Supporting the Breastfeeding Mother
Published: 08 January 2020
Published: 08 January 2020
The first few days following birth offer precious opportunities to help new mothers establish confidence in breastfeeding.
Mothers who have physical and emotional support during this period are known to be more successful and experience fewer difficulties (Hunter and Cattelona 2014).
They are also more likely to reach the suggested goal of exclusive breastfeeding for six months, as suggested by WHO (World Health Organization).
Both WHO and UNICEF recommend:
(World Health Organization 2019)
However, these are stringent requirements for mothers to meet and failure to breastfeed can leave many mothers feeling inadequate, and leave midwives wondering what more they could have done.
So how can mothers be helped to breastfeed for as long as possible?
Current UK guidance recommends that all mothers attempt to breastfeed their babies for the first six months of life.
Yet a poll conducted by the Royal College of Midwives revealed that 43% of women surveyed did not feel as though they were given enough support and guidance to help them.
Meanwhile, a separate poll of 2,000 midwives revealed that:
(Nursing Times 2014)
In the view of the Baby Friendly Initiative (2019) support needs to be offered for the whole journey from pregnancy to new parenthood and not just for the first few days postnatally.
Sensitive conversations during pregnancy, skilled help after birth, ongoing guidance and social support are all needed to enable mothers to feel confident and breastfeed successfully.
For support to be effective it needs to be:
(Baby Friendly Initiative 2019)
Maycock et al. (2013) also raise an important point suggesting that although studies have identified numerous factors affecting breastfeeding including maternal education; mode of delivery; birth weight; and socioeconomic status, it’s support from the infant’s father that often plays a crucial role in the success of breastfeeding.
Research shows that fathers can have a considerable influence on a mother’s decision to initiate and continue with breastfeeding.
Despite this, many midwives fail to engage with fathers in supporting breastfeeding.
First-time mothers who identified as having support from the infant’s father during the early post-partum period were more likely to initiate breastfeeding and had longer breastfeeding durations (Hunter and Cattelona 2014).
Although high-quality research remains relatively sparse in this area Sherriff, Hall and Panton (2014) suggest that there are five main factors that influence a father’s role in breastfeeding support.
As Brown and Davies (2014) comment, the more the father feels included the better the outcome. It’s a view backed up by Sherriff and Hall (2011) who suggest that fathers are potentially the missing part of the jigsaw in terms of breastfeeding support.
That said, there is still relatively little research exploring the fathers' role and more importantly, the information and guidance he may need.
As Brown and Davies (2014) suggest, there is room for improvement here in the ways maternity staff embrace the father’s role, as many felt excluded from antenatal classes and breastfeeding education.
Contrary to the idea that a fathers’ involvement in breastfeeding is always helpful, Emmott and Mace (2015) discovered that frequent grandmother contact, and father’s involvement are both associated with lower levels of breastfeeding, suggesting a negative relationship between practical support and long term breastfeeding.
In contrast, however, the father’s presence and emotional support is associated with more successful breastfeeding. This suggests that practical support and emotional support function differently, and that practical support may not always be as welcome or useful as previously thought.
Rempel et al. (2016) also report on two studies examining the relationships between fathers’ perceptions of their breastfeeding support and the mothers' perceptions of the support she received.
Interestingly, mothers' intended breastfeeding duration was shorter when fathers wanted them to continue for a long time and when they were more appreciative and knowledgeable about breastfeeding.
Likewise, when fathers reported being more appreciative and directly involved, mothers breastfed for a shorter duration.
In both these studies, mothers' perceptions of their partners' responsiveness and fathers' reports of their own responsiveness predicted that breastfeeding would continue for longer than it actually did in practice.
These findings suggest that the most effective breastfeeding support is provided using a sensitive, coordinated teamwork approach that is always responsive and adaptable to the mother's needs.
The theme of technical expert versus skilled companion also extends into the role of the midwife.
As Swerts et al. (2016) suggest, midwives value breastfeeding education and breastfeeding support as a significant part of their role. However, how a midwife approaches and supports the breast-feeding mother can be broadly classified into two distinct approaches:
Most midwives seem to naturally favour the hands-off role of being a skilled companion but working in a busy hospital setting doesn’t always support this, leaving most limited to the role of technical expert (Swerts et al. 2016).
Perhaps then, in the light of these studies, there is room for both midwives and fathers to embrace the softer role of skilled companion, rather than a ‘hands-on’ expert.
Certainly, there is room for a more inclusive and innovative approach to a fathers’ influence, from early thoughts on breastfeeding through to established feeding and eventual weaning.