title: Supplementing breast-fed babies in the UK to protect their mothers from tiredness or distress.
abstract: OBJECTIVE
  To explore mothers' and healthcare professionals' beliefs, expectations and experiences in relation to supplementation of breast feeding in the postnatal ward and newborn-baby unit.
  
  
  METHODS
  A qualitative study using an ethnographic approach which involved participant observation and interviews. Analysis of the observation data informed who would be approached for interview and interviews also guided further observation work. Categories and themes were generated from the field notes and interviews.
  
  
  METHODS
  A maternity unit in the South of England using six methods of supplementary feeding.
  
  
  METHODS
  30 mothers, 17 midwives, four neonatal nurses, three paediatricians, three senior house officers and 3 healthcare assistants were interviewed in the postnatal ward and newborn-baby unit over a period of nine months in 2002.
  
  
  RESULTS
  A major theme was the healthcare professionals' desire to protect the mothers from tiredness or distress, although this at times conflicted with their role in promoting breast feeding. The categories 'protecting the mother from guilt', 'making it easy to give up' and 'protecting the mother from distress' were linked to this theme. Sometimes midwives suggested supplementation because they perceived mothers to be tired, sometimes mothers themselves made the request. Thus the researcher constructs of 'midwife led' and 'mother led' supplementation emerged. KEY CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Healthcare professionals need to be aware that they may not be helping mothers in the longer-term when supplementation is used as a quick 'solution' to a mother's tiredness or distress. However, other strategies such as providing emotional support or role modelling 'settling' skills are time consuming and have resource implications for the maternity services.
authors.affiliation: St. George's Hospital Medical School, London SW17 0RE, UK.
authors.forename: Michele
authors.initials: M
authors.lastname: Cloherty
authors.forename: Jo
authors.initials: J
authors.lastname: Alexander
authors.forename: Immy
authors.initials: I
authors.lastname: Holloway
mesh_terms: D000328:Adult; D001903:Bottle Feeding / Q000523:psychology / Q000706:statistics & numerical data; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data; D004739:England; D005221:Fatigue / Q000209:etiology / Q000451:nursing / Q000517:prevention & control*; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D008880:Midwifery / Q000592:standards; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D011247:Pregnancy; D013315:Stress, Psychological / Q000209:etiology / Q000451:nursing / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D013997:Time Factors