Abstract
Objective
The purpose of this qualitative study was to identify those attitudes and actions by healthcare professionals that detracted from the breastfeeding mother's confidence in nursing her infant.
Methods
The subjects of this research were a convenience sample of 40 mothers: 35 were recruited at a breastfeeding counseling room at a nursing college in Tokyo and five from a sibling preparation class at the same location. Data were collected from August through November 2007 following established ethical procedures. Researchers used semi-structured interviews about problems and coping with breastfeeding and providing nutrition for their infant. All interviews were taped and transcribed. The data were systematically analyzed. Codes were extracted and then aggregated into sub-categories from which categories were created. A research team provided conformability.
Results
Regarding breastfeeding support, the interviews revealed that some interactions with health care professionals were described as: "unhelpful", "causing anxiety", and "results in confusion". Identified were five categories of behavior of healthcare professionals that failed to support the breastfeeding mother thus, contributing her sense of confusion and anxiety about nursing her infant: (i) intrusive behavior of healthcare professionals dismissing the mother's wishes and intentions to breastfeed, (ii) insufficient help to become independent with breastfeeding, (iii) dismissing the mothers' feelings, (iv) discordant advice from the mothers' expectation, and (v) provision of inconsistent information. Mothers desired to institute frequent breastfeeding including the addition of human milk substitute provided by healthcare professionals. Unfortunately those health care providers did not listen?to their requests nor did they?respond?empathically to?the?mother's sense?of?suffering?and anxiety of breastfeeding and the child?rearing. Mothers choose to breastfeed; they felt a sense of commitment to providing the best nutrition that could to protect their infants. The lack of support and concern by health care providers left mothers with a burden of regret and a sense of failure about their ability to breastfeed. The sense of failure continued after discharge and they continued to experience challenges?and?difficulties about their breastfeeding or expression?of?their milk at home. Mothers were left alone to manage their breastfeeding problems.
Conclusions
Women were motivated to breastfeed but their interactions with health care providers resulted in feelings of failure, confusion and anxiety. Health care providers need education to promote: (i) mother-driven support considering mother's intentions, (ii) support for mothers to be independent breast-feeders, (iii) empathy for the mother's feelings, (iv) adequate observation and assessment ability, and (v) provision of consistent information based on an evidence.
