A framework of long-term breastfeeding counseling and support in Finland

Breastfeeding beyond infancy provides health benefits for both children and breastfeeding parents but supporting it is not an established practice in health promotion in Western countries. The present study is the first to present a framework describing the measures required in health care settings to develop counseling and support for long-term breastfeeding. The study was carried out in Finland and provides perspectives into the development of breastfeeding counseling practice in Western healthcare settings.

This qualitative descriptive study employed online focus group interviews (n = 4) and inductive content analysis. The participants (N = 22) were public health nurses (n = 12) with experience in supporting long-term breastfeeding in maternity and child health clinics, and trained breastfeeding peer supporters (n = 10), who play a key role in promoting breastfeeding beyond infancy. To support consensus-building during the development of the framework, a feedback round of the analysis was conducted among the participants.

The framework consisted of two main categories: Individual counseling, and Structural-level support. Individual counseling involved active promotion of long-term breastfeeding, counseling during infancy to enable continuation of breastfeeding, counseling for long-term breastfeeding and a family-centered approach. Structural-level support included a system structured to support long-term breastfeeding and ensured competence related to long-term breastfeeding support.

The framework outlines the key counseling content and practical strategies to effectively support families with breastfeeding beyond infancy. The results emphasize the need for multi-level actions, from individual professionals to organizational structures, to create supportive environments for long-term breastfeeding within health care services.

The framework offers practical value for enhancing training initiatives for health professionals and for developing maternal and child health services at the organizational level.