Breastfeeding supports and services : a community perspective

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2011-12
Authors
Flood, Jeanie Livernois
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[Honolulu] : [University of Hawaii at Manoa], [December 2011]
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Abstract
In the State of Hawaiʻi, breastfeeding initiation rates are higher than the national average but fall below target rates for duration of breastfeeding. Appropriate and timely breastfeeding services can improve breastfeeding exclusivity and duration but gaining access to these types of services is challenging for mothers living in rural areas of the state. Health care workers (HCW) providing services to mothers and infants are in a key position to encourage and support breastfeeding efforts. Specific aims of this study were to: (a) describe the characteristics and breastfeeding patterns of women living in Hilo, Hawaiʻi; (b) describe the characteristics of the HCWs working with childbearing mothers in Hilo, Hawaiʻi; (c) describe HCWs‟ understanding of community breastfeeding supports and services that exist within Hilo, Hawaiʻi; and d) geographically illustrate breastfeeding services in Hilo, Hawaiʻi. Method The study design used a mixed methods approach involving qualitative and quantitative data collection to address the research study aims. The quantitative data collected included demographic characteristics of the participants and available breastfeeding data about women in Hilo including initiation, duration, and exclusivity of breastfeeding. The qualitative method used was a focused ethnography. This approach was used to gather data from participant HCWs (N = 23) about their individual or shared experience(s) about the breastfeeding supports and services available in their community. An iterative process of coding and categorizing the data followed by conceptual abstraction into patterns was completed. Data from the research aims were compiled to create a map of the available community breastfeeding resources. Results Available data reveals that the State of Hawaiʻi exceeds national targets for breastfeeding initiation but rates drop following delivery, and mixed feedings of infants is common. Three patterns emerged from the qualitative interviews: Operating within Constraints of the Particular Environment, Coexisting Messages, and Process Interrupted. Participants identified a number of gaps in breastfeeding services available to their clients including the lack of available lactation consultants and the inconsistent communication between hospital and community providers. Finally, a number of implications for practice and further research are suggested to address the identified gaps in breastfeeding services.
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Ph.D. University of Hawaii at Manoa 2011.
Includes bibliographical references.
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breastfeeding
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Theses for the degree of Doctor of Philosophy (University of Hawaii at Manoa). Nursing.
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