The improvement of maternity care quality and the reduction of infant morbidity are the main concerns of maternity nursing. It has been broadly addressed in professional literature, research findings, and statistical data that the health of a newborn child vastly depends on breastfeeding initiation. The World Health Organization (2018) prioritizes breastfeeding as the main source of nutrients that have a strong positive effect on the health of both the mother and the baby. Moreover, the professionals emphasize the essential role of the initiation of breastfeeding within the first hour after birth and continuation lasting from a minimum of six months and up to two years or more (World Health Organization [WHO], 2018). Since breastfeeding rates differ from country to country and from population to population, it is important to implement encouraging interventions that will contribute to a higher rate of breastfeeding worthwhile. In this paper, a case study of Sara, who is having her first baby, will be reviewed to discuss factors that might positively affect the woman’s breastfeeding initiation and continuation.
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Case Study Overview
The case under discussion presents a thirty-year-old woman named Sara, who is pregnant with her first child. Sara and her husband have been planning to have a child; thus the atmosphere in the family is favorable for a smooth pregnancy. At the early stage of her pregnancy, the woman undergoes a series of necessary tests. She attends scheduled visits to a health care professional during which she clarifies all the issues related to the risks of health impairments the baby might be exposed to and genetic predispositions. In later stages of pregnancy, Sara has a sonogram and plans on attending pregnancy meetings with specialists to access more information about labor and preparation to it.
During the final stage of pregnancy, Sara starts planning the process of labor. As the woman states, she does not have particular preferences. She intends to make specific decisions during the birth to address all possible issues that might occur. Overall, she feels confident about the support of health care workers and is willing to adhere to their recommendations. However, Sara mentions that she would prefer to abstain from analgesia if it is possible to be avoided. The woman does not articulate any concerns related to breastfeeding. It is important to validate the positive effects of human lactation and deliver the information to the woman in the most effective way (Association of Women’s Health, Obstetric and Neonatal Nurses, 2015). To succeed at this, it is necessary to single out particular antenatal and intrapartum factors that might have a positive effect on the woman’s decision to adhere to the natural feeding of an infant.
The Importance of Breastfeeding During the Postpartum Period
The attention of pediatricians and physicians around the world is attached to the question of breastfeeding rates. Such influential organizations as the World Health Organization, Association of Women’s Health, Obstetric and Neonatal Nurses, and others promote and support the initiation and continuation of breastfeeding. They perceive it as “the ideal and normative method for feeding infants, including the provision of human milk” for newborns (Association of Women’s Health, Obstetric and Neonatal Nurses, 2015, p. 83). Thus, the nutrients contained in mother’s milk, as well as the direct contact wbetween a mother and a child, have both short- and long-term benefits.
The initiation of breastfeeding during the first hour after giving birth is an essential element of baby care. It ensures the support for the immune system of a child (Balogun et al., 2016). Babies who eat breast milk are less likely to develop such illnesses as gastrointestinal infections, respiratory infections, obesity, diabetes, and even some types of cancer (“Importance of breastfeeding,” 2019). Besides the decrease in the risks of particular illnesses, there are developmental advantages. Indeed, the babies who are exclusively fed breast milk are exposed to better cognition and neurodevelopment (Association of Women’s Health, Obstetric and Neonatal Nurses, 2015). Also, direct and continuous contact between the mother and child ensures a better psychological bond between them.
In addition, there are multiple benefits of breastfeeding for women’s health and well-being. According to research, women who feed their children breast milk have a reduced risk of developing diabetes, breast cancer, ovarian cancer, and osteoporosis after giving birth (“Importance of breastfeeding,” 2019). Also, it improves the processes of recovery after labor by balancing body weight and advancing the healing progress. Breastfeeding is advantageous for public health as well because it strengthens the population’s health since early childhood and ultimately contributes to better health outcomes and fewer illnesses. Therefore, it is important to address specific factors that contribute to breastfeeding rates.
Factors that Positively Influence Breastfeeding Initiation and Continuation
Consuming breast milk by a newborn child is a universally recommended guideline for maintaining public health. According to Cohen et al. (2018), “exclusive breastfeeding through the first six months of age with continued breastfeeding through 12 months” is recommended in all medical settings around the world (p. 190). The term exclusive breastfeeding implies the limitation of the child’s sources of nutrients to breast milk only. In such a manner, the infant can receive a well-balanced portion of nutritious elements that are necessary at the given stage of development.
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The benefits and vast information concerning the positive effects of breastfeeding are undeniable. However, not all women initiate or continuously adhere to this manipulation due to a variety of factors (Hmone, Li, Agho, Alam, & Dibley, 2017). The determinants vary from socio-economic ones, including geographical location, cultural preferences, and educational level, to healthcare-related ones, such as breastfeeding promotion, mode of labor, analgesia, duration of labor, and others. It is crucial to discuss the factors that might have a positive effect on the initiation of breastfeeding with the aim of further enforcement of such.
The preparation for giving birth and taking care of the baby during the antenatal period is a foundation for healthy outcomes in both the mother and baby. As the case study’s information implies, Sara trusts the level of expertise of midwives and obstetricians who accompany her through the journey of pregnancy and labor. This fact reflects the overall tendency in maternity health care, where the influence of nurses is predominant (Association of Women’s Health, Obstetric and Neonatal Nurses, 2015). The quality and amount of information health care professionals provide for women determine her decisions concerning childbirth in general, and breastfeeding, in particular.
Promotion of natural nutrition of infants must be implemented through specific practices. They might include educational endeavors, meetings with doctors and nurses, exchange of experience, and dissemination of statistics and research (Almeida, Araújo Barros Luz, & Veiga Ued, 2015). Moreover, it is vital to ensure that the educational and promoting interventions implemented by nurses are aimed at developing positive breastfeeding intentions in pregnant women to ensure their breastfeeding confidence (Meedya, Fahy, & Kable, 2010). Therefore, breastfeeding education might be a positive antenatal factor that might encourage women to initiate lactation at the early stages after giving birth. In such a manner, the woman will be able to obtain all necessary information, understand the importance of breastfeeding for her and her child, as well as resolve any uncertainties or doubts with the help of consulting with professionals.
As for the factors that emerge during the process of giving birth, there are several issues that might have a positive effect on women’s decision to breastfeed. Importantly, the level of health professionals’ expertise determines the overall success of birth due to their immediate involvement in the enforcing of particular factors (Munabi-Babigumira, Glenton, Lewin, Fretheim, & Nabudere, 2017). According to Cadwell and Brimdyr (2017), the administration of particular medication during labor has negative effects on the baby and mother health outcomes. In particular, the administration of synthetic oxytocin is associated with “decreased neonatal pre-feeding cues, decreased neonatal reflexes associated with breastfeeding,” and other negative implications (Cadwell & Brimdyr, 2017, p. 1). Therefore, it is considered that the minimization of the cases of synthetic oxytocin use during the intrapartum period will have a positive effect on breastfeeding initiation.
Another positive factor encouraging breastfeeding is skin-to-skin contact between the baby and mother immediately after birth. According to Lau et al. (2017), the early skin-to-skin contact within the first thirty seconds after birth indicates a higher rate of breastfeeding initiation at the early stages postpartum compared to skin-to-skin contact within thirty to sixty minutes after labor. The benefits of early contact are evident for both the mother and baby because it triggers “neuropsychobiological paths that increase maternal behaviors and immediate response to infant needs and increased lactogenesis” (Lau et al., 2017). Therefore, the factor of skin-to-skin contact is very influential in breastfeeding initiation and continuation.
Evidence Based Strategies to Support Early Breastfeeding
The rate of breastfeeding at different stages after birth varies. In particular, in Australia, the breastfeeding prevalence immediately after giving birth is 96% but the number decreases to 61% by several months postpartum (Phoebe, Fetherston, & Nilson, 2019). Therefore, it is vital to implement specific strategies that will not only encourage women’s initiation to breastfeed within the first hour after labor but continue this manipulation throughout a minimum of six months postpartum.
The overall childbirth experience and its outcomes greatly depend on the competency and expertise of health care professionals. According to Radzyminski and Callister (2015), health care professionals have been “identified as having a significant influence on breastfeeding initiation rates and duration” (p. 203). Close and continuous interaction of a mother with nurses and physicians in a mode when the opinion of a healthcare worker is perceived as professional and well-validated advice determines the willingness of a woman to breastfeed (Bengough, von Elm, Heyvaert, & Hannes, 2018). Moreover, the WHO (2018) emphasizes the essential role of evidence based practice application during the intrapartum period. Therefore, it is vital for midwives, obstetricians, and other health professionals engaged in pregnancy and labor to be able to use effective strategies when working with women.
Extensive research provides sufficient evidence illustrating the positive results of healthcare education provided by nurses, doctors, peer support, and other means of information distribution on the rates of breastfeeding. According to Balogun (2016), “women who received breastfeeding education … from doctors or nurses were more likely to start breastfeeding compared to women who received standard care” (para. 5). These results were retrieved from five research studies involving 564 women. Moreover, insufficient milk volume was found to be associated with “the lack of access to timely lactation counseling” rather than biological factors (“Supporting breastfeeding research,” 2019, para.3). Therefore, well-planned and personalized strategic interventions need to be implemented in all hospitals to ensure the access of women to education on breastfeeding during the prenatal period.
There exist specific evidence-based strategies that are implemented in different countries. The importance of breastfeeding education and promotion is an inherent element of such strategies as Baby Friendly Hospital Initiative and Ten Steps to Successful Breastfeeding program (Phoebe et al., 2019). These strategies are developed to encourage women to breastfeed immediately after giving birth. Specific interventions such as education, promotion, skin-to-skin contact between an infant and mother, enforcement of family and social support, as well as active inclusion of health care professionals, are aimed at increasing breastfeeding rates (Meek & Noble, 2016). Thus, further advancement in the implementation of such strategies with adherence to the positive factors will benefit the health and well-being of newly born children and their mothers.
To summarize, breastfeeding is an essential element of infant care that is strongly recommended by the majority of maternity and nursing organizations, as well as researchers. The multiple benefits of early breastfeeding initiation and continuous human lactation as a source of infants’ nutrition encourage millions of mothers to adhere to natural feeding after birth. In order to encourage the continuation of this manipulation, it is necessary to implement specific measures within such strategies as Baby Friendly Hospital Initiative and Ten Steps to Successful Breastfeeding program. The inclusion of such factors as breastfeeding education, limitations in medication during labor, and skin-to-skin contact might improve the rates of breastfeeding. Ultimately, such encouraging endeavors will benefit public health and well-being.
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