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110 Abigail Locke Chapter 9 The seemingly paradoxical construct of breastfeeding as a “natural skill that needs teaching” has been examined in detail elsewhere and is evident by the plethora of books written by those who have been successful, giving advice to other mothers reflecting on their own experiences.1 In these breastfeeding texts, breastfeeding is represented as the ideal way to feed one’s baby, and women are encouraged toward making the “informed choice” to breastfeed.2 But most women learn how to breastfeed from health care workers, many from teachers in prenatal classes. This chapter examines the teaching of breastfeeding to understand if something in the presentation of breastfeeding in prenatal classes contributes to high rates of early weaning. The inclusion of prenatal teaching as one of the ten steps to successful breastfeeding demonstrates the importance of educating expectant mothers about lactation. As Riordan and others claim, most women decide on how they are going to feed their babies before and during pregnancy.3 The instructor in prenatal classes becomes a support to the mother, correcting inaccurate information around breastfeeding and offering advice. Prenatal breastfeeding classes educate women about correct positioning and reaffirm that breastfeeding is a skill that needs to be learned, worked at, and supported by knowledgeable others if difficult. Most commonly, breastfeeding information given in prenatal classes is backed up with written information and access to postnatal support.4 There is a wealth of research suggesting that the teaching of breastfeeding has a positive impact on breastfeeding rates and women’s reported experiences of it. Some research has found that prenatal breastfeeding education increased Preparing Women to Breastfeed Teaching Breastfeeding in Prenatal Classes in the United Kingdom Preparing Women to Breastfeed 111 both initiation and duration of feeding. One study noted how thirty-one out of thirty-five women who had received prenatal breastfeeding support were still exclusively breastfeeding at the six-week mark, compared with ten out of thirty-five in the control group. Others found that those women who had attended such a class were 75 percent more likely to exclusively breastfeed their child. These latter studies note, however, that teaching had no effect on duration rates. Thus, the teaching of breastfeeding seems to have an important role in late pregnancy and early parenting, but its role in improving breastfeeding duration is as yet unclear.5 While the need for breastfeeding education is clear, the actual teaching of breastfeeding both in terms of subject matter and teaching style may benefit from further scrutiny. As the data in this chapter demonstrates, there appears to be a tension when discussing potential problems that may arise. The dilemma then becomes: How do we educate women prior to the birth of their babies around some of the realities of breastfeeding, offering them practical strategies to deal with difficulties, rather than only telling them to seek support and guidance? As studies have documented, some women are loathe to seek guidance, regarding health professionals’ guidance as an intrusion, particularly in the early weeks of new motherhood.6 Support for breastfeeding from medical professionals is varied. Some studies have noted that midwives went against the official breastfeeding promotions , speaking of the need to “survive baby feeding.”7 Moves away from ideals set out by the Baby-Friendly Hospital Initiative were justified on the grounds of maternal care, so that the mother might rest and come to terms with the transition to motherhood. These justifications point to a lack of knowledge among health professionals regarding how to encourage breastfeeding. In the United Kingdom, for example, health professionals have gaps in specific knowledge around breastfeeding, often giving conflicting advice.8 Louise M. Wallace, head of the Breastfeeding Best Start project in the UK, acknowledges that there are bureaucratic barriers in the support given to breastfeeding mothers.9 Similarly, midwifery researchers Stephen Abbott, Mary J. Renfrew, and Alison McFadden argue that training and support to breastfeed are done informally by a few breastfeeding “champions.” They argue that more support is needed.10 The form that this support takes can vary. For example, one study found that in rural Australia, telephone-based support helped increase breastfeeding duration.11 Another found there to be no difference in terms of duration between hands-off advice and physical demonstration.12 These studies suggest that postnatal support to breastfeed may indeed be more useful than information given prenatally. This chapter places its focus on the actual teaching of...

Additional Information

ISBN
9780813553160
Related ISBN
9780813553030
MARC Record
OCLC
805510887
Pages
356
Launched on MUSE
2012-08-22
Language
English
Open Access
No
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