Dienst van SURF
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Background: In the Netherlands, 81% of mothers initiate breastfeeding. After one month the percentage of mothers still breastfeeding drops, despite positive intentions. Little is known about women’s perceptions of breastfeeding during the period of intention.Aim: This qualitative study aimed to gain insight into these perceptions among first-time mothers from middle and high socioeconomic backgrounds in the northern part of the Netherlands.Methods: We used the theory of planned behaviour as the deductive model. In 2008, 16 in-depth interviews were conducted with 8 mothers who intended to breastfeed. The interviews were conducted at two time points (prepartum and postpartum) and covered the same period (that is, from the time when the intention was formed until after childbirth). The interviews were transcribed verbatim and analysed using grounded theory.Findings: Five inductive themes were identified: combining breastfeeding with work, learning about breastfeeding, making arrangements for childbirth, reflecting on the intention, and becoming a mother. During the extended period of intention, the women anticipated breastfeeding, but were cautious in expressing their intentions. They felt that the experience of becoming a mother would be critical to their breastfeeding outcomes.Conclusion: The theory of planned behaviour has been widely used in breastfeeding research. However, the period of intention is relatively long for breastfeeding. Rather than recommending an intensification of antenatal breastfeeding education, recommendations must incorporate the awareness that practising breastfeeding should not be considered the continuous outcome of the intention to do so – it takes a mother to practise breastfeeding.
In the Netherlands the government advises mothers to breastfeed for six months or longer; however, only 51% of Dutch mothers still breastfeed at six months and many women do not maintain the practice for as long as they intended. This study examines how an existing intervention, the Breastfeeding Support Program (BSP), influences breastfeeding duration. Breastfeeding duration in the BSP group (n=67) was compared to a control group (n=73) by means of a quasi-experiment. The BSP consisted of a series of 6 consults delivered by lactation consultant, starting during pregnancy and continuing up until 10 weeks after delivery. Questionnaires for the pre-test and post-test were administered through the internet. A logistic regression was used to compare the BSP group and the control group on the percentage of women still breastfeeding (exclusively) at 6 months, while controlling for differences at baseline. Additionally an analysis was performed to produce an extra conservative estimate of the effects of the BSP.Controlling for differences at baseline, both the odds to still be breastfeeding at six months and the odds to still be breastfeeding exclusively at six months are 3.8 times higher for women in the BSP group than in the control group. The extra conservative analysis produced similar results, with the effects of the BSP still being significant. The BSP appears to be highly effective at increasing the odds of women to still be breastfeeding at six months and the odds to still be breastfeeding exclusively at six months.
Background:In the context of decreasing breastfeeding rates and unsuccessful breastfeeding promotion campaigns, a qualitative research project in the Northern part of the Netherlands was initiated.Objectives:As part of the overall project, the aim of this study was to explore the content and sources of breastfeeding knowledge among primiparous women. Identifying and categorizing the content and the sources of breastfeeding knowledge could guide professionals such as midwives and maternity nurses as well as others in the women’s surroundings to engage in disseminating knowledge and therefore support women in achieving their breastfeeding goals.Methods:We conducted 26 in-depth interviews from the emic perspective with 13 new mothers pre- and postpartum, up to saturation level. Transcripts were analysed applying thematic analysis. As sensitising concepts, the themes identified were divided into two categories: those gained from 'professional' sources and those obtained from 'popular' sources.Results:Five knowledge content themes were identified: (1) pros and cons of breastfeeding, (2) how breastfeeding works, (3) individual breastfeeding practice, (4) expressing milk, and (5) formula feeding. ‘Professional’ sources are perceived as more helpful than ‘popular’ sources, whereas ‘intuition’ was inductively identified as an important knowledge source.Conclusion:Limited breastfeeding practice exposure, along with the recommendations to breastfeed for six months and perceptions of breastfeeding as ‘natural’ at the same time, generates much pressure in women. Emphasizing all knowledge content in campaigns, addressing a variety of target groups in women’s social environment, and recognizing intuition as an adequate source of knowledge supported by professionals will facilitate women in making informed infant feeding decisions.
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Borstvoeding heeft belangrijke gezondheidseffecten, voor zowel kinderen als moeders. Een halve eeuw geleden vond borstvoeding bijna nooit tegelijk met werk plaats aangezien vrouwen stopten met werken als ze trouwden, maar tegenwoordig werken moeders vaak door. Daarom is het belangrijk om te onderzoeken hoe de combinatie van arbeid en borstvoeding het best kan worden gefaciliteerd. Uit recent onderzoek blijkt namelijk dat de combinatie van werken en borstvoeding één van de belangrijkste redenen is om vroegtijdig te stoppen met borstvoeding. De gebouwde omgeving, in de vorm van kolfkamers, is belangrijk om de combinatie van borstvoeding en werken zo goed mogelijk te ondersteunen. Op dit moment ontbreekt echter kennis over de invloed van de gebouwde omgeving op vrouwen die borstvoeding geven en/of kolven op het werk: dit is dan ook de focus van het huidige promotieonderzoek.