The purpose of this research was to provide insight into midwives' different approaches or attitudes during breastfeeding consultations.
A new mother who experiences difficulty breastfeeding often feels vulnerable and exposed. She needs affirmation; not giving her affirmation can result in her experiencing even more stress and insecurity , thus increasing the distance to the child. Protecting and promoting breastfeeding should primarily involve seeing mother and child as an integrated unit, and, to the extent possible, attempting to bring the two together. When infant formula becomes necessary as a result of medical issues, it is even more important that the mother feels as though she is part of the process and important to her child. Breastfeeding is based on collaboration between mother and child, and the mother often requires the midwife's support in the process. Not feeling respected or supported by the midwife during delivery resulted in women seeking alternative care for their next delivery . Central aspects for a positive experience involve the woman feeling that she takes part in decisions and in her having confidence in the midwife as a result of mutual confidence. Feeling involved does not always mean sharing responsibility for decisions taken. Rather, it involves feeling respected and listened to, and being familiar with the various perspectives even if the decision-making process is left to those who are responsible for medical issues . This also emphasizes the importance of mutual confidence. The midwife's role, thus, should be to balance normalcy and the medical perspective. Genuine dialogue between the midwife and the new mother are necessary to achieve this balance. Being able to support, protect and promote breastfeeding  is based on an attitude in which the mother and child are seen as an integrated unit and in which they are important for one another. Berg outlined a care model for assisting mothers whose pregnancy is high risk based on a dignified, protective relationship to the mother and in which natural and medical perspectives are balanced as a result of well-integrated knowledge . Genuine care can in this way be administered to the genuine woman . The mother-child relationship could also be emphasized and safeguarded in the same manner. Mother and child are important for one another, and the strong emotional bond between them [2, 24] should be reinforced in every manner possible; the bond is important to the health of both mother and child.
The normal way to collect data in phenomenographic studies is to carry out in-depth interviews to explore how individuals experience, perceive or conceive a phenomenon in different ways. The decision to have midwives record their reflections in writing was based, in part, on the importance of being able to ensure their anonymity. It was also carried out in a desire to disrupt day-to-day work as little as possible. Since the researcher is a midwife herself, she knows or knows of several of the midwives who recorded their reflections, and it was important that the researcher be unable to associate any of the accounts with a specific author at any point in the process. The midwives decided themselves whether they wished to record their opinions in writing or not, as well as how many accounts they wished to write if they were responsible for more than one child who was receiving infant formula at the time of the study. The accounts also varied a great deal in scope -- from a couple of lines up to two pages of text. All of the midwives agreed to share their viewpoints and opinions, and the 101 accounts correspond to the number of children receiving infant formula.
The accounts were often written very quickly and without a great deal of reflection or consideration. At first, the author considered this to be a major disadvantage since the ambition was to obtain a second -order perspective in terms of how the outside world was understood [13, 18, 21]. Interviews would probably have been a better method to get close to participants and to go in-depth. However, by utilizing the underlying philosophy that intimately links the WHAT and HOW processes and which designates humans as individuals who create meaning and who are intentionally focused , the researcher was able to recognize the value of speed and that choice of words can reveal underlying values . In an interview, the respondent may take the time to reflect more. In the present case I captured the first thing that came to mind and therefore detected the "real thinking".
Some of the accounts pertain to the midwives themselves as caregivers while others pertain to care previously administered by other colleagues. Recovering the real phenomenographic question, the WHAT aspect, posed a challenge in this study.
The result indicates that mothers and children are looked upon as two separate individuals in the organization rather than as an important unit. In this way, care can be said to reinforce one-dimensional thinking rather than multi-dimensional holistic thinking.
Since a person's knowledge is developed in a dialectical interplay with his/her surroundings , surroundings probably also play a large role for both WHAT and HOW in terms of how one learns to perceive what is important. When humans create meaning between themselves and the outside world, a framework is formed on which knowledge is based. Learning takes place when humans acquire a new relationship to the outside world. After learning has taken place, knowledge is based on humans obtaining a slightly different perception of the outside world than they had before, consciously or unconsciously . Defining and perceiving a situation is related to personal knowledge development . The results do not indicate that individual midwives necessarily act as one single group; different approaches or attitudes exist. A holistic view in health care entails, for example, achieving an encounter between two subjects. It is a matter of a professional approach between the patient and the caregiver at the same time as it is a relationship between two individuals .