Promoting successful breast feeding among women with a low income.
OBJECTIVE
To identify those factors which promote or discourage successful breast feeding in a sample of women with a low income.


METHODS
Qualitative research using in-depth, semi-structured interviews.


METHODS
All women with a low income who were identified as having breast fed their latest baby at least once and who had delivered at a district general hospital in the south west of England from 17 September 1996 to 5 February 1997.


RESULTS
Three behavioural areas which determined whether or not women with a low income continued to breast feed were identified: individual and social environmental, baby and midwifery practice factors. In terms of individual and social environmental factors those women who continued to breast feed were more likely to have: positive attitudes; realistic expectations; greater levels of self-esteem; a supportive mother/friend; a partner who was not against breast feeding; and the ability to cope with the perceived temporary social isolation. In terms of baby factors those women who continued to breast feed had babies who were more likely to: have three- or four-hourly feeds; be perceived as a contented baby; and have gained weight. And finally, in terms of midwifery practice factors, those women who continued to breast feed were more likely to have: not been separated from their baby; not been given supplementary or complementary feeds; received good advice, especially with regard to positioning the baby at the breast; had greater continuity of midwifery input; had sufficient quality time with a midwife; and had the opportunity to solve problems with a community midwife's help.


CONCLUSIONS
Midwifery practice can be improved to promote successful breast feeding among women with a low income by: 1) creating realistic expectations and increasing women's confidence/desire to succeed in breast feeding; 2) providing good quality advice and support to mothers of newborn babies, particularly with regard to positioning the baby at the breast; 3) improving social-support networks available to breast-feeding mothers, perhaps through educating grandmothers (or partners) in breast-feeding matters.
Whelan
A
A
Department of Social Medicine, University of Bristol, UK.
Lupton
P
P
D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009035:Mothers / Q000193:education / Q000523:psychology*; D009721:Nurse Midwives / Q000523:psychology; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D011203:Poverty / Q000523:psychology*; D012307:Risk Factors; D012944:Social Support; D011795:Surveys and Questionnaires; D006113:United Kingdom