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Breastfeeding initiation rates in Australia are high but duration rates fall well below the World Health Organization targets. Return to work is a known factor impacting 6 months exclusive breastfeeding and continuation into the infants second year of life. Work related factors can influence a woman's confidence in maintaining breastmilk supply after return to employment and determine whether she meets her personal breastfeeding goals. This cross‐sectional online survey is the first Australian study to explore women's experience of maintaining breastfeeding after return to work, in all work sectors. Results revealed variations across work sectors reflected in worker autonomy and confidence in speaking up about breastfeeding rights. Women who had autonomy or flexibility in planning their workday were more likely to be confident in maintaining breastmilk supply. The main predictors for milk supply confidence and meeting personal breastfeeding goals included having: a suitable place to express milk; confidence in speaking out about rights; a formal return‐to‐work plan; a supportive workplace; and returning to work after the period of exclusive breastfeeding. This study reveals that supportive workplace environments can lead to increased confidence in maintaining milk supply, extending durations of breastfeeding. Women who are confident in their rights to express breastmilk, or breastfeed at work, are more likely to meet their own breastfeeding goals. Education, and awareness raising, on the rights of breastfeeding women in the workplace, is a gender equity imperative that can improve experiences for breastfeeding women, and, increase manager and co‐worker knowledge for creating enabling workplace environments for breastfeeding employees. Key messages: Return to work after the birth of a baby impacts breastfeeding duration and personal goal attainment. Unsupportive employment factors can lead to a loss of confidence in ability to maintain adequate breastmilk supply.Having access to sufficient paid parental leave, a suitable place to express milk, autonomy, or ability to take lactation breaks, a formal return to work plan, and confidence in speaking up about breastfeeding rights, impacts meeting breastfeeding goals.Increasing knowledge and awareness on the rights of breastfeeding workers, and the components of supportive and enabling environments, will improve women's confidence in their ability to maintain adequate breastmilk supply, and meet their breastfeeding goals, after return to work. [ABSTRACT FROM AUTHOR]

In Australia, one of the most frequent reasons for not breastfeeding is a previously unsuccessful experience. This qualitative study used an appreciative inquiry approach to co‐design a model of peer and professional breastfeeding support, in a metropolitan area of New South Wales (NSW) Australia, in collaboration with women who have had previous negative experiences of breastfeeding. In total, 30 mothers, health professionals and peer supporters participated in a two‐part study, involving interviews and a collaborative workshop. The data were analysed using content analysis. The appreciative inquiry approach led to a solution focused attitude among participants and a commitment to improving breastfeeding support. We noted a level of apathy when the participant groups were interviewed individually prior to the collective workshop. During the collaborative workshop, all three participant groups came together to look at what was currently working well and designed improvements for the future. Midwifery care was identified as important for the start of the breastfeeding journey, during pregnancy and for the first 1–2 weeks after birth, but thereafter it was community and trained peer counsellors who were prioritised for breastfeeding support. Participants identified the need for a variety of support options including face‐to‐face meetings, Skype meetings, phone calls and/or texting. Workshop participants emphasised the need for women, especially those with previous negative experiences, to be linked in with their local peer support community group. An appreciative inquiry approach brought together all key stakeholders to develop practice‐based change which included the end user and care providers. The collaborative workshop enabled participants to come together, as individuals, rather than as designated health professionals or trained peer counsellors, or breastfeeding women with negative experiences. This led to a unified approach and a harnessing of collective energy to initiate positive change. [ABSTRACT FROM AUTHOR]

Migrants to Thailand come from low‐income border countries, such as Burma (Myanmar). Generally, migrant women experience difficulties obtaining high‐quality health care due to socioeconomic barriers and conflicts with their practices. The aim of this study was to explore migrant Burmese women's experiences of becoming a mother while living in Thailand and their perceptions of motherhood, family support, and traditional postpartum practices. The study used an ethnographic design. In 2015, data were gathered through individual interviews with 10 migrant Burmese women before and after birth. Interview and field note data were analyzed using thematic analysis. Four themes emerged from the data: (i) the more children, the stronger the family; (ii) finding ways to promote baby's health and growth; (iii) sharing responsibility to fulfill parenting role; and (iv) peer and family support. Becoming a mother was important to the Burmese women interviewed; however, as migrants in Thailand, they had to juggle work and care for young children. Most decided that once their child was school age they would be sent to Burma to live with relatives. They engaged in a range of traditional practices to support their infant's health and well‐being and protect their baby from evil spirits. Support from family, and the ability to participate in postpartum practices, were important for Burmese migrant women becoming mothers in Thailand. [ABSTRACT FROM AUTHOR]

Background: Improving breastfeeding support to mothers has been the focus of several national and international health organisations. There is evidence that theoretical and clinical education improves breastfeeding knowledge and attitudes among nursing and other health professional students prior to clinical placement, to support women who are breastfeeding. Aims and objectives: To explore the expectations and experiences of Taiwanese nursing students in supporting breastfeeding on clinical placement. To gain additional insight into student experience, we also sought the perspectives of mothers, nursing staff and teachers about the role of nursing students in supporting breastfeeding mothers. Design: A qualitative descriptive approach guided this study. Methods: Focus groups and small group interviews were conducted with four participant groups in southern Taiwan. Ethical approval was obtained prior to data collection. The consolidated criteria for reporting qualitative research checklist was used. Findings: Three main themes emerged from the data that captured the nursing students' experiences during clinical practice, which were "High expectations"; "The reality is different"; and "Improving confidence in students." The study found that students lacked confidence in supporting breastfeeding in the clinical setting. Students were expected to support women to achieve their breastfeeding goals under the supervision. The students highlighted the importance of establishing trust to effectively support mothers, and for the students to feel confident to provide the breastfeeding information. Conclusions: Despite structured theoretical breastfeeding education prior to clinical placement, students did not feel they were adequately prepared to support women who are breastfeeding during their clinical placement. The findings demonstrated the need for further support in developing effective communication skills and building confidence prior to clinical placement. Relevance to clinical practice: Enhancing the content of theoretical and simulated breastfeeding education to incorporate women's breastfeeding experience combined with realistic clinical student allocation could serve to improve students' confidence in supporting breastfeeding. [ABSTRACT FROM AUTHOR]

Internationally, women give mixed reports regarding professional support during the early establishment of breastfeeding. Little is known about the components of midwifery language and the support practices, which assist or interfere with the early establishment of breastfeeding. In this study, critical discourse analysis has been used to describe the language and practices used by midwives when supporting breastfeeding women during the first week after birth. Participant observation at two geographically distant Australian health care settings facilitated the collection of 85 observed audio-recorded dyadic interactions between breastfeeding women and midwives during 2008-2009. Additionally, 23 interviews with women post discharge, 11 interviews with midwives and four focus groups (40 midwives) have also been analysed. Analysis revealed three discourses shaping the beliefs and practices of participating midwives. In the dominant discourse, labelled 'Mining for Liquid Gold', midwives held great reverence for breast milk as 'liquid gold' and prioritised breastfeeding as the mechanism for transfer of this superior nutrition. In the second discourse, labelled 'Not Rocket Science', midwives constructed breastfeeding as 'natural' or 'easy' and something which all women could do if sufficiently committed. The least well-represented discourse constructed breastfeeding as a relationship between mother and infant. In this minority discourse, women were considered to be knowledgeable about their needs and those of their infant. The language and practices of midwives in this approach facilitated communication and built confidence. These study findings suggest the need for models of midwifery care, which facilitate relationship building between mother and infant and mother and midwife. [ABSTRACT FROM AUTHOR]

Background: In Australia, during the early establishment phase of breastfeeding, women can access telephone peer support counselling provided by the Australian Breastfeeding Association (ABA) however options for face-to-face peer support are limited. The known factors which improve ongoing and exclusive breastfeeding include face-to-face support, peer and/or professional support, and trained personnel. This study aimed to examine women's experiences of accessing one breastfeeding drop-in peer support service provided by trained peer support volunteer counsellors from the ABA. Methods: Women who accessed the service were invited, in 2014, to participate in an anonymous online survey which collected both quantitative and qualitative data. Participants were asked about their experiences of breastfeeding support, as well as their experiences of the drop-in service. In total, 53 women completed the online survey, and subsequent analysis generated descriptive statistics and qualitative themes. Results: Responses to the survey revealed that women attended the drop-in service with infants ranging in age from less than 1 week through to 12 months of age. Most women reported attending with infants aged 0–8 weeks of age (72%). The predominant presenting problems identified were sore/damaged nipples, difficulties with infant latching to the breast, or concerns about using nipple shields. Analysis of the open text qualitative responses revealed one overarching theme 'Support to continue breastfeeding' and four subthemes: 'feeling listened to and not judged'; 'emotional support and confidence building'; 'the importance of face-to-face, practical support'; and 'the need for ongoing, free access'. Discussion: In this study many women were seeking support for ongoing breastfeeding difficulties. Health professionals who had limited breastfeeding knowledge and skills were identified as most unhelpful in providing support with ongoing breastfeeding difficulties. Women valued having access to trained peer counsellors, who had the capacity to provide non-judgemental, face-to-face support; who could sit through a feed; in a space that was 'safe'; and who could enhance a woman's confidence with breastfeeding over the course of her full breastfeeding journey. Conclusions: Reactive peer support, provided in response to need, at an Australian Breastfeeding Association drop-in service, was described by participants as pivotal to enabling their ongoing breastfeeding. [ABSTRACT FROM AUTHOR]

Breast milk is the perfect food during infancy. Adequate support from family and health systems can be helpful to continue breastfeeding. This study aimed to determine the status of breastfeeding challenges and its relationship with social support and socio-demographic factors. In this correlational-descriptive study, 348 breastfeeding mothers were recruited using cluster random sampling from health care centers in Tabriz, Iran in 2022. Socio-demographic, breastfeeding challenges and social support questionnaires were used for data collection. Data were analyzed for descriptive and inferential statistics (Pearson correlation tests, independent t-test, one-way ANOVA and general linear model) using SPSS version 16. Difficulty in completing household tasks and breastfeeding at the same time (32.5 percent) was the most common challenge reported by mothers. There was an inverse and significant correlation between perceived social support and experiencing challenges (r = −0.199؛ p =.001). Based on the adjusted general linear model, with increasing social support, the score of breastfeeding challenges decreased (B = −0.165; 95 percent CI: −0.07–0.25, p <.001). Considering the relationship between perceived social support and the challenges experienced during breastfeeding, it can be concluded that adequate support from family along with training and guidance from health care providers can lead women to have better breastfeeding experiences and overcome breastfeeding problems. [ABSTRACT FROM AUTHOR]

Background: Significant efforts by governments at a global and national level have not resulted in a significant increase in the duration of breastfeeding to six months. The views of family and social networks, and community attitudes particularly around breastfeeding in public, influence infant feeding decisions. Yet many interventions designed to increase breastfeeding focus on the individual woman and have not been developed from the 'ground up' in consultation with women and communities. This study aimed to identify the key components of Mother Infant Caring Communities that promote and support breastfeeding and early parenting. Methods: Appreciative Inquiry was used to facilitate a 'Community Conversation' workshop in two local councils in Australia. Thirty-five participants attended the community conversation workshops including new parents, grandparents, children's services, local government, and representatives from maternity and child health services. In addition, one focus group discussion was conducted with six retail business owners or managers. Qualitative content analysis was used to analyse data. This paper presents the findings of the first phase (the Discovery phase) of the study. Results: Four major themes emerged: "PLACE – A community for everyone"; "A PLACE for children and families"; "Sometimes a PLACE to breastfeed" and "The parent room: a hidden and unsafe PLACE to breastfeed". Participants described the characteristics of communities that provided a sanctuary and fostered well-being for parents and infants including, open green spaces, safe playgrounds, walking tracks and community hubs. Shopping centres were described as having the potential to be the 'village'. Community-based services to support breastfeeding and parenting were highly valued. Yet in both sites, participants stated that breastfeeding was rarely observed in public and bottle feeding was more evident. Conclusion: Breastfeeding and parenting are embedded in the places where women and families live. Community spaces including shopping centres, should be designed to include infants and young children and offer appropriate facilities such as safe and clean parenting rooms. Health services must work with local government, businesses, and diverse community members to identify what parents' value about their community and design and implement innovative local strategies to support breastfeeding. [ABSTRACT FROM AUTHOR]