Journal of Qualitative Research in Health Sciences
Journal of Qualitative Research in Health Sciences

Breastfeeding Mothers’ Informational Support Needs: A Qualitative Study in Iran

Document Type : Original Article

Authors

Nahid Maleki 1
Khadigeh Mirzaei 2

1 Department of Midwifery, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran

2 Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

10.34172/jqr.1412
Abstract
Background: Breastfeeding is a health promotion priority due to its implications for both maternal and infant health in the short and long term. However, breastfeeding rates have been steadily declining globally. Therefore, protecting, promoting, and supporting breastfeeding are recognized as public health priorities. Accordingly, this study aimed to explore the informational support needs of breastfeeding mothers.
Methods: This qualitative study was performed from March 2018 to April 2021 in five health centers and four hospitals affiliated with Mashhad University of Medical Sciences in Iran. Data were collected through individual semi-structured in-depth interviews with 25 breastfeeding mothers, 2 family members, and 9 healthcare providers. Data were analyzed using directed content analysis based on the approach proposed by Elo and Kyngas via MAXQDA 2010 software.
Results: Data analysis led to the identification of informational and educational services as the primary category with four subcategories including the need for instruction on proper breastfeeding behavior, the need for breastfeeding information, the need for information on maternal-related issues, and the need for information on infant-related issues.
Conclusion: Breastfeeding mothers require informational support to sustain breastfeeding. Significant others, such as healthcare providers, family members, and peers, play an important role in fulfilling breastfeeding mothers’ informational support needs.

Highlights

Nahid Maleki (PubMed) (Google Scholar)

Keywords

Breastfeeding mothers
Qualitative research
Social support
Informational Support
Need Assessment
  1. Department of Health. Healthy Child Programme: From 5-19 Years Old. Department of Health; 2009.
  2. Bachrach VR, Schwarz E, Bachrach LR. Breastfeeding and the risk of hospitalization for respiratory disease in infancy: a meta-analysis. Arch Pediatr Adolesc Med. 2003;157(3):237- 43. doi: 10.1001/archpedi.157.3.237.
  3. Bhandari N, Bahl R, Mazumdar S, Martines J, Black RE, Bhan MK. Effect of community-based promotion of exclusive breastfeeding on diarrhoeal illness and growth: a cluster randomised controlled trial. Lancet. 2003;361(9367):1418- 23. doi: 10.1016/s0140-6736(03)13134-0.
  4. Dewey KG, Heinig MJ, Nommsen-Rivers LA. Differences in morbidity between breast-fed and formula-fed infants. J Pediatr. 1995;126(5):696-702. doi: 10.1016/s0022- 3476(95)70395-0.
  5. Kramer MS, Guo T, Platt RW, Sevkovskaya Z, Dzikovich I, Collet JP, et al. Infant growth and health outcomes associated with 3 compared with 6 mo of exclusive breastfeeding. Am J Clin Nutr. 2003;78(2):291-5. doi: 10.1093/ajcn/78.2.291.
  6. World Health Organization (WHO). World Health Statistics 2012. Geneva, Switzerland: WHO; 2012-2013.
  7. Amel Barez M, Maleki N. Self-esteem and its associated factors in primiparous mothers referred to health centers in the city of Mashhad. J Clin Nurs Midwifery. 2016;5(2):19-28.
  8. Maleki-Saghooni N, Amel Barez M, Karimi FZ. Investigation of the relationship between social support and breastfeeding self-efficacy in primiparous breastfeeding mothers. J Matern Fetal Neonatal Med. 2020;33(18):3097-102. doi: 10.1080/14767058.2019.1568986.
  9. Maleki- Saghooni N, Amel Barez M, Moeindarbari S, Karimi FZ. Investigating the breastfeeding self-efficacy and its related factors in primiparous breastfeeding mothers. J Pediatr Perspect. 2017;5(12):6275-83. doi: 10.22038/ ijp.2017.25656.2182.
  10. Maleki-Saghooni N, Karshki H, Esmaily H, Zaidi Feroz F, Mirzaii Najmabadi K. Mothers’ breastfeeding experiences of emotional support needs: a qualitative study in Iran. J Caring Sci. 2021;10(3):169-76. doi: 10.34172/jcs.2021.023.
  11. Maleki-Saghooni N, Kareshki H, Esmaily H, Mirzaii Najmabadi K. A qualitative study exploring breastfeeding mother’s perceptions and experiences of appraisal support needs in Iran. J Midwifery Reproductive Health. 2022;10(2):3210-9. doi: 10.22038/jmrh.2022.62424.1762.
  12. Masala-Chokwe ME, Ramukumba TS. The lived experiences and social support needs of first-time mothers at health care facilities in the city of Tshwane, South Africa. Curationis. 2017;40(1):e1-8. doi: 10.4102/curationis.v40i1.1680.
  13. Ayers S, Crawley R, Webb R, Button S, Thornton A. What are women stressed about after birth? Birth. 2019;46(4):678-85. doi: 10.1111/birt.12455.
  14. Baldwin S, Malone M, Sandall J, Bick D. A qualitative exploratory study of UK first-time fathers’ experiences, mental health and wellbeing needs during their transition to fatherhood. BMJ Open. 2019;9(9):e030792. doi: 10.1136/ bmjopen-2019-030792.
  15. Vallin E, Nestander H, Wells MB. A literature review and meta-ethnography of fathers’ psychological health and received social support during unpredictable complicated childbirths. Midwifery. 2019;68:48-55. doi: 10.1016/j. midw.2018.10.007.
  16. House JS. Work Stress and Social Support. Addison-Wesley Series on Occupational Stress. Addison-Wesley Publishing Company; 1983.
  17. Cross-Barnet C, Augustyn M, Gross S, Resnik A, Paige D. Long-term breastfeeding support: failing mothers in need. Matern Child Health J. 2012;16(9):1926-32. doi: 10.1007/ s10995-011-0939-x.
  18. Nakano AM. [Breastfeeding experiences in a group of women: the limits of “the body for the child” and “the body for oneself”]. Cad Saude Publica. 2003;19 Suppl 2:S355-63. doi: 10.1590/s0102-311x2003000800017. [Portuguese].
  19. Shakespeare J, Blake F, Garcia J. Breast-feeding difficulties experienced by women taking part in a qualitative interview study of postnatal depression. Midwifery. 2004;20(3):251-60. doi: 10.1016/j.midw.2003.12.011.
  20. Wambach KA, Cohen SM. Breastfeeding experiences of urban adolescent mothers. J Pediatr Nurs. 2009;24(4):244-54. doi: 10.1016/j.pedn.2008.03.002.
  21. Akaberian S, Dianat M. Evaluation of factors influencing on non-exclusive breast feeding during the first six months of life in Bushehr port using focus group discussion. Iran South Med J. 2004;6(2):165-71.
  22. Chandrashekhar TS, Joshi HS, Binu V, Shankar PR, Rana MS, Ramachandran U. Breast-feeding initiation and determinants of exclusive breast-feeding - a questionnaire survey in an urban population of western Nepal. Public Health Nutr. 2007;10(2):192-7. doi: 10.1017/s1368980007248475.
  23. Dubois L, Girard M. Social determinants of initiation, duration and exclusivity of breastfeeding at the population level: the results of the Longitudinal Study of Child Development in Quebec (ELDEQ 1998-2002). Can J Public Health. 2003;94(4):300-5. doi: 10.1007/bf03403610.
  24. Hasani-Tayyebi M, Kermanshahi S. Influence of the supportive program on the exclusive feeding of neonates with mothers milk. J Health Care. 2013;15(4):9-17. [Persian].
  25. Tiwari R, Mahajan PC, Lahariya C. The determinants of exclusive breast feeding in urban slums: a community-based study. J Trop Pediatr. 2009;55(1):49-54. doi: 10.1093/tropej/ fmn037.
  26. Vohr BR, Poindexter BB, Dusick AM, McKinley LT, Wright LL, Langer JC, et al. Beneficial effects of breast milk in the neonatal intensive care unit on the developmental outcome of extremely low birth weight infants at 18 months of age. Pediatrics. 2006;118(1):e115-23. doi: 10.1542/peds.2005- 2382.
  27. Britton C, McCormick FM, Renfrew MJ, Wade A, King SE. Support for breastfeeding mothers. Cochrane Database Syst Rev. 2007(1):CD001141. doi: 10.1002/14651858. CD001141.pub3.
  28. Emami Naeini M. Because mothers succeed in breast feeding; what to do? Available from: https://vista.ir/w/a/16/fkgct.
  29. Barona-Vilar C, Escribá-Agüir V, Ferrero-Gandía R. A qualitative approach to social support and breast-feeding decisions. Midwifery. 2009;25(2):187-94. doi: 10.1016/j. midw.2007.01.013.
  30. Amirian M, Mirzaei Najmabadi K, Maleki N. Instrumental support needs of breastfeeding mothers: a qualitative study in Iran. J Midwifery Reproductive Health. 2024:1-8. doi: 10.22038/jmrh.2024.78918.2359.
  31. Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107-15. doi: 10.1111/j.1365- 2648.2007.04569.x.
  32. Humble ÁM. Technique triangulation for validation in directed content analysis. Int J Qual Methods. 2009 Sep;8(3):34-51. doi: 10.1177/160940690900800305.
  33. Polit DF, Beck CT. Nursing Research: Generating and Assessing Evidence for Nursing Practice. Lippincott Williams & Wilkins; 2008.
  34. Yılmaz E, Doğa Öcal F, Vural Yılmaz Z, Ceyhan M, Kara OF, Küçüközkan T. Early initiation and exclusive breastfeeding: factors influencing the attitudes of mothers who gave birth in a baby-friendly hospital. Turk J Obstet Gynecol. 2017;14(1):1- 9. doi: 10.4274/tjod.90018.
  35. Allahgholi L, Rahmani A, Hajikazemi ES, Hosseini AF. The relationship between the duration of breast feeding and child weight gain up to the end of the age of 24-months. Iran Journal of Nursing. 2011;24(71):83-92. [Persian].
  36. Kohan S, Heidari Z, Keshvari M, Dolati A. Promoting breastfeeding empowerment in primiparous women: effect of family-center education and support. Daneshvar Medicine. 2020;24(4):51-8. [Persian].
  37. Arshad SM, Khani-Jeihooni A, Moradi Z, Kouhpayeh SA, Kashfi SM, Dehghan A. Effect of theory of planned behavior-based educational intervention on breastfeeding behavior in pregnant women in Fasa city, Iran. J Educ Community Health. 2017;4(2):55-63. doi: 10.21859/jech.4.2.55.
  38. Karimi FZ, Miri HH, Khadivzadeh T, Maleki-Saghooni N. The effect of mother-infant skin-to-skin contact immediately after birth on exclusive breastfeeding: a systematic review and meta-analysis. J Turk Ger Gynecol Assoc. 2020;21(1):46-56. doi: 10.4274/jtgga.galenos.2019.2018.0138.
  39. Mellin PS, Poplawski DT, Gole A, Mass SB. Impact of a formal breastfeeding education program. MCN Am J Matern Child Nurs. 2011;36(2):82-8. doi: 10.1097/ NMC.0b013e318205589e.
  40. Shahbazi-Sighaldeh S, Parvanevar S, Tayebi Z. Explaining mothers’ experiences from breastfeeding education. J Qual Res Health Sci. 2017;6(3):310-24. [Persian].
  41. Jafari F, Farahrooz H, Abyar Z, Tadayyon B, Azami F. The relationship between duration of breastfeeding and maternal factors. J Adv Biomed Sci. 2015;5(2):202-9. [Persian].
  42. Jenaabadi H, Jafarpour M. The effectiveness of time perspective treatment in sense of coherence and perceived stress of mothers of children with learning disorders. J Learn Disabil. 2019;9(1):53-71. doi: 10.22098/jld.2019.833. [Persian].
  43. McLelland G, Hall H, Gilmour C, Cant R. Support needs of breast-feeding women: views of Australian midwives and health nurses. Midwifery. 2015;31(1):e1-6. doi: 10.1016/j. midw.2014.09.008.
  44. Niazi A, Yousefzadeh S, Rakhshandeh H, Esmaily H. Comparison of the effects of purslane cream and lanolin for treatment of breast fissure on lactation self-efficacy: a randomized clinical trial. Iran J Obstet Gynecol Infertil. 2018;21(8):75-83. doi: 10.22038/ijogi.2018.11972. [Persian].
  45. Dykes F, Moran VH, Burt S, Edwards J. Adolescent mothers and breastfeeding: experiences and support needs--an exploratory study. J Hum Lact. 2003;19(4):391-401. doi: 10.1177/0890334403257562.
  46. Grassley JS. Adolescent mothers’ breastfeeding social support needs. J Obstet Gynecol Neonatal Nurs. 2010;39(6):713-22. doi: 10.1111/j.1552-6909.2010.01181.x.
  47. Lester A. Paternal Support for Breastfeeding: A Mixed Methods Study to Identify Positive and Negative Forms of Paternal Social Support for Breastfeeding as Perceived by First-time Parent Couples [dissertation]. University of South Florida; 2014. Available from: https://digitalcommons.usf.edu/etd/5059.
  48. Palupi RA, Devy SR. Role of social support in breastfeeding for adolescent mothers. KnE Life Sci. 2018;4(4):223-31. doi: 10.18502/kls.v4i4.2281.
Journal of Qualitative Research in Health Sciences
Volume 14
Pages 1-8

  • Receive Date 20 March 2024
  • Revise Date 18 January 2025
  • Accept Date 22 September 2024

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