PROMOTING SUCCESSFUL BREAST-FEEDING AMONG WOMEN WITH A LOW-INCOME

Objective: to identify those factors which promote or discourage succe ssful breast feeding in a sample of women with a low income, Design: q ualitative research using in-depth, semi-structured interviews, Sample : all women with a low income who were identified as having breast fed their latest baby at least once and who had delivered at a district g eneral hospital in the south west of England from 17 September 1996 to 5 February 1997, Findings: three behavioural areas which determined w hether or not women with a low income continued to breast feed were id entified: individual and social environmental, baby and midwifery prac tice factors. In terms of individual and social environmental factors those women who continued to breast feed were more likely to have: pos itive attitudes; realistic expectations; greater levels of self-esteem ; a supportive mother/friend; a partner who was not against breast fee ding; and the ability to cope with the perceived temporary social isol ation. In terms of baby factors those women who continued to breast fe ed had babies who were move likely to: have three- or four-hourly feed s; be perceived as a contented baby; and have gained weight. And final ly, in terms of midwifery practice factors, those women who continued to breast feed were more likely to have: not been separated from their baby; not been given supplementary or complementary feeds; received g ood advice, especially with regard to positioning the baby at the brea st; had greater continuity of midwifery input; had sufficient quality time with a midwife; and had the opportunity to solve problems with a community midwife's help, Implications for practice: midwifery practic e can be improved to promote successful breast feeding among women wit h a low income by: 1) creating realistic expectations and increasing w omen's confidence/desire to succeed in breast feeding; 2) providing go od quality advice and support to mothers of newborn babies, particular ly with regard to positioning the baby at the breast; 3) improving soc ial-support networks available to breast-feeding mothers, perhaps thro ugh educating grandmothers (or partners) in breastfeeding matters.