title: Supporting Breastfeeding Establishment among Socially Disadvantaged Women: A Meta-Synthesis.
abstract: BACKGROUND
  Many women from socially disadvantaged groups discontinue breastfeeding in the early postnatal period before lactation is fully established. This suggests that existing health service practices do not adequately meet the breastfeeding support needs of this population. The aim of this meta-synthesis is to review the literature exploring how women from socioeconomically deprived backgrounds experience breastfeeding establishment and to identify factors associated with supportive practice.
  
  
  METHODS
  The meta-synthesis includes qualitative studies exploring the perception of women from disadvantaged groups of in-hospital and professionally led interventions to support the establishment of breastfeeding. Searches were conducted for studies published between 1992 and 2013; after critical appraisal, eight studies were retained.
  
  
  RESULTS
  Three overarching themes of the influences on maternal perception of the efficacy of breastfeeding support were identified. These included practical skill and knowledge of the breastfeeding process, the influence of psychological factors on perceived breastfeeding ability, and the provision of a person-centered approach to infant feeding support.
  
  
  CONCLUSIONS
  The findings illustrate that the factors associated with supportive breastfeeding practice are extensive, complex, and interrelated. Strategies which enable mothers to gain confidence in their ability to successfully breastfeed by acquiring technical expertise, which offer positive encouragement, and which are culturally specific are more likely to be perceived as supportive by women from socially disadvantaged groups.
authors.affiliation: Institute of Health and Wellbeing, Robert Gordon University, Aberdeen, UK.
authors.forename: Sonya
authors.initials: S
authors.lastname: MacVicar
authors.affiliation: School of Nursing and Midwifery, Robert Gordon University, Aberdeen, UK.
authors.forename: Pamela
authors.initials: P
authors.lastname: Kirkpatrick
authors.affiliation: School of Nursing and Midwifery, Robert Gordon University, Aberdeen, UK.
authors.forename: Tracy
authors.initials: T
authors.lastname: Humphrey
authors.affiliation: School of Applied Social Studies, Robert Gordon University, Aberdeen, UK.
authors.forename: Katrina E
authors.initials: KE
authors.lastname: Forbes-McKay
mesh_terms: D001942:Breast Feeding / Q000379:methods / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D011181:Postnatal Care / Q000379:methods / Q000523:psychology; D011584:Psychology; D012944:Social Support; D012959:Socioeconomic Factors; D035862:Vulnerable Populations / Q000523:psychology / Q000706:statistics & numerical data
keywords: breastfeeding; meta-synthesis; social disadvantage; support