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Significant others, situations and infant feeding behaviour change processes: a serial qualitative interview study

BACKGROUND: Exclusive breastfeeding until six months followed by the introduction of solids and continued breastfeeding is recommended by the World Health Organisation. The dominant approach to achieving this has been to educate and support women to start and continue breastfeeding rather than under...

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Autores principales: McInnes, Rhona J, Hoddinott, Pat, Britten, Jane, Darwent, Kirsty, Craig, Leone CA
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3663663/
https://www.ncbi.nlm.nih.gov/pubmed/23679158
http://dx.doi.org/10.1186/1471-2393-13-114
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author McInnes, Rhona J
Hoddinott, Pat
Britten, Jane
Darwent, Kirsty
Craig, Leone CA
author_facet McInnes, Rhona J
Hoddinott, Pat
Britten, Jane
Darwent, Kirsty
Craig, Leone CA
author_sort McInnes, Rhona J
collection PubMed
description BACKGROUND: Exclusive breastfeeding until six months followed by the introduction of solids and continued breastfeeding is recommended by the World Health Organisation. The dominant approach to achieving this has been to educate and support women to start and continue breastfeeding rather than understanding behaviour change processes from a broader perspective. METHOD: Serial qualitative interviews examined the influences of significant others on women’s feeding behaviour. Thirty-six women and 37 nominated significant others participated in 220 interviews, conducted approximately four weekly from late pregnancy to six months after birth. Responses to summative structured questions at the end of each interview asking about significant influences on feeding decisions were compared and contrasted with formative semi-structured data within and between cases. Analysis focused on pivotal points where behaviour changed from exclusive breastfeeding to introducing formula, stopping breastfeeding or introducing solids. This enabled us to identify processes that decelerate or accelerate behaviour change and understand resolution processes afterwards. RESULTS: The dominant goal motivating behaviour change was family wellbeing, rather than exclusive breastfeeding. Rather than one type of significant other emerging as the key influence, there was a complex interplay between the self-baby dyad, significant others, situations and personal or vicarious feeding history. Following behaviour change women turned to those most likely to confirm or resolve their decisions and maintain their confidence as mothers. CONCLUSIONS: Applying ecological models of behaviour would enable health service organisation, practice, policy and research to focus on enhancing family efficacy and wellbeing, improving family-centred communication and increasing opportunities for health professionals to be a constructive influence around pivotal points when feeding behaviour changes. A paradigm shift is recommended away from the dominant approach of support and education of individual women towards a more holistic, family-centred narrative approach, whilst acknowledging that breastfeeding is a practical skill that women and babies have to learn.
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spelling pubmed-36636632013-05-25 Significant others, situations and infant feeding behaviour change processes: a serial qualitative interview study McInnes, Rhona J Hoddinott, Pat Britten, Jane Darwent, Kirsty Craig, Leone CA BMC Pregnancy Childbirth Research Article BACKGROUND: Exclusive breastfeeding until six months followed by the introduction of solids and continued breastfeeding is recommended by the World Health Organisation. The dominant approach to achieving this has been to educate and support women to start and continue breastfeeding rather than understanding behaviour change processes from a broader perspective. METHOD: Serial qualitative interviews examined the influences of significant others on women’s feeding behaviour. Thirty-six women and 37 nominated significant others participated in 220 interviews, conducted approximately four weekly from late pregnancy to six months after birth. Responses to summative structured questions at the end of each interview asking about significant influences on feeding decisions were compared and contrasted with formative semi-structured data within and between cases. Analysis focused on pivotal points where behaviour changed from exclusive breastfeeding to introducing formula, stopping breastfeeding or introducing solids. This enabled us to identify processes that decelerate or accelerate behaviour change and understand resolution processes afterwards. RESULTS: The dominant goal motivating behaviour change was family wellbeing, rather than exclusive breastfeeding. Rather than one type of significant other emerging as the key influence, there was a complex interplay between the self-baby dyad, significant others, situations and personal or vicarious feeding history. Following behaviour change women turned to those most likely to confirm or resolve their decisions and maintain their confidence as mothers. CONCLUSIONS: Applying ecological models of behaviour would enable health service organisation, practice, policy and research to focus on enhancing family efficacy and wellbeing, improving family-centred communication and increasing opportunities for health professionals to be a constructive influence around pivotal points when feeding behaviour changes. A paradigm shift is recommended away from the dominant approach of support and education of individual women towards a more holistic, family-centred narrative approach, whilst acknowledging that breastfeeding is a practical skill that women and babies have to learn. BioMed Central 2013-05-16 /pmc/articles/PMC3663663/ /pubmed/23679158 http://dx.doi.org/10.1186/1471-2393-13-114 Text en Copyright © 2013 McInnes et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
McInnes, Rhona J
Hoddinott, Pat
Britten, Jane
Darwent, Kirsty
Craig, Leone CA
Significant others, situations and infant feeding behaviour change processes: a serial qualitative interview study
title Significant others, situations and infant feeding behaviour change processes: a serial qualitative interview study
title_full Significant others, situations and infant feeding behaviour change processes: a serial qualitative interview study
title_fullStr Significant others, situations and infant feeding behaviour change processes: a serial qualitative interview study
title_full_unstemmed Significant others, situations and infant feeding behaviour change processes: a serial qualitative interview study
title_short Significant others, situations and infant feeding behaviour change processes: a serial qualitative interview study
title_sort significant others, situations and infant feeding behaviour change processes: a serial qualitative interview study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3663663/
https://www.ncbi.nlm.nih.gov/pubmed/23679158
http://dx.doi.org/10.1186/1471-2393-13-114
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