Assisting women to establish breastfeeding: exploring midwives' practices

Breastfeeding is recognised by many mothers, families and health professionals to be important for the health and wellbeing of mothers and babies. Successful breastfeeding depends on the acquisition of basic skills, accurate information and practice, and is strongly influenced by the support provided following childbirth. Midwives' practices may therefore have the potential to influence breastfeeding outcomes. Correct positioning and attachment of the newborn at the breast is a crucial component of the successful establishment of breastfeeding. A literature review revealed that minimal research exists on the practices that midwives use when assisting women to initiate breastfeeding. A series of focus group interviews were therefore conducted to stimulate in-depth exploration of midwives' understanding and practices in the positioning and attachment of a newborn infant at the breast. Eighteen midwives, each of whom had worked at least 12 months in the postnatal environment of a large metropolitan hospital in Adelaide, participated in the focus group discussions. Using thematic analysis, the following broad themes emerged from discussions--education, problem-solving, support, midwives' views about breastfeeding and influences on midwives' practice. These themes identify the roles and practices that midwives take on when assisting women to establish breastfeeding following childbirth, and also raise awareness of influences on their practice.