Edinburgh Napier University

  Background: Breast‐feeding is considered the optimum method of infant nutrition conveying health and psychological benefits for mother and baby. Women from disadvantaged groups are less likely to initiate or successfully establish breast‐feeding and with the current emphasis on addressing health inequalities there is an identified need to tailor breast‐feeding strategies towards this population.
Objectives: To appraise and synthesize the best available evidence on effectiveness and maternal satisfaction of interventions supporting the establishment of breast‐feeding in the early postnatal period, up to seven days following delivery, for women from disadvantaged groups.
Results: The quantitative review demonstrated that technical assistance and information provision resulted in greater awareness of breast‐feeding physiology, increased rates and a longer duration of breast‐feeding. The qualitative synthesized findings suggested that maternal satisfaction was enhanced when proactive practical assistance was given within the confines of a collaborative relationship. Professional support offering positive encouragement and delivering socially and culturally appropriate strategies were considered by mothers as helping to meet their breast‐feeding objectives. Disempowering practices included inaccessible information, conflicting advice and judgmental attitudes from health care providers.
Conclusions: The review identified interventions aimed at enhancing technical skill and knowledge as clinically effective in establishing successful breast‐feeding. Disadvantaged women considered support strategies offering culturally relevant advice and specific to their individualized needs as the most acceptable and effective in meeting their breast‐feeding intentions.
Implications for practice: The evidence suggests that health care interventions facilitating both maternal awareness of the physiology of breast‐feeding and the acquisition of technical skill assists establishment of breast‐feeding. Proactive, professional support complementing practical advice with positive encouragement and tailored to the mother's specific needs appears to be both useful and acceptable for disadvantaged women establishing breast‐feeding.
Implications for research: Future studies should evaluate how health care professionals promote the establishment of breast‐feeding for women from disadvantaged groups specifically in relation to the additional social and cultural barriers experienced by these groups.