Comparing Perceived Barriers to Breastfeeding among Patients and Providers in East Tennessee

Authors' Affiliations

Blakelely Griffin, Department of Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN. Melissa White-Archer, Department of Health Services Management and Policy, CARE Women’s Health, College of Public Health, East Tennessee State University, Johnson City, TN. Kate Beatty, Department of Health Services Management and Policy, CARE Women’s Health, College of Public Health, East Tennessee State University, Johnson City, TN.

Location

Culp Center Ballroom

Start Date

4-25-2023 9:00 AM

End Date

4-25-2023 11:00 AM

Poster Number

57

Faculty Sponsor’s Department

Health Services Management & Policy

Name of Project's Faculty Sponsor

Melissa White-Archer

Additional Sponsors

Dr. Kate Beatty

Classification of First Author

Graduate Student-Master’s

Competition Type

Competitive

Type

Poster Presentation

Project's Category

Maternal Health

Abstract or Artist's Statement

Breastfeeding (BF) reduces maternal and infant risk for the development of a variety of short and long-term health outcomes. Appalachia faces several health disparities, with infants at increased risk for poor birth outcomes. The purpose of this study was to explore postpartum patients’ (PP) infant feeding experiences (IFE) and examine perceived barriers to BF among PPs and international board-certified lactation consultants (IBCLC) in Northeast Tennessee, located in Appalachia. PPs and IBCLCS were recruited using convenience and snowball sampling, respectively. Fourteen semi-structured interviews were conducted, 7 PPs and 7 IBCLCs. Interviews were conducted in-person or via Zoom and were recorded, transcribed, and de-identified. PPs were asked about their IFEs and barriers to BF, while IBCLCs were asked about perceived barriers to BF for their patient population. Rapid qualitative analysis was conducted with two coders, both summarizing the first interview for each participant type. Summaries were compared to ensure consistency and subsequent interviews were coded by a single coder. Summaries were used to identify high-level themes related to barriers to BF for each participant type. All analysis was conducted in Microsoft Excel, and the study was approved by the ETSU Institutional Review Board. High-level themes for PP IFEs included stressful experiences and the positive impacts of IBCLCs. Stressful experience sub-themes included latch and supply issues, pump and syringe feeding, PP and infant health complications, lack of hospital support, and expectations for supplementing. Barriers to BF for PPs incorporated physiological (latch and milk supply sub-themes) and environmental barriers (employment and family support sub-themes). High-level themes for IBCLCs perceived barriers to BF included PPs having access to too much information, perceptions and expectations of BF, cultural barriers, lack of support and prenatal education, physiological barriers, and maternal comorbidities. Overlap between PPs stressful IFEs and IBCLCs perceived barriers to BF included themes related to BF expectations, lack of support, physiological barriers, and comorbidities. Similarly, overlap between PPs and IBCLCs perceived barriers to BF included physiological and environmental factors. IBCLCs mentioned additional barriers such as access to too much information and lack of prenatal BF education, while these themes were not identified in PP interviews. A future focus for BF support includes discussions with clinicians after delivery about any physiologic barriers that PPs may face and informing providers on how to both avoid and treat these barriers as they arise to alleviate stress. Connection to BF support in the community before and after delivery could improve the chances that mothers receive help in addressing these issues as they arise. Furthermore, including family members in these discussions may help build family and overall social support.

This document is currently not available here.

Share

COinS
 
Apr 25th, 9:00 AM Apr 25th, 11:00 AM

Comparing Perceived Barriers to Breastfeeding among Patients and Providers in East Tennessee

Culp Center Ballroom

Breastfeeding (BF) reduces maternal and infant risk for the development of a variety of short and long-term health outcomes. Appalachia faces several health disparities, with infants at increased risk for poor birth outcomes. The purpose of this study was to explore postpartum patients’ (PP) infant feeding experiences (IFE) and examine perceived barriers to BF among PPs and international board-certified lactation consultants (IBCLC) in Northeast Tennessee, located in Appalachia. PPs and IBCLCS were recruited using convenience and snowball sampling, respectively. Fourteen semi-structured interviews were conducted, 7 PPs and 7 IBCLCs. Interviews were conducted in-person or via Zoom and were recorded, transcribed, and de-identified. PPs were asked about their IFEs and barriers to BF, while IBCLCs were asked about perceived barriers to BF for their patient population. Rapid qualitative analysis was conducted with two coders, both summarizing the first interview for each participant type. Summaries were compared to ensure consistency and subsequent interviews were coded by a single coder. Summaries were used to identify high-level themes related to barriers to BF for each participant type. All analysis was conducted in Microsoft Excel, and the study was approved by the ETSU Institutional Review Board. High-level themes for PP IFEs included stressful experiences and the positive impacts of IBCLCs. Stressful experience sub-themes included latch and supply issues, pump and syringe feeding, PP and infant health complications, lack of hospital support, and expectations for supplementing. Barriers to BF for PPs incorporated physiological (latch and milk supply sub-themes) and environmental barriers (employment and family support sub-themes). High-level themes for IBCLCs perceived barriers to BF included PPs having access to too much information, perceptions and expectations of BF, cultural barriers, lack of support and prenatal education, physiological barriers, and maternal comorbidities. Overlap between PPs stressful IFEs and IBCLCs perceived barriers to BF included themes related to BF expectations, lack of support, physiological barriers, and comorbidities. Similarly, overlap between PPs and IBCLCs perceived barriers to BF included physiological and environmental factors. IBCLCs mentioned additional barriers such as access to too much information and lack of prenatal BF education, while these themes were not identified in PP interviews. A future focus for BF support includes discussions with clinicians after delivery about any physiologic barriers that PPs may face and informing providers on how to both avoid and treat these barriers as they arise to alleviate stress. Connection to BF support in the community before and after delivery could improve the chances that mothers receive help in addressing these issues as they arise. Furthermore, including family members in these discussions may help build family and overall social support.