Efforts to provide accessible and effective infant feeding support are advancing to set up new families to meeting their goals. However, data continue to be limited for understanding how inpatient postpartum support and experiences contribute to exclusive breastfeeding during hospitalization.
Research Aims:
To explore postnatal unit experiences including skin-to-skin contact, overnight support, rooming-in, responsive clinicians, and understandable communication that correlate with early infant feeding outcomes among a sample of mothers who intended to breastfeed.
Methods:
This was a prospective cross-sectional survey study. Through secure online survey, participants submitted (N = 2,401) responses from November 2016 to May 2017 about their experiences with maternity healthcare and offered thoughts on the postnatal unit environment. Descriptive statistics were used to examine distributions of maternal characteristics, postpartum experience, and birthing facility characteristics.
Results:
Exclusive breastfeeding was positively correlated with the following postnatal unit experiences: mother did not ask that her infant be taken out of the postnatal unit room; infant staying in postnatal unit room except for treatment(s); mother got help from clinical staff when needed after pressing the call button; and nurse, midwife, and/or doctor always explained information to mother in ways that they understood.
Conclusion:
Postnatal unit experiences associated with exclusive breastfeeding during postpartum hospitalization were rooming in; parents who did not ask for their infant to be taken out of the unit room; whether mothers received timely help from clinical staff; and information was explained in a way they could understand.
AsioduI. V.BuggK.PalmquistA. E. L. (2021). Achieving breastfeeding equity and justice in Black communities: Past, present, and future. Breastfeeding Medicine, 16(1), https://doi.org/10.1089/bfm.2020.0314
Baby-Friendly USA, Inc. (2021b). Guidelines and evaluation criteria for facilities seeking Baby-Friendly designation (6th Ed.). Baby-Friendly USA.
5.
BartickM. C.SchwarzE. B.GreenB. D.JegierB. J.ReinholdA. G.ColaizyT. T.BogenD. L.SchaeferA. J.StuebeA. M. (2017). Suboptimal breastfeeding in the United States: Maternal and pediatric health outcomes and costs. Maternal and Child Nutrition, 13(1), e12366. https://doi.org/10.1111/mcn.12450
6.
BartickM. C.ValdésV.GiustA.ChapinE. M.BhanaN. B.Hernández-AguilarM.-T.DuarteE. D.JenkinsL.GaughanJ.Feldman-WinterL. (2021). Maternal and infant outcomes associated with maternity practices related to COVID-19: The COVID Mothers Study. Breastfeeding Medicine, 16(3), 189–199. https://doi.org/10.1089/bfm.2020.0353
7.
BiggsK. V.HurrellK.MatthewsE.KhalevaE.MunblitD.BoyleR. J. (2018). Formula milk supplementation on the postnatal ward: A cross-sectional analytical study. Nutrients, 10(5), 608. https://doi.org/10.3390/nu10050608
8.
BobanM.Zakarija-GrkovićI. (2016). In-hospital formula supplementation of healthy newborns: Practices, reasons, and their medical justification. Breastfeeding Medicine, 11(9), 448–454. https://doi.org/10.1089/bfm.2016.0039
9.
BrockwayM.BenziesK.HaydenK. A. (2017). Interventions to improve breastfeeding self-efficacy and resultant breastfeeding rates: A systematic review and meta-Analysis. Journal of Human Lactation, 33(3), 486–499. https://doi.org/10.1177/0890334417707957
10.
BrownA.ShenkerN. (2021). Experiences of breastfeeding during COVID-19: Lessons for future practical and emotional support. Maternal and Child Nutrition, 17(1), e13088-n/a. https://doi.org/10.1111/mcn.13088
ChiangK. V.LiR.AnsteyE. H.PerrineC. G. (2021). Racial and ethnic disparities in breastfeeding initiation—United States, 2019. MMWR. Morbidity and Mortality Weekly Report, 70(21), 769–774. https://doi.org/10.15585/mmwr.mm7021a1
13.
ColomboL.CrippaB. L.ConsonniD.BettinelliM. E.AgostiV.ManginoG.BezzeE. N.MauriP. A.ZanottaL.RoggeroP.PlevaniL.BertoliD.GiannìM. L.MoscaF. (2018). Breastfeeding determinants in healthy term newborns. Nutrients, 10(1), 48. https://doi.org/10.3390/nu10010048
14.
Crear-PerryJ.MaybankA.KeeysM.MitchellN.GodboltD. (2020). Moving towards anti-racist praxis in medicine. The Lancet, 396(10249), 451–453. https://doi.org/10.1016/S0140-6736(20)31543-9
15.
CrippaB. L.ConsalesA.MorniroliD.LunettoF.BettinelliM. E.SanninoP.RampiniS.ZanottaL.MarchisioP.PlevaniL.GiannìM. L.MoscaF.ColomboL. (2021). From dyad to triad: A survey on fathers’ knowledge and attitudes toward breastfeeding. European Journal of Pediatrics, 180(9), 2861–2869. https://doi.org/10.1007/s00431-021-04034-x
16.
Eagen-TorkkoM. (2019). Concordance as a person-centered measure of breastfeeding success: From adequacy to agency. Journal of Midwifery & Women’s Health, 64(6), 749–753. https://doi.org/10.1111/jmwh.13036
17.
EdmondsJ. K.DeclercqE.SakalaC. (2021). Women’s childbirth experiences: A content analysis from the Listening to Mothers in California Survey. Birth, 48(2), 221–229. https://doi.org/10.1111/birt.12531
18.
FaheyJ. O.ShenassaE. (2013). Understanding and meeting the needs of women in the postpartum period: The perinatal maternal health promotion model. Journal of Midwifery & Women’s Health, 58(6), 613–621. https://doi.org/10.1111/jmwh.12139
19.
Feldman-WinterL.UstianovJ.AnastasioJ.Butts-DionS.HeinrichP.MerewoodA.BuggK.Donohue-RolfeS.HomerC. J. (2017). Best fed beginnings: A nationwide quality improvement initiative to increase breastfeeding. Pediatrics, 140(1), e20163121. https://doi.org/10.1542/peds.2016-3121
20.
GianniM. L.BettinelliM. E.ManfraP.SorrentinoG.BezzeE.PlevaniL.CavallaroG.RaffaeliG.CrippaB. L.ColomboL.MorniroliD.LiottoN.RoggeroP.VillamorE.MarchisioP.MoscaF. (2019). Breastfeeding difficulties and risk for early breastfeeding cessation. Nutrients, 11(10), 2266. https://doi.org/10.3390/nu11102266
21.
GrayK. D.HannonE. A.EricksonE.StewartA. B.WoodC. T.FisherK.ShaikhS. K.TanakaD. (2021). Influence of early lactation assistance on inpatient exclusive breastfeeding rates. Journal of Human Lactation, 37(3), 556–565. https://doi.org/10.1177/0890334420957967
22.
GutschowK.Davis-FloydR. (2021). The impacts of COVID-19 on US maternity care practices: A followup study. Frontiers in Sociology, 6, 655401. https://doi.org/10.3389/fsoc.2021.655401
23.
HemingwayS.Forson-DareZ.EbelingM.TaylorS. N. (2021). Racial disparities in sustaining breastfeeding in a baby-friendly designated southeastern united states hospital: An opportunity to investigate systemic racism. Breastfeeding Medicine, 16(2), 150–155. https://doi.org/10.1089/bfm.2020.0306
24.
JeffersonU. T.BloomT. L.LewisK. R. (2021). Infant feeding exposure and personal experiences of African American mothers. Breastfeeding Medicine, 16(2), 124–130. https://doi.org/10.1089/bfm.2020.0073
25.
JungS.NobariT. Z.WhaleyS. E. (2019). Breastfeeding outcomes among WIC-participating infants and their relationships to baby-friendly hospital practices. Breastfeeding Medicine, 14(6), 424–431. https://doi.org/10.1089/bfm.2019.0004
26.
LabbokM. H.StarlingA. (2012). Definitions of breastfeeding: Call for the development and use of consistent definitions in research and peer-reviewed literature. Breastfeeding Medicine, 7(6), 397–402. https://doi.org/10.1089/bfm.2012.9975
27.
McCarterD.MacLeodC. E. (2019). What do women want? Looking beyond patient satisfaction. Nursing for Women’s Health, 23(6), 478–484. https://doi.org/10.1016/j.nwh.2019.09.002
28.
MerewoodA.BuggK.BurnhamL.KraneK.NickelN.BroomS.EdwardsR.Feldman-WinterL. (2019). Addressing racial inequities in breastfeeding in the southern United States. Pediatrics, 143(2), e20181897. https://doi.org/10.1542/peds.2018-1897
29.
MunnA. C.NewmanS. D.PhillipsS. M.MuellerM.TaylorS. N. (2018). Factors influencing southeastern U.S. mothers’ participation in baby-friendly practices: A mixed- methods study. Journal of Human Lactation, 34(4), 821–834. https://doi.org/10.1177/0890334417750143
30.
MooreE. R.BergmanN.AndersonG. C.MedleyN. (2016). Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews, 11(11), CD003519–CD003519. https://doi.org/10.1002/14651858.CD003519.pub4
31.
O’ConnorM.AllenJ.KellyJ.GaoY.KildeaS. (2018). Predictors of breastfeeding exclusivity and duration in a hospital without baby friendly hospital initiative accreditation: A prospective cohort study. Women and Birth, 31(4), 319–324. https://doi.org/10.1016/j.wombi.2017.10.013
32.
OgboF. A.EzehO. K.KhanlariS.NazS.SenanayakeP.AhmedK. Y.McKenzieA.OgunsijiO.AghoK.PageA.UssherJ.PerzJ.BarnettB. A. M.EastwoodJ. (2019). Determinants of exclusive breastfeeding cessation in the early postnatal period among culturally and linguistically diverse (CALD) Australian mothers. Nutrients, 11(7), 1611. https://doi.org/10.3390/nu11071611
33.
Pérez-EscamillaR.MartinezJ. L.Segura-PérezS. (2016). Impact of the baby-friendly hospital initiative on breastfeeding and child health outcomes: A systematic review. Maternal and Child Nutrition, 12(3), 402–417. https://doi.org/10.1111/mcn.12294
34.
PerrineC. G.ChiangK. V.AnsteyE. H.GrokkniklausD. A.BoundyE. O.Sauber-SchatzE. K.NelsonJ. M. (2020). Implementation of hospital practices supportive of breastfeeding in the context of COVID-19 – United States, July 15–August 20, 2020. Morbidity and Mortality Weekly Report, 69(47), 1767–1770. http://dx.doi.org/10.15585/mmwr.mm6947a3
35.
PoundsL.ShostromV. (2018). Analyzing factors that impact breastfeeding duration in the postpartum period: A secondary analysis of PRAMS data. Breastfeeding Medicine, 13(5), 335–340. https://doi.org/10.1089/bfm.2018.0020
36.
SchliepK. C.DenhalterD.GrenL. H.PanushkaK. A.SinghT. P.VarnerM. W. (2019). Factors in the hospital experience associated with postpartum breastfeeding success. Breastfeeding Medicine, 14(4), 334–341. https://doi.org/10.1089/bfm.2018.0039
37.
SebastianR. A.CoronadoE.OteroM. D.McKinneyC. R.RamosM. M. (2019). Associations between maternity care practices and 2-month breastfeeding duration vary by race, ethnicity, and acculturation. Maternal and Child Health Journal, 23(6), 858–867. https://doi.org/10.1007/s10995-018-02711-2
38.
SipsmaH. L.RabinowitzM. R.YoungD.PhillipiC.LarsonI. A.KairL. R. (2019). Exposure to hospital breastfeeding support by maternal race and ethnicity: A pilot study. Journal of Midwifery & Women’s Health, 64(6), 743–748. https://doi.org/10.1111/jmwh.13048
39.
StuebeA. M.JegierB. J.SchwarzE. B.GreenB. D.ReinholdA. G.ColaizyT. T.BogenD. L.SchaeferA. J.JegierJ. T.GreenN. S.BartickM. C. (2017). An online calculator to estimate the impact of changes in breastfeeding rates on population health and costs. Breastfeeding Medicine, 12(10), 645–658. https://doi.org/10.1089/bfm.2017.0083
40.
TullyK. P.StuebeA. M.VerbiestS. B. (2017). The fourth trimester: A critical transition period with unmet maternal health needs. American Journal of Obstetrics and Gynecology, 217(1), 37–41. https://doi.org/10.1016/j.ajog.2017.03.032
41.
VerbiestS.TullyK.P.SimpsonM.StuebeA.M. (2018). Elevating mothers’ voices: Recommendations for improved patient-centered postpartum. Journal of Behavioral Medicine, 41(5), 577–590. https://doi.org/10.1007/s10865-018-9961-4
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