By Lizzie Ette, Lecturer in Nursing, University of Hull and PhD candidate, Edinburgh Napier University. @busygirlizzie
The first week of August sees the return of the World Breastfeeding Week (WBW). Co-ordinated by the World Alliance for Breastfeeding Action (WABA) this event is usually well-known amongst midwifery and health visiting teams. However, WBW is perhaps less well-recognized by nurses more widely, unless they have a specific interest in infant feeding, maternal health or have perhaps breastfed their own baby. So, why do nurses need to celebrate breastfeeding – indeed why do nurses need to know anything about breastfeeding?
- Breastfeeding has a positive impact on multiple health outcomes for both a mother and her child1.
- Breastfeeding prevents childhood illnesses such as gastro-enteritis, respiratory tract infections, otitis media, and reduces the risks of overweight and obesity in later life – in mothers, it reduces the risk of developing breast cancer, ovarian cancer and osteoporosis2.
- In the UK, the financial burden of illness associated with not breastfeeding are considerable3.
- 80% of women stop breastfeeding earlier than they wished – often due to lack of support4.
Much the same as learning to drive or getting fit, learning to breastfeed takes time, energy, physical and psychological resources, help, support, determination….all the things that learning any complex new skill requires. Personal resources such as these can become depleted in early family life due to the often-overwhelming nature of the arrival of a newborn baby in a family home. Breastfeeding frequently gets blamed when mothers are struggling to adjust to having a baby – the period sometimes known as the 4th trimester5, particularly in relation to a mother’s fatigue and emotional distress6. This is perhaps because of its intimate relationship to maternal identity7, maternal body image and other factors such as breastfeeding being seen as inconvenient, difficult and anxiety-provoking8. So, when a woman overcomes these barriers to achieve her own breastfeeding goals she should be lauded, and breastfeeding should be celebrated.
Nurses have a key role in normalizing breastfeeding, and supporting informed choice – nurses continue to be the most trusted profession in the UK9 and, like all health care professionals, they have power and influence in their relationships with patients and clients10 throughout the life-stage. Furthermore, the quality of nurses’ communication skills have a significant impact on patient outcome11, and information, support and signposting relating to parental infant feeding decisions should adhere to best practice guidelines. The Nursing and Midwifery Council require nurses to promote health and apply evidence based practice, but for many nurses, it is easy to overlook breastfeeding as the public health priority that it is, but rather to engage in infant feeding conversations based on their own attitude to breastfeeding12, unaware of the significance a mother’s infant feeding experiences can have on her long term physical and emotional health13.
Nurses are in an ideal position to support non-judgmental, health-promoting, evidence-based conversations about breastfeeding using strategies such as Making Every Contact Count, the principles of which are simple and effective, and can be incorporated into everyday practice encounters. To learn more about breastfeeding as a key public health topic, visit the free All Our Health: Best Start in Life e-learning session, or visit WABA to find resources to support World Breastfeeding Week.
- Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, et al. Breastfeeding 2 Why invest, and what it will take to improve breastfeeding practices? [Internet]. Vol. 387, www.thelancet.com. 2016 [cited 2019 Sep 4]. Available from: www.thelancet.com
- Victora CG, Bahl R, Barros AJD, França VA, Horton S, Krasevec J, et al. Breastfeeding 1 Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong eff ect [Internet]. Vol. 387, www.thelancet.com. 2016 [cited 2020 Jan 17]. Available from: http://mics.
- Pokhrel S, Quigley MA, Fox-Rushby J, McCormick F, Williams A, Trueman P, et al. Potential economic impacts from improving breastfeeding rates in the UK. Arch Dis Child [Internet]. 2015 Apr [cited 2018 Nov 26];100(4):334–40. Available from: http://adc.bmj.com/lookup/doi/10.1136/archdischild-2014-306701
- Mcandrew F, Thompson J, Fellows L, Large A, Speed M, Renfrew MJ. UK Data Archive Study Number 7281-Infant Feeding Survey. 2010 [cited 2021 Jul 19]; Available from: www.ic.nhs.uk
- Savage JS. A Fourth Trimester Action Plan for Wellness. J Perinat Educ [Internet]. 2020 Apr 15 [cited 2021 Jul 15];29(2):103–12. Available from: https://connect.springerpub.com/content/sgrjpe/29/2/103
- S C, N S, A D. Fatigue and breastfeeding: an inevitable partnership? J Hum Lact [Internet]. 2006 May [cited 2021 Jul 19];22(2):182–7. Available from: https://pubmed.ncbi.nlm.nih.gov/16684906/
- Williamson I, Leeming D, Lyttle S, Johnson S. ‘It should be the most natural thing in the world’: exploring first-time mothers’ breastfeeding difficulties in the UK using audio-diaries and interviews. Matern Child Nutr [Internet]. 2012 Oct 1 [cited 2021 Jul 15];8(4):434–47. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1740-8709.2011.00328.x
- Brown A, Raynor P, Lee M. Healthcare professionals’ and mothers’ perceptions of factors that influence decisions to breastfeed or formula feed infants: a comparative study. J Adv Nurs [Internet]. 2011 Sep 1 [cited 2021 Jul 15];67(9):1993–2003. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2648.2011.05647.x
- Pezaro SNS. The value nurses and midwives hold. https://doi.org/1012968/bjom202028122 [Internet]. 2020 Jan 9 [cited 2021 Jul 15];28(1):22. Available from: https://www.magonlinelibrary.com/doi/abs/10.12968/bjom.2020.28.1.22
- Evans EC. Exploring the Nuances of Nurse-Patient Interaction through Concept Analysis: Impact on Patient Satisfaction. http://dx.doi.org/101177/0894318415614904 [Internet]. 2015 Dec 11 [cited 2021 Jul 15];29(1):62–70. Available from: https://journals.sagepub.com/doi/full/10.1177/0894318415614904
- O’Hagan S, Manias E, Elder C, Pill J, Woodward-Kron R, McNamara T, et al. What counts as effective communication in nursing? Evidence from nurse educators’ and clinicians’ feedback on nurse interactions with simulated patients. J Adv Nurs [Internet]. 2014 Jun 1 [cited 2021 Jul 15];70(6):1344–55. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/jan.12296
- Daneault S, Beaudry M, Godin G. Psychosocial Determinants of the Intention of Nurses and Dietitians to Recommend Breastfeeding. 2004.
- Brown A. What Do Women Lose if They Are Prevented From Meeting Their Breastfeeding Goals? Clin Lact [Internet]. 2018 Nov 1 [cited 2021 Jul 19];9(4):200–7. Available from: https://connect.springerpub.com/content/sgrcl/9/4/200