La inducción de la lactancia en madres que no han dado a luz: un desafío para las matronas ante nuevas demandas / The induction of lactation in mothers who have not given birth: a challenge for midwives in the face of new demands

Objetivo: Conocer las demandas que dirigen a las matronas las mujeres que han pasado por un proceso de inducción de la lactancia o relactación en España, así como profundizar en los sentimientos que pueden presentar estas mujeres. Métodos: Estudio cualitativo fenomenológico. Se realizó un muestreo de máxima variabilidad con el fin de entrevistar a 9 mujeres españolas: 3 de cada perfil (adopción, subrogación, pareja de dos mujeres) que habían pasado por un proceso de inducción de la lactancia materna o relactación entre los años 2000 y 2015. Como técnica se usó la entrevista en profundidad. Después de transcribir las entrevistas, los datos fueron interpretados mediante análisis de contenido con la ayuda del programa Atlas.ti versión 7.5.7.Resultados: Participaron 9 mujeres. De los principales hallazgos se desprenden demandas de información, seguimiento y apoyo durante el proceso. La mayoría de las mujeres no recibió seguimiento por parte de los profesionales sanitarios, quienes mostraron desconocimiento o poca confianza en el proceso y en su éxito. El apoyo recibido vino fundamentalmente por parte de sus parejas. Esta falta de apoyo profesional se tradujo en sentimientos de soledad y vulnerabilidad entre las participantes. Los foros sobre lactancia en internet, las experiencias en la red de otras madres que habían pasado por el mismo proceso y los grupos de lactancia fueron la fuente principal de información para poder realizar los procesos.Conclusiones: Para dar respuesta a la demanda de información, seguimiento y apoyo durante el proceso de inducción de la lactancia y relactación es necesario incluir dichos contenidos en la formación de matronas y otros profesionales sanitarios. Dando respuesta a estas demandas, se podrán evitar situaciones de soledad y vulnerabilidad entre las mujeres que deciden pasar por estos procesos, así como mejorar los índices de lactancia materna. (AU)

Objective: To know what are the demands that women who have undergone a process of induction of lactation or relactation direct to midwives, as well as to delve into the feels that these women may present. Methods: Qualitative phenomenological study. A maximum variability sampling was carried out in order to interview 9 Spanish women: 3 of each profile (adoption, surrogacy, female couple) who had undergone a process of induction of breastfeeding or relactation between the years 2000 and 2015. The in-depth interview was used as a technique. After transcribing the interviews, the data were analyzed by content analysis with the help of Atlas.ti version 7.5.7 program.Results: 9 women participated. The women interviewed expressed demands for information, follow-up and support during the process. Most of the women were not followed up by health professionals, since they showed ignorance or little confidence in the process and its success. The women state that the support, received which was mainly from their partners. This lack of professional support translated into feelings of loneliness and vulnerability among the participants. The forums on breastfeeding on the Internet, experiences in the network of other mothers who had gone through the process and the breastfeeding groups were the main source of information to be able to carry out the processes of induction of lactation and relactation.Conclusions: It is necessary to include both processes, induction of lactation and relactation, in the training of midwives and other health professionals to avoid situations of loneliness and vulnerability of women who decide to go through these processes. (AU)

Methods and Success Factors of Induced Lactation: A Scoping Review.

BACKGROUND: Induced lactation enables a woman who has not given birth to breastfeed a child. Lactation may be induced through both pharmacological and non-pharmacological methods, although the desired outcome cannot always be achieved. RESEARCH AIMS: The aims of this scoping review was to assess the different methods used to induce lactation, as well as the factors related to sucking the breast effectively and the production of human milk. METHODS: We searched five databases from June 2019-February 2020 for studies referring to methods and factors related to breast suckling and/or the volume of milk produced after inducing lactation, using the following search terms and Boolean operators: breastfeeding AND induced lactation AND adoptive mothers OR surrogate mothers OR female homosexuality OR non-gestating. The final review included a total of 24 articles. RESULTS: Pharmacological methods were not always used to produce milk, although breast stimulation was essential. The age of the child, interference due to bottle feeding, breast stimulation, and the support received were important factors in the induction of lactation. There were several factors that may account for the differences between developing and higher income countries in methods of induced lactation and the amount of milk that study participants produced. There was no consensus over whether previous pregnancy and/or breastfeeding experience influenced induced lactation. CONCLUSION: Health professionals need to have adequate knowledge about induction methods, the preferences of each woman, and the reasons for inducing lactation, to provide proper assistance. However, the lack of standardization about induction of lactation makes it difficult.

Understanding the Challenges of Induction of Lactation and Relactation for Non-Gestating Spanish Mothers.

BACKGROUND: Induced lactation and relactation are the processes that enable breastfeeding in non-gestating mothers. RESEARCH AIM: The aim of this study was to describe and interpret the challenges faced by mothers who undergo induced breastfeeding and relactation for adopted infants, infants born via surrogacy, and infants born to same-sex female partners. METHODS: A qualitative study was performed using in-depth interviews conducted with Spanish women (N = 9) who had decided to undergo induced lactation or relactation. The data were collected between October 2014 and May 2017. The length of the study was due to the difficulty in locating and recruiting the sample. Interviews were transcribed and coded with the ATLAS.ti v.7.5.7 software. We performed a deductive thematic analysis, creating categories based on the interview questions, which we developed on the basis of previous literature about induced lactation and relactation. RESULTS: Participants described the following challenges: the physical hardships of the process; breastfeeding problems; difficulty with accessing information about induced lactation or relactation; and lack of support from health professionals. Breastfeeding periods lasted from 1.5 months to 4 years. Participants reported that breastfeeding increased the closeness between the mother and child and that this feeling of closeness tended to decrease after breastfeeding cessation. CONCLUSION: We offer data and analysis that can improve our understanding of the lived experiences of women undergoing the process of relactation or induced lactation and may help guide intervention strategies to support women in this situation.