title: Supporting breastfeeding mothers: qualitative synthesis.
abstract: OBJECTIVE
  This paper is a report of a synthesis of mothers' and healthcare professionals' experiences and perceptions of breastfeeding support.
  
  
  BACKGROUND
  Despite increasing knowledge, breastfeeding rates remain relatively static and mothers continue to report dissatisfaction with their experiences of breastfeeding. Greater understanding of breastfeeding may be achieved through rigorous qualitative research, and there has been a recent increase in such studies.
  
  
  METHODS
  Electronic databases and citation lists of published papers were searched for articles listed between 1990 and 2005 and updated in May 2007. Studies were included if they used qualitative methods, were published in English, explored an aspect of breastfeeding and were based in a westernized country.
  
  
  METHODS
  Papers were included if they reported studies using qualitative methods to explore breastfeeding and were published in English and based in a westernized country. Each study was reviewed and assessed independently, key themes extracted and grouped, and secondary thematic analysis used to explore key concepts.
  
  
  RESULTS
  From the 1990-2005 search, five themes emerged in health service support of breastfeeding: the mother-health professional relationship, skilled help, pressures of time, medicalization of breastfeeding and the ward as a public place. Social support had two themes: compatible and incompatible support. One additional theme emerged from the update to 2007: health professional relationships.
  
  
  CONCLUSIONS
  Mothers tended to rate social support as more important than health service support. Health service support was described unfavourably with emphasis on time pressures, lack of availability of healthcare professionals or guidance, promotion of unhelpful practices and conflicting advice. Changes are required within the health services to address the needs of both mothers and staff.
authors.affiliation: NMAHP Research Unit, University of Stirling, UK. rjm2@stir.ac.uk
authors.forename: Rhona J
authors.initials: RJ
authors.lastname: McInnes
authors.forename: Julie A
authors.initials: JA
authors.lastname: Chambers
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data; D002675:Child, Preschool; D005260:Female; D006293:Health Promotion / Q000592:standards*; D006379:Helping Behavior; D006771:Hospitals, Maternity / Q000592:standards; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D009035:Mothers / Q000523:psychology; D009723:Nurse-Patient Relations; D010353:Patient Education as Topic / Q000592:standards; D049590:Postpartum Period / Q000502:physiology / Q000523:psychology; D011247:Pregnancy; D036301:Qualitative Research; D012944:Social Support