title: A mother's feelings for her infant are strengthened by excellent breastfeeding counseling and continuity of care.
abstract: OBJECTIVE
  Continuous support during the childbirth process ultimately may strengthen the mother's self-esteem and her capacity to interact with and nurture her infant and also may improve paternal involvement in general. In the present study, we investigated whether mothers, who were attended by midwives and nurses who had had a process-oriented training program in breastfeeding counseling, perceived stronger maternal feelings for their infant than mothers who had received only routine care.
  
  
  METHODS
  In a previous study, an intervention that included a process-oriented program on breastfeeding counseling for health professionals and continuity in family classes through childbirth was conducted. The 10 largest municipalities were classified in pairs that were similar in size and had similar figures of breastfeeding duration. The municipalities were randomized pairwise to either an intervention or a control group. The present study is a follow-up study on women's feelings for their infants in relation to the kind of care that they had had and was undertaken between April 2000 and January 2003. The sampling frame was based on women who were cared for at either the intervention clinic or control clinics. The mothers at the control clinics had received standard routine care and had attended family classes through the point of birth. Data collection for control group A started before effects of the intervention could be studied. Data for control group B were collected simultaneously with data collection for the intervention group (n = 540). The mothers responded to 3 questionnaires at 3 days and at 3 and 9 months postpartum. Background data of the mothers were collected. The perception of support that was provided by the health professionals and the perception of mother-infant relationship and feelings for the infant were rated on Likert scales.
  
  
  RESULTS
  At 3 days postpartum, both the intervention group and control group B versus the control group A thought that their understanding of the infant was better, they perceived more strongly that the infant as their own, and they enjoyed more breastfeeding and resting with the infant. Although there was no significant difference between the intervention group and control group B at 3 days and 3 months observation, mothers in the intervention group talked more to their infant, perceived their infant to be more beautiful than other infants, and perceived more strongly that the infant was their own than did the mothers in control group B at 9 months observation. In addition, the mothers in the intervention group felt significantly more confident with the infant and felt the infant to be closer than did the mothers in control group B.
  
  
  CONCLUSIONS
  A process-oriented breastfeeding training program for antenatal midwives and postnatal nurses that included an intervention that guaranteed continuity of care strengthened the maternal relationship with the infant and the feelings for the infant.
authors.affiliation: School of Life Sciences, University of Skövde, Box 408, SE 541 28 Skövde, Sweden. anette.ekstrom@his.se
authors.forename: Anette
authors.initials: A
authors.lastname: Ekström
authors.forename: Eva
authors.initials: E
authors.lastname: Nissen
mesh_terms: D000328:Adult; D001007:Anxiety / Q000517:prevention & control; D001942:Breast Feeding / Q000523:psychology*; D002409:Cathexis; D003266:Continuity of Patient Care; D003376:Counseling; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D006801:Humans; D007223:Infant; D007224:Infant Care; D007231:Infant, Newborn; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D016389:Maternal-Child Nursing / Q000193:education; D008880:Midwifery; D009034:Mother-Child Relations; D009035:Mothers / Q000193:education / Q000523:psychology*; D015337:Multicenter Studies as Topic; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D049590:Postpartum Period / Q000523:psychology; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic; D012494:Sampling Studies; D013315:Stress, Psychological / Q000517:prevention & control