Professionals Category > Breastfeeding Review Journal

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Back Issue Vol 12 No 1 March 2004 The influence of context on the success of adoptive breastfeeding: Developing countries and the west Karleen D Gribble Abstract: It is commonly believed that adoptive mothers in developing countries are more successful breastmilk producers than women in the west. A review of published research supports this assertion. However, an examination of the practice of adoptive breastfeeding in developing countries and in the west via the literature reveals differences that may explain the variation in success. Adoptive mothers in developing countries may have greater milk production than mothers in the west because they are more knowledgeable about breastfeeding, practice frequent breastfeeding, remain in close physical contact with their children and live in cultures that are supportive of breastfeeding. They also have reproductive and breastfeeding histories that may make breastfeeding easier, though they are less likely to have pharmaceutical galactagogues available. Adoptive mothers in the west should be encouraged to maximise their milk supply by emulating the mothering styles of women in developing countries and developing a strong support network for breastfeeding. It may be that most adoptive mothers are physically capable of producing sufficient breastmilk for their child but that in the west, sociocultural factors act as preventatives. Keywords: Factors influencing mothers' decision to breastfeed in public Yvonne L Hauck Abstract: Breastfeeding in public was a major theme that emerged in a previous Western Australian study that explored the maternal process of managing breastfeeding and subsequent weaning. This paper highlights the factors that influenced mothers' decisions to breastfeed in public. Confidence with breastfeeding, the ability to be discreet, the mother's body image, previous experience, age of the breastfeeding child, the audience, feelings of the partner, breastfeeding location and perceptions of societal expectations all impacted upon the decision of how to manage breastfeeding in public. Initiatives to promote a breastfeeding friendly community are briefly discussed as well as strategies that participants employed to manage their breastfeeding in public. These findings add to our knowledge on breastfeeding and have implications for how we support breastfeeding women Keywords: Midwives' knowledge of newborn feeding ability and reported practice managing the first breastfeed Ruth Cantrill, Debra Creedy and Marie Cooke Abstract: Continuous uninterrupted skin-to-skin contact is known to facilitate newborn transition to extrauterine life, the ability to actively find the nipple and establishment of effective breastfeeding but is not promoted consistently in practice. The Newborn Feeding Ability Questionnaire (NFAQ) was developed to measure midwives' knowledge and practice in supporting the first breastfeed. The NFAQ was administered to 3 500 midwives in Australia through a mailed survey. A response rate of 31.6% (n=1 105) was achieved and the sample was representative of the national midwifery population for age, sex, education and experience. Mean total score for knowledge was 85.94 (range 40-110 out of 110, SD=10.55) and mean practice score was 95.89 (range 57-117 out of 120, SD=9.19). Knowledge of newborn feeding ability was consistently associated with best practice in managing the first breastfeed. Almost all midwives reported that skin-to-skin contact for newborn infants immediately after birth was important, but few understood the significance of 'continuous uninterrupted' skin-to-skin contact to facilitate correct attachment and effective suckling. One-third reported separating mother and baby for routine interventions before allowing the opportunity to demonstrate pre-feeding behaviour or actually breastfeed. Although midwives attempt to ensure the first breastfeed is facilitated soon after birth, the practice of continuous uninterrupted skin-to-skin contact seems poorly understood and not uniformly practised. Further research is needed to investigate how midwives teach mothers' positioning and attachment for the first breastfeed. Education of midwives so they can optimally facilitate the first breastfeed is required to improve breastfeeding initiation rates. Keywords: Book Reviews Research Summaries