Postnatal Unit Experiences Associated With Exclusive Breastfeeding During the Inpatient Stay: A Cross-Sectional Online Survey.

BACKGROUND: Efforts to provide accessible and effective infant feeding support are advancing to set up new families to meeting their goals. However, data continue to be limited for understanding how inpatient postpartum support and experiences contribute to exclusive breastfeeding during hospitalization. RESEARCH AIMS: To explore postnatal unit experiences including skin-to-skin contact, overnight support, rooming-in, responsive clinicians, and understandable communication that correlate with early infant feeding outcomes among a sample of mothers who intended to breastfeed. METHODS: This was a prospective cross-sectional survey study. Through secure online survey, participants submitted (N = 2,401) responses from November 2016 to May 2017 about their experiences with maternity healthcare and offered thoughts on the postnatal unit environment. Descriptive statistics were used to examine distributions of maternal characteristics, postpartum experience, and birthing facility characteristics. RESULTS: Exclusive breastfeeding was positively correlated with the following postnatal unit experiences: mother did not ask that her infant be taken out of the postnatal unit room; infant staying in postnatal unit room except for treatment(s); mother got help from clinical staff when needed after pressing the call button; and nurse, midwife, and/or doctor always explained information to mother in ways that they understood. CONCLUSION: Postnatal unit experiences associated with exclusive breastfeeding during postpartum hospitalization were rooming in; parents who did not ask for their infant to be taken out of the unit room; whether mothers received timely help from clinical staff; and information was explained in a way they could understand.

#EveryGenerationMatters: Intergenerational Perceptions of Infant Feeding Information and Communication Among African American Women.

Objective: African American (AA) women look to their mother and maternal grandmother for parenting information and support; this intergenerational communication may reinforce or hinder breastfeeding practices. Rooted in Black Feminist Thought, this study's objective was to use an asset-based approach to explore infant feeding information shared across at least two generations of AA female family members. Materials and Methods: Fifteen family triads/dyads (N = 35 women), residing in Southeastern United States, participated in semistructured interviews in 2019. Qualitative data were analyzed using thematic analysis. Results: Infant feeding information shared across generations was characterized into six themes: Guidance, Practical assistance, Reservations, Affirmations, Observational learning, and Perceived undermining. Typically, conversations occurred in one of four reproductive life stages (preconception, prenatal, birth, and post-birth) of the youngest adult generation and may have been influenced by each family's feeding history ("One generation breastfed," "Two generations breastfed," and "Three generations breastfed"). Notably, with each additional generation of breastfeeding experience, perceived undermining and reservation reporting decreased. In addition, families reclaimed and reconnected with ancestral breastfeeding practices. Conclusions: Findings suggest that every generation matters to breastfeeding behaviors in AA families. Therefore, nuanced, family-centered approaches should build on assets within AA families to support them in meeting their feeding goals. Practitioners should recognize the importance of oral tradition as a mode of transmitting infant feeding information among AAs and understand the influence of family feeding history in intergenerational infant feeding communication. When working with AAs, practitioners must be flexible, respectful, supportive, and actively learning about an individual's beliefs and culture, creating space to reframe, without judgment or paternalism.

" [T]his is What We are Missing": The Value of Communicating Infant Feeding Information Across Three Generations of African American Women.

BACKGROUND: Breast/Chestfeeding remains a public health issue for African Americans, and increased rates would mitigate many health disparities, thus promoting health equity. RESEARCH AIMS: To explore the interplay of generational familial roles and meaning (or value) ascribed to communicating infant feeding information across three generations. METHOD: This prospective, cross-sectional qualitative study used an asset-driven approach and was guided by Black Feminist Thought and Symbolic Interactionism. African American women (N = 35; 15 family triads/dyads), residing in the southeastern United States were interviewed. Data were analyzed using thematic analysis. RESULTS: The older two generations described their role using assertive yet nurturing terms, while the younger generation carefully discussed the flexibility between their familial roles. Emergent themes described the meaning each generation attributed to communicating infant feeding information: "My Responsibility," "Comforting," "Bonding Experience," "She Cared," and "Gained Wisdom." CONCLUSIONS: Our findings have potential to contribute to achieving health equity in African American families. Future breast/chestfeeding promotion efforts may benefit from reframing the current approach to including protection language and not solely support language. Lactation professionals should further recognize and support strengths and resource-richness of intergenerational infant feeding communication within African American families using strength-based, empowerment-oriented, and ethnically sensitive approaches.