title: Women's perceptions and experiences of breastfeeding support: a metasynthesis.
abstract: BACKGROUND
  Both peer and professional support have been identified as important to the success of breastfeeding. The aim of this metasynthesis was to examine women's perceptions and experiences of breastfeeding support, either professional or peer, to illuminate the components of support that they deemed "supportive."
  
  
  METHODS
  The metasynthesis included studies of both formal or "created" peer and professional support for breastfeeding women but excluded studies of family or informal support. Qualitative studies were included as well as large-scale surveys if they reported the analysis of qualitative data gathered through open-ended responses. Primiparas and multiparas who initiated breastfeeding were included. Studies published in English, in peer-reviewed journals, and undertaken between January 1990 and December 2007 were included. After assessment for relevance and quality, 31 studies were included. Meta-ethnographic methods were used to identify categories and themes.
  
  
  RESULTS
  The metasynthesis resulted in four categories comprising 20 themes. The synthesis indicated that support for breastfeeding occurred along a continuum from authentic presence at one end, perceived as effective support, to disconnected encounters at the other, perceived as ineffective or even discouraging and counterproductive. A facilitative approach versus a reductionist approach was identified as contrasting styles of support that women experienced as helpful or unhelpful.
  
  
  CONCLUSIONS
  The findings emphasize the importance of person-centered communication skills and of relationships in supporting a woman to breastfeed. Organizational systems and services that facilitate continuity of caregiver, for example continuity of midwifery care or peer support models, are more likely to facilitate an authentic presence, involving supportive care and a trusting relationship with professionals.
authors.affiliation: School of Nursing and Midwifery, University of Western Sydney, New South Wales, Australia.
authors.forename: Virginia
authors.initials: V
authors.lastname: Schmied
authors.forename: Sarah
authors.initials: S
authors.lastname: Beake
authors.forename: Athena
authors.initials: A
authors.lastname: Sheehan
authors.forename: Christine
authors.initials: C
authors.lastname: McCourt
authors.forename: Fiona
authors.initials: F
authors.lastname: Dykes
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data*; D003142:Communication; D005260:Female; D006266:Health Education / Q000379:methods; D006282:Health Personnel / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D009035:Mothers / Q000523:psychology*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010379:Peer Group; D011181:Postnatal Care / Q000379:methods*; D011369:Professional-Patient Relations; D012657:Self-Help Groups; D012944:Social Support; D055815:Young Adult