title: Experience of the first breastfeeding session in association with the use of the hands-on approach by healthcare professionals: a population-based Swedish study.
abstract: OBJECTIVE
  The aim of this study was to investigate the prevalence of healthcare professionals' use of the hands-on approach during the first breastfeeding session postpartum and its possible association with the mothers' experience of their first breastfeeding session.
  
  
  METHODS
  This was a population-based longitudinal study conducted at Uppsala University Hospital, Uppsala, Sweden, of all women giving birth at the hospital from May 2006 to June 2007. Six months postpartum, a questionnaire including questions regarding breastfeeding support, caregiving routines, depressive symptoms, and the woman's experience of the first breastfeeding session was sent to the mothers. The main outcome measures were use of the hands-on approach during the first breastfeeding session and the mother's experience of the breastfeeding session.
  
  
  RESULTS
  In total, 879 women participated in the study. Thirty-eight percent of the women received the hands-on approach during the first breastfeeding session. High body mass index, primiparity, and having the first breastfeeding session postponed were all independently associated with the hands-on approach. Women who received the hands-on approach were more likely to report a negative experience of the first breastfeeding session (odds ratio=4.48; 95% confidence interval, 2.57-7.82), even after adjustment for possible confounders (odds ratio=2.37; 95% confidence interval, 1.02-5.50).
  
  
  CONCLUSIONS
  This study indicates that the hands-on approach is commonly used during the first breastfeeding session and is associated with a more negative experience of the first breastfeeding session. Consequently, caregivers need to question the use of this method, and further research about breastfeeding support is required.
authors.affiliation: Department of Women's and Children's Health, Uppsala University , Uppsala University Hospital, Uppsala, Sweden .
authors.forename: Karin
authors.initials: K
authors.lastname: Cato
authors.forename: Sara M
authors.initials: SM
authors.lastname: Sylvén
authors.forename: Alkistis
authors.initials: A
authors.lastname: Skalkidou
authors.forename: Christine
authors.initials: C
authors.lastname: Rubertsson
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000379:methods*; D005260:Female; D006282:Health Personnel; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology / Q000706:statistics & numerical data; D016017:Odds Ratio; D010298:Parity; D011181:Postnatal Care; D049590:Postpartum Period; D011247:Pregnancy; D012657:Self-Help Groups; D012944:Social Support; D011795:Surveys and Questionnaires; D013548:Sweden; D013997:Time Factors