellow in the School of Nursing and Midwifery, University of Western Sydney, New South Wales, Australia; Christine McCourt is a Professor of Maternal and Child Health in the City University, London, United Kingdom; and Fiona Dykes is a Professor of Maternal and Infant Health and Director of Maternal and Infant Nutrition and Nurture Unit, School of Public Health and Clinical Sciences, University of Central Lancashire, United Kingdom, and Adjunct Professor, University of Western Sydney, New South Wales, Australia.
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  • Athena Sheehan PhD, MN, RM,

    1. Virginia Schmied is an Associate Professor (Maternal and Child Health) in the School of Nursing and Midwifery, University of Western Sydney, New South Wales, Australia; Sarah Beake is a Research Associate in the Florence Nightingale School of Nursing and Midwifery, Kings College, London, United Kingdom; Athena Sheehan is a Senior Lecturer in the Faculty of Nursing and Health, Avondale College, and Adjunct Fellow in the School of Nursing and Midwifery, University of Western Sydney, New South Wales, Australia; Christine McCourt is a Professor of Maternal and Child Health in the City University, London, United Kingdom; and Fiona Dykes is a Professor of Maternal and Infant Health and Director of Maternal and Infant Nutrition and Nurture Unit, School of Public Health and Clinical Sciences, University of Central Lancashire, United Kingdom, and Adjunct Professor, University of Western Sydney, New South Wales, Australia.
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  • Christine McCourt PhD, BA,

    1. Virginia Schmied is an Associate Professor (Maternal and Child Health) in the School of Nursing and Midwifery, University of Western Sydney, New South Wales, Australia; Sarah Beake is a Research Associate in the Florence Nightingale School of Nursing and Midwifery, Kings College, London, United Kingdom; Athena Sheehan is a Senior Lecturer in the Faculty of Nursing and Health, Avondale College, and Adjunct Fellow in the School of Nursing and Midwifery, University of Western Sydney, New South Wales, Australia; Christine McCourt is a Professor of Maternal and Child Health in the City University, London, United Kingdom; and Fiona Dykes is a Professor of Maternal and Infant Health and Director of Maternal and Infant Nutrition and Nurture Unit, School of Public Health and Clinical Sciences, University of Central Lancashire, United Kingdom, and Adjunct Professor, University of Western Sydney, New South Wales, Australia.
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  • Fiona Dykes PhD, MA, RM

    1. Virginia Schmied is an Associate Professor (Maternal and Child Health) in the School of Nursing and Midwifery, University of Western Sydney, New South Wales, Australia; Sarah Beake is a Research Associate in the Florence Nightingale School of Nursing and Midwifery, Kings College, London, United Kingdom; Athena Sheehan is a Senior Lecturer in the Faculty of Nursing and Health, Avondale College, and Adjunct Fellow in the School of Nursing and Midwifery, University of Western Sydney, New South Wales, Australia; Christine McCourt is a Professor of Maternal and Child Health in the City University, London, United Kingdom; and Fiona Dykes is a Professor of Maternal and Infant Health and Director of Maternal and Infant Nutrition and Nurture Unit, School of Public Health and Clinical Sciences, University of Central Lancashire, United Kingdom, and Adjunct Professor, University of Western Sydney, New South Wales, Australia.
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  • The design and conduct of this metasynthesis was partly supported by an international research initiative scheme grant from the University of Western Sydney, Sydney, Australia.

Address correspondence to Virginia Schmied, School of Nursing and Midwifery, Building EB LG 08 Parramatta Campus, Penrith South Dc 1797, Penrith NSW 17997, Australia.

Abstract

Abstract:  Background:  Both peer and professional support have been identified as important to the success of breastfeeding. The aim of this metasynthesis was to examine women’s perceptions and experiences of breastfeeding support, either professional or peer, to illuminate the components of support that they deemed “supportive.”

Methods:  The metasynthesis included studies of both formal or “created” peer and professional support for breastfeeding women but excluded studies of family or informal support. Qualitative studies were included as well as large-scale surveys if they reported the analysis of qualitative data gathered through open-ended responses. Primiparas and multiparas who initiated breastfeeding were included. Studies published in English, in peer-reviewed journals, and undertaken between January 1990 and December 2007 were included. After assessment for relevance and quality, 31 studies were included. Meta-ethnographic methods were used to identify categories and themes.

Results:  The metasynthesis resulted in four categories comprising 20 themes. The synthesis indicated that support for breastfeeding occurred along a continuum from authentic presence at one end, perceived as effective support, to disconnected encounters at the other, perceived as ineffective or even discouraging and counterproductive. A facilitative approach versus a reductionist approach was identified as contrasting styles of support that women experienced as helpful or unhelpful.

Conclusions:  The findings emphasize the importance of person-centered communication skills and of relationships in supporting a woman to breastfeed. Organizational systems and services that facilitate continuity of caregiver, for example continuity of midwifery care or peer support models, are more likely to facilitate an authentic presence, involving supportive care and a trusting relationship with professionals. (BIRTH 38:1 March 2011)

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