Protecting Your Ability to Breastfeed Your Baby: A Pilot Feasibility Study of an Educational Program for Breastfeeding Mothers and Babies

Abstract

Despite the fact that the first 6 months of exclusive breastfeeding is recommended by WHO/UNICEF and the American Academy of Pediatrics, only 16% of mothers in the United States exclusively breastfeed their infants for the first 6 months postpartum. Perceived insufficient milk (PIM) is the number one reason for early breastfeeding discontinuation cross culturally. Discontinuation from PIM begins in the first 1 to 2 weeks postpartum and continues to be a primary concern over the course of breastfeeding regardless of the infant’s age. There are two mutable causes of PIM: (1) maternal perception about infant behavior and (2) maternal lack of confidence in her ability to breastfeed her infant. Breastfeeding behaviors aimed at modifiable factors can help mothers establish and sustain their breastfeeding practice. The goals of this study were to add to a mother’s knowledge and skills in breastfeeding; to increase her sensitivity to infant behavioral cues; to increase the likelihood that she will respond to infant behavior by unrestricted breastfeeding directly on the breast; and to enhance her confidence (self-efficacy) in breastfeeding. By achieving these goals, the hypothesis was that the mother would be less likely to perceive her infant’s behavior to be a result of PIM, and she would be more likely to establish and sustain breastfeeding directly on the breast in the first month postpartum. The specific purpose of this study was to evaluate the feasibility and short-term impact of the program, Protecting Your Ability to Breastfeed Your Baby, using mixed methods within a single group, three-occasion pretest-posttest design. The educational program was implemented during three home intervention sessions delivered to 15 dyads of breastfeeding mothers and their healthy, full term singleton infants within 1 month postpartum. The study was feasible. However, recruitment was particularly challenging. The intervention significantly increased participating mother’s sensitivity to infant behavioral cues, improved maternal breastfeeding self-efficacy, and enhanced the relationship between infant crying behavior and perceived adequate milk supply. In addition, there was a significant improvement in the quality of the mother and infant relationship. A larger study using a more rigorous research design is warranted.