Maternal perceptions of early breastfeeding experiences and breastfeeding outcomes at 6 weeks

Objective:

To explore whether breastfeeding status at 6 weeks postpartum is related to the mother’s perceptions of her infant’s behavior, the breastfeeding experience itself, and of herself as a mother during postpartum hospitalization.

Design:

A prospective correlational design.

Setting:

A tertiary care setting in Eastern Canada.

Participants:

One hundred and ten women who met the inclusion criteria were recruited from the postpartum unit. The majority were primaparous, over 25 years of age, well educated, and had partners.

Outcome measures:

(1) Maternal perceptions of the overall infant behavior, of the breastfeeding experience, and of herself using the Mother and Baby Scales (MABS) neonatal (Wolke, D., 1995. St. James Roberts and Wolke Mother and Baby Scales (MABS) (1986,1995). In: Brazelton, T.B., Nugent, J.K. (Eds.), Neonatal Behavioral Assessment Scale. Clinics in Developmental Medicine 137, 135–137) and (2) breastfeeding rates at 6 weeks postpartum.

Results:

At 6 weeks postpartum, 80 (74.8%) participants were breastfeeding and 27 (25.8%) had stopped. Maternal perceptions of infant alertness/responsiveness (A) (r = 0.54, p < 0.01), irritability during feeds (IDF) (r = −0.34, p < 0.01) and lack of confidence in feeding (LCF) (r = 0.33, p < 0.01) of the MABS neonatal scales were significantly correlated with breastfeeding status at 6 weeks. At 6-week telephone follow-up, the majority of women reported positive breastfeeding experiences, which included feelings of enhanced attachment, enjoyment and a sense of pride and fulfillment. Participants indicated that learning about infant states, behaviors, and cues contributed to their positive feelings about the baby and enjoyment of breastfeeding. Negative experiences were related to perceived insufficient milk supply, illness, and incompatibility of lactation with personal needs and life style.

Conclusions:

The findings highlight the importance of maternal perceptions of their infant’s behavior and of self as a mother in sustaining breastfeeding. In the absence of personal and social pressures to stop breastfeeding, interventions that begin with how to look at feeding from an infant perspective may be the best starting point to a successful breastfeeding.