Indicators of ‘good’ feeding, breastfeeding latch, and feeding experiences among healthy women with healthy infants: A qualitative pathway analysis using Grounded Theory

TY - JOUR

T1 - Indicators of ‘good’ feeding, breastfeeding latch, and feeding experiences among healthy women with healthy infants

T2 - A qualitative pathway analysis using Grounded Theory

AU - Davie, Philippa

AU - Chilcot, Joseph

AU - Jones, Louise

AU - Bick, Debra

AU - Silverio, Sergio A.

N1 - Funding Information: This research was funded as part of a PhD Research Studentship awarded to Philippa Davie Author Agreement from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London , and supported by funding awarded to the PIPINS Study (Ref: 18/LO/0740) from Guy’s and St Thomas’ Charity, London, UK (Grant Reference EIC181002 ). Guy’s and St Thomas’ Charity do not have any permissions or influence over study design, methodology (including data collection), data analysis, or manuscript preparation. Funding Information: This research study was funded as part of a PhD studentship stipend awarded to XX (King’s College London IoPPN Studentship Prize 2016/17) and funding awarded to the PIPINS Study (Ref: 18/LO/0740) from Guy’s and St Thomas’ Charity, London, UK (Grant Reference EIC181002). The authors wish to extend their thanks and gratitude to all the women enrolled in the PIPINS Study for their time and contribution to this research. XxX (King’s College London) is supported by the National Institute for Health Research Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NIHR of the Department of Health and Social Care. Funding Information: This research was funded as part of a PhD Research Studentship (IoPPN Prize Studentship 2016/17) awarded to Philippa Davie from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, and supported by funding awarded to the PIPINS Study (Ref: 18/LO/0740) from Guy's and St Thomas? Charity, London, UK (Grant Reference EIC181002). Guy's and St Thomas? Charity do not have any permissions or influence over study design, methodology (including data collection), data analysis, or manuscript preparation. Publisher Copyright: © 2020 Australian College of Midwives Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/7/1

Y1 - 2021/7/1

N2 - Background: Breastfeeding behaviour remains a public health priority worldwide. Despite evidence-based guidelines, healthy women who give birth to healthy, term infants continue to face barriers to breastfeeding. Understanding women's experiences of feeding in the early postnatal period is crucial to identify how support may be better tailored to improve breastfeeding outcomes, including women's experiences. Question: To understand women's experiences of infant feeding amongst healthy women who give birth to healthy, average-weight, term infants. Methods: Grounded Theory methodology was used to analyse data from a nested qualitative interview study. Twelve women between four and twelve months postpartum were recruited from a longitudinal cohort study and public advertisements. Semi-structured face-to-face interviews were audio-recorded and transcribed for analysis. Findings: Three distinct themes were found, subsuming identified super-categories: perceived indicators of ‘good’ feeding (infant ‘output’; infant crying; weight gain; feeding frequency and duration); women's experiences of breastfeeding latch (‘good’ latch; ‘bad’ latch with pain and discomfort); and overall breastfeeding experience (positive; negative; and uncertain). Data suggest women give precedence to their latch experiences over indicators of ‘good’ feeding, highlighting breastfeeding latch as a possible mediating factor to the overall breastfeeding experience. Feeding experience can be achieved through four distinct pathways. Discussion: The physical and psychological impacts of latch pain were pronounced. Even amongst healthy women with healthy infants, a positive breastfeeding experience overall was uncommon, highlighting the difficulties women continue to encounter. Understanding women's perceptions of ‘good’ feeding, and ensuring a pain-free latch, may better support women to have a positive breastfeeding experience.

AB - Background: Breastfeeding behaviour remains a public health priority worldwide. Despite evidence-based guidelines, healthy women who give birth to healthy, term infants continue to face barriers to breastfeeding. Understanding women's experiences of feeding in the early postnatal period is crucial to identify how support may be better tailored to improve breastfeeding outcomes, including women's experiences. Question: To understand women's experiences of infant feeding amongst healthy women who give birth to healthy, average-weight, term infants. Methods: Grounded Theory methodology was used to analyse data from a nested qualitative interview study. Twelve women between four and twelve months postpartum were recruited from a longitudinal cohort study and public advertisements. Semi-structured face-to-face interviews were audio-recorded and transcribed for analysis. Findings: Three distinct themes were found, subsuming identified super-categories: perceived indicators of ‘good’ feeding (infant ‘output’; infant crying; weight gain; feeding frequency and duration); women's experiences of breastfeeding latch (‘good’ latch; ‘bad’ latch with pain and discomfort); and overall breastfeeding experience (positive; negative; and uncertain). Data suggest women give precedence to their latch experiences over indicators of ‘good’ feeding, highlighting breastfeeding latch as a possible mediating factor to the overall breastfeeding experience. Feeding experience can be achieved through four distinct pathways. Discussion: The physical and psychological impacts of latch pain were pronounced. Even amongst healthy women with healthy infants, a positive breastfeeding experience overall was uncommon, highlighting the difficulties women continue to encounter. Understanding women's perceptions of ‘good’ feeding, and ensuring a pain-free latch, may better support women to have a positive breastfeeding experience.

KW - Breastfeeding

KW - Breastfeeding experience

KW - Grounded Theory

KW - Infant

KW - Support

KW - Women's health

UR - http://www.scopus.com/inward/record.url?scp=85090064716&partnerID=8YFLogxK

U2 - 10.1016/j.wombi.2020.08.004

DO - 10.1016/j.wombi.2020.08.004

M3 - Article

SN - 1871-5192

VL - 34

SP - E357-E367

JO - Women and Birth

JF - Women and Birth

IS - 4

ER -