The impact of the maternal experience with a jaundiced newborn on the breastfeeding relationship.

OBJECTIVE: To examine the process by which mothers' experiences with neonatal jaundice affect breastfeeding. STUDY DESIGN: We used ethnographic interviews with grounded theory methodology. Audiotaped data were transcribed and analyzed for themes using ATLAS/ti qualitative data analysis software (Scientific Software Development, Berlin, Germany). POPULATION: We studied a total of 47 Spanish- and English-speaking breastfeeding mothers of otherwise healthy infants diagnosed with neonatal jaundice. OUTCOME MEASURED: Our outcomes were the qualitative descriptions of maternal experiences with neonatal jaundice. RESULTS: Interactions with medical professionals emerged as the most important factor mediating the impact of neonatal jaundice on breastfeeding. Breastfeeding orders and the level of encouragement from medical professionals toward breastfeeding had the strongest effect on feeding decisions. Maternal reaction to and understanding of information from their physicians also played an important role. Guilt was common, as many mothers felt they had caused the jaundice by breastfeeding. CONCLUSIONS: By providing accurate information and encouragement to breastfeed, medical professionals have great impact on whether a mother continues breastfeeding after her experience with neonatal jaundice. Health care providers must be aware of how mothers receive and interpret information related to jaundice to minimize maternal reactions, such as guilt, that have a negative impact on breastfeeding.