Breastfeeding Decision-Making in an Addiction Trajectory: An Exploratory Grounded Theory Study
1East Carolina University College of Nursing, Greenville, NC Kristy.Cook@vidanthealth.com.
Research and Theory for Nursing Practice
|November 17, 2020
Summary
This study developed a conceptual model to understand breastfeeding in women with opioid use disorder (OUD). Findings highlight the impact of stigma and healthcare provider sensitivity on breastfeeding decisions for mothers in recovery.
Area of Science:
- Reproductive Health
- Addiction Medicine
- Maternal-Child Health
Background:
- Opioid use disorder (OUD) affects millions of women globally, with lower breastfeeding rates compared to the general population.
- Breastfeeding disparities in women with OUD increase the risk of neonatal withdrawal syndrome.
- Existing theoretical frameworks do not adequately address breastfeeding in the context of OUD.
Purpose of the Study:
- To develop a conceptual model for understanding breastfeeding disparities in women with OUD.
- To explore factors influencing breastfeeding decisions among women in recovery from OUD.
Main Methods:
- Grounded theory study utilizing in-depth interviews with 10 women with OUD who breastfed and six support persons.
- Data collected from August 2018 to March 2019 in North Carolina.
- Iterative coding used for data analysis, focusing on maternal perspectives.
Main Results:
- The central theme identified was breastfeeding decision-making within an addiction trajectory.
- A recovery-relapse cycle was observed, influenced by antecedent pathways.
- Perceived stigma linked the recovery-relapse cycle with 'breastworks,' an emergent concept encompassing knowledge, intentions, and provider sensitivity.
Conclusions:
- The developed grounded theory model can guide clinicians in supporting breastfeeding and newborn well-being for mothers with OUD.
- Suggested strategies include a mobile application, integrating women in recovery into healthcare teams, and incorporating breastfeeding guidelines.
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