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Using art to raise awareness of breastfed children with medical complexity

Abstract

Background

Current infant feeding support is often targeted at establishing breastfeeding in healthy term infants, or supporting lactation for preterm infants in the neonatal setting. Breastfeeding presents different challenges for children beyond the neonatal period who have a medical complexity. The tendency to focus on breastfeeding as a preventative public health intervention overlooks the fact that mothers and children with medical complexity often require additional and targeted support to continue to breastfeed. Despite this identified need, there is very little research, policy or clinically specific teaching within paediatrics that is nuanced enough to support this vulnerable population.

Raising awareness of breastfed children with medical complexity in paediatrics

While research, policy and embedded Baby Friendly Health Initiative (BFHI) standards in both the maternity and neonatal directorates exists, paediatrics is a separate discipline and contrastingly, has very little lactation support infrastructure. To this end, a doctoral study was commenced aiming to identify the differences for this vulnerable and largely overlooked group. One of the related outputs of the ongoing research is the use of creative methods to raise awareness. This commentary highlights a project with an artist to develop a series of portraits alongside a book and health professional education to increase awareness of these children’s needs.

Conclusions

The breastfeeding needs and challenges of children in the paediatric setting are unique and require additional awareness, creativity and skills to support optimal infant and young child breastfeeding. Using art can connect professionals to the lived experiences of families trying to persevere through medical complexity.

Background

Optimising breastfeeding may be particularly beneficial for infants and children with complex medical needs to prevent additional disease and infection [1,2,3,4], as well as to provide comfort [5] and pain relief [6, 7].

However, childhood acute and chronic illness or disability is associated with increased challenge and lower breastfeeding rates [8,9,10,11]. Many of these sick children are cared for in the paediatric setting, which is a separate organisational directorate to the neonatal and maternity units. The Baby Friendly Hospital Initiative (BFHI) has been shown to increase initiation of breastfeeding [12]. However, the standards have not been adapted for clinical use with older children or children with complex needs, and BFHI is also not widely adopted in paediatric wards or hospitals. This means that there is usually not a designated lactation support service on paediatric wards and no mandatory training or audit for paediatric clinicians. While expertise is sometimes ‘borrowed’ from maternity or neonatal colleagues, this is dependent on workload and staff availability and is thus only inconsistently provided [13].

Therefore, in paediatrics, not only do mothers of children with medical complexity have different challenges initiating and maintaining breastfeeding compared to healthy newborns or preterm neonates, but they also receive less support to overcome these challenges.

The needs of breastfed children and their mothers in paediatrics is under-researched. There is therefore a paucity of literature about this population, and the literature that exists is often dated, and focused on specific conditions – namely cardiac conditions [14,15,16,17], cleft lip and palate [17, 18], Down syndrome [19, 20], and phenylketonuria [21]. At present, there is very limited literature relating more generally to supporting children with various medical challenges beyond the neonatal period.

While much is known about what works to support breastfeeding initiation, duration and exclusivity [22], many of the systemic structures that enable optimal breastfeeding are not in place on the paediatric ward.

As a paediatric nurse, International Board Certified Lactation Consultant (IBCLC), and mother of a breastfed childhood cancer and sepsis survivor, the frustrations with widespread lack of breastfeeding support for families within paediatrics led me to commence a doctoral study. This study aims to understand the challenges for children with medical complexity, as well as the gaps in knowledge for the health and lactation professionals supporting them. Alongside the PhD, a support group – Breastfeeding the Brave – hosted in Facebook, was established to provide support and advocacy for mothers and parents breastfeeding their children with various medical needs. Different strategies have been used to educate and raise awareness, including the use of social media and video. A project utilising art is the latest innovation to promote better understanding of this under-studied area. Alongside the researcher, Leanne Pearce, an artist known for her art with purpose, chose several images shared by parents to capture in oil paint, in the hope that professionals will understand the research by connecting with the stories through the art. The portraits will be toured in an exhibition, used in teaching, digital prints will be available, and prints will also be donated to various hospitals. All parents have been keen to share their stories widely to support both healthcare professional learning and development, as well as inspire parents going through similar challenges, and all consented to being included in this article.

Using stories and art to augment research impact

Many healthcare professionals, academics, policymakers and even non-medical lactation professionals do not universally understand the specific differences for this population of children with complex medical needs. The more familiar research and lactation strategies within the maternity and neonatal settings may not always apply to this group but, without clinical experience, professionals may struggle to appreciate the challenges. Health and lactation professionals are thus welcomed into the Breastfeeding the Brave group in order to passively learn about the challenges of breastfeeding children with medical complexity in a unique way. However, more education is needed, and therefore creative approaches to raising the profile of this group have been utilised.

One way to support professional learning is to use art and stories to connect new and emerging theory to lived experiences. Art in healthcare teaching is not a commonly utilised approach, despite caring often being described as an ‘art’ and the fact that it has been shown to help practitioners understand caring [23] and become more compassionate [24]. Art can be used successfully in healthcare teaching [25] and has been shown to support professionals to better understand the patient perspective, as well as enhance communication and empathy [26]. One study found that students exposed to art-based teaching were better able to connect the empathic and cognitive aspects of learning [27]. Art can be used therapeutically both to support suffering and grieving parents, but it has also been shown to reduce compassion fatigue in healthcare professionals [28].

A unique population

Breastfeeding may be harder for mothers of children with medical needs for a variety of reasons. A recent systematic review found seven key themes in the available literature [29]. Broadly, there were four parent- and child-related themes, and three professional and institutional themes. Parent themes included logistical and practical problems of being resident overnight, the general unwillingness by staff to facilitate bedsharing, difficulties accessing usual community breastfeeding support and practical breastfeeding challenges such as mastitis and low supply that were not adequately managed in the paediatric setting.

Mothers also struggled with psychological challenges, with many reporting anxiety, depression, stress and impaired milk ejection reflex due to the pressure of needing to produce high volumes under extraordinarily stressful circumstances. Numerous parents in the Breastfeeding the Brave group have reported that these issues continue to be problematic, including one mother of a child born with mitochondrial disease. The child spent much of her life in hospital and sadly died just before she was 6 months old. Throughout her daughter’s life, her mother had to defend feeding for comfort, skin to skin and bedsharing (Fig. 1).

Fig. 1
figure 1

Hannah and Maisie. Hannah is holding Maisie while supported by clinical staff in the PICU who were continuing to provide critical care. PICU paediatric intensive care unit. Artist: Leanne Pearce

When parents in the group have endured trauma and grief that has been made more difficult by lack of understanding, they have often been highly motivated to get involved in projects that seek to address the encountered challenges. In this way, the art benefits both the subject and the viewer.

The challenge of conveying nuance

While aspects of breastfeeding support in different settings overlap, different skills are sometimes needed to support lactation in older sick children. Since hospitalised families often find it impractical to access sources of community support, the burden of responsibility lies with clinical staff to support lactation alongside critical care which is difficult if they have received no training – a common finding [29,30,31,32,33,34].

Current training and knowledge usually leans towards the challenges most commonly encountered by staff supporting breastfeeding in the maternity and neonatal settings. Therefore, art may be an innovative way to convey the nuances, visually connecting the healthcare professional with the lived experience of older children. In one study, the researchers noted that art may increase healthcare staff awareness of suffering, and thus improve nursing care. However, they also note that observation of art activates reward centres in the brain which makes associated learning pleasurable and thus more memorable [35]. This has potential implications for improving not only awareness but also retention of new learning.

It is hoped that the paintings will illustrate several key differences and problems in the paediatric setting. For example, there are multiple research studies supporting the use of human milk for preterm neonates to promote optimal neurodevelopment and reduction in risk of necrotising enterocolitis [36,37,38] thus, early expressing and the use of donor human milk is more likely to be expected and encouraged. While it is recognised that positive experiences of receiving support in the neonatal unit are not universal, by comparison, paediatrics lags behind. No studies discuss scaling up of donor human milk provision within paediatrics, nor are there studies that explore skin to skin care within paediatric wards or the paediatric intensive care unit (PICU), compared with the many studies that support this intervention in neonatal units [39,40,41,42]. When no literature exists, it is difficult to recommend or defend practice change, even in very difficult or palliative cases where it would be a compassionate intervention to improve quality of life. Art and stories that depict these aspects of unresearched care may increase the prevalence of these interventions on the paediatric ward.

Practically speaking, it can be awkward to breastfeed children with lines, drains, large wounds, stomas, splints, and casts, as well as those receiving non-invasive respiratory support, and larger children can be difficult to manoeuvre into a mutually comfortable position. Difficulties establishing oral feeding after surgery have been found to be more common with longer ventilation times [43]. Maintaining milk supply and returning to breastfeeding is not always straightforward after enteral feeding, supplementation, suctioning, opiate withdrawal or ventilation. One baby had an episode of prolonged apnoea and became unresponsive at home. He was treated in the paediatric high dependency unit (HDU) and his mother was given no information about how to maintain her milk supply. The mother used her own breast pump but most of the staff were unaware or unsupportive of using expressed breastmilk. Maintaining milk supply was extremely challenging but the mother persevered largely through her own knowledge and experience (Fig. 2).

Fig. 2
figure 2

Edward and Jacob. Jacob’s father Edward is feeding his son Jacob with Laura’s expressed milk via a syringe while he was in the HDU. HDU high dependency unit. Artist: Leanne Pearce

Supporting breastfed children who are unwell or have medically complex conditions and needs is a less well-trodden path. Paediatrics can feel like a breastfeeding ‘skill-desert’, with families cared for in a clinical environment that is not able to fully support their feeding goals. Both healthcare and lactation staff can only develop increased awareness about these challenges and how to overcome them once they are cognisant of them. Art might be one channel through which we can prompt curiosity and problem-solving.

How art may support understanding and improve patient experience

Patient stories are meaningful, and for practitioners who are unfamiliar with a novel topic, art depicting these stories can provide another way of learning [44]. Art has been shown to improve psychological wellbeing [35]. This is sometimes because the person observing the art finds pleasure in looking at it, but enjoyment can also be derived by understanding the meaning of the artwork [35]. Indeed, it has also been suggested that upsetting subject matter can also provoke a positive response, which is why tragedy is a popular genre [45]. Negative emotions can create a high level of emotional response and make the subject matter more memorable, which is particularly pertinent for staff supporting breastfed children with medical complexity [45].

In other healthcare settings where artwork is displayed, it can transform a clinical environment into a space that celebrates the bravery of individuals enduring health challenges. This publicly displayed courage serves to inspire both fellow patients and families, and also staff [46].

One study found that art can become an important part of the psychological needs of paediatric patients and their families [47]. Healthcare professionals often report positive impacts of interventions such as art therapy for children, and art can introduce a concept in a non-threatening way. Thus, having images displayed may serve to open conversations or provide a passive sense of permission or possibility for breastfeeding in a situation where it might otherwise feel impossible. A further benefit of art is that healthcare professionals often deal with traumatic and distressing experiences during the course of their working day. The needs of professionals who support dying children and their bereaved families are often unmet. Art may be potentially one way for healthcare staff to acknowledge this more difficult aspect of their role [47].

Finally, one study found that teaching medical students using artwork can help them connect visual clues to underlying disease. The skill of observation can be taught, and art may serve as a medium through which we can teach healthcare professionals not only to care, but to accurately observe both the obvious and the subtler clues [48].

Through the artwork being created, we invite viewers to see a family’s perspective through the combination of their story and portrait. Some of the portraits convey tenderness and connection in the face of adversity (Fig. 1) and others hint at the practical challenges of maintaining breastfeeding (Fig. 2). Some portraits were chosen to illustrate strength and determination (Fig. 3).

Fig. 3
figure 3

Cara with her two unwell children. Cara is breastfeeding 4-month old Maya at the hospital bedside of Jayke, aged four. Artist: Leanne Pearce

The older child in Fig. 3 was diagnosed with acute lymphoblastic leukaemia at the age of 4 years. His infant sister was then diagnosed with Fibromatosis requiring chemotherapy 4 months later. The children’s mother was exclusively breastfeeding her daughter, and in addition expressed milk for her son, fed via his nasogastric tube when he was undergoing intensive chemotherapy. The mother recalls that one of the hardest parts was caring for two sick children away from home. She and her husband would take it in turns to stay in hospital accommodation while the other was resident for long periods on the paediatric oncology ward. The practical challenge of trying to maintain normal parenting routines and continue to breastfeed in an unfamiliar and intense environment, with serious health challenges was significant.

While all the stories the parents have to tell are profound, the art that accompanies them allows the reader an additional insight into the private struggle. In all the images, re-created from photos shared by the parents, a window into the world of breastfeeding a child with medical complexity is opened. The artwork alone cannot teach professionals how to manage similar situations, yet it may provide opportunities to discuss clinical scenarios where creative adaptations and novel approaches might be required. More importantly, the portraits provide inspiration, reassurance and hope to both professionals and parents that despite huge challenges, breastfeeding is possible.

Conclusion

In an era of evidence-based practice and an increasing importance for demonstrating empirical proof, research into under-studied areas is a priority. However, these are by definition usually topics about which people have very little knowledge or awareness. Writing and research in these cases may effectively convey a literary narrative of a novel concept or experience, but they may not connect the reader as effectively as visual imagery.

By using art that captures the poignancy of a moment, we hope to be able to more accurately and meaningfully convey the lived experiences of mothers and parents breastfeeding their sick children.

Availability of data and materials

Not applicable.

Abbreviations

BFHI:

Baby Friendly Hospital Initiative

HDU:

High Dependency Unit

IBCLC:

International Board Certified Lactation Consultant

PICU:

Paediatric Intensive Care Unit

References

  1. Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475–90.

    PubMed  Google Scholar 

  2. Edwards TM, Spatz DL. An innovative model for achieving breast-feeding success in infants with complex surgical anomalies. J Perinat Neonatal Nurs. 2010;24(3):246–53.

    PubMed  Google Scholar 

  3. Breastfeeding TV, Babies S. In: Brown A, Jones W, editors. A guide to supporting breastfeeding for the medical profession. Hove: Routledge; 2020. p. 141–50.

    Google Scholar 

  4. Bartick M, Hernández-Aguilar MT, Wight N, Mitchell KB, Simon L, Hanley L, et al. ABM Clinical Protocol# 35: supporting breastfeeding during maternal or child hospitalization. Breastfeed Med. 2021;16(9):664–74.

    PubMed  Google Scholar 

  5. Brown A. What do women lose if they are prevented from meeting their breastfeeding goals? Clin Lact. 2018;9(4):200–7.

    Google Scholar 

  6. Shah V, Taddio A, McMurtry CM, Halperin SA, Noel M, Riddell RP, et al. Pharmacological and combined interventions to reduce vaccine injection pain in children and adults: systematic review and meta-analysis. Clin J Pain. 2015;31(10 Suppl):S38-63.

    PubMed  PubMed Central  Google Scholar 

  7. Harrison D, Reszel J, Bueno M, Sampson M, Shah VS, Taddio A, et al. Breastfeeding for procedural pain in infants beyond the neonatal period. Cochrane Database Syst Rev. 2016;10(10):CD011248.

    PubMed  Google Scholar 

  8. Rivera AF, Torres RR, Rodríguez AM, de Longo IM, Peralta JJ. Exploratory study: knowledge about the benefits of breastfeeding and barriers for initiation in mothers of children with spina bifida. Matern Child Health J. 2008;12(6):734–8.

    PubMed  Google Scholar 

  9. Colón E, Dávila-Torres RR, Parrilla-Rodríguez AM, Toledo A, Gorrín-Peralta JJ, Reyes-Ortiz VE. Exploratory study: barriers for initiation and/or discontinuation of breastfeeding in mothers of children with down syndrome. P R Health Sci J. 2009;28(4):340–5.

    PubMed  Google Scholar 

  10. Torowicz DL, Seelhorst A, Froh EB, Spatz DL. Human milk and breastfeeding outcomes in infants with congenital heart disease. Breastfeed Med. 2015;10(1):31–7.

    PubMed  Google Scholar 

  11. Coentro VS, Geddes DT, Perrella SL. Altered sucking dynamics in a breastfed infant with Down syndrome: a case report. Int Breastfeed J. 2020;15:71.

    PubMed  PubMed Central  Google Scholar 

  12. Pérez-Escamilla R, Martinez JL, Segura-Pérez S. Impact of the Baby-friendly Hospital Initiative on breastfeeding and child health outcomes: a systematic review. Matern Child Nutr. 2016;12(3):402–17.

    PubMed  PubMed Central  Google Scholar 

  13. Hookway L. Breastfeeding the critically unwell child: a call to action. Clin Lact. 2020;11(3):141–9.

    Google Scholar 

  14. Lambert JM, Watters NE. Breastfeeding the infant/child with a cardiac defect: an informal survey. J Hum Lact. 1998;14(2):151–5.

    CAS  PubMed  Google Scholar 

  15. Duhn G. Struggling to feed for survival: mothers and infants with congenital heart disease and severe feeding difficulties. ProQuest Dissertations and Theses. Web; 1998. https://www.bac-lac.gc.ca/eng/services/theses/Pages/item.aspx?idNumber=46582679.

  16. Barbas KH, Kelleher DK. Breastfeeding success among infants with congenital heart disease. Pediatr Nurs. 2004;30(4):285–9.

    PubMed  Google Scholar 

  17. Ryan K, Smith L, Alexander J. When baby’s chronic illness and disability interfere with breastfeeding: women’s emotional adjustment. Midwifery. 2013;29(7):794–800.

    PubMed  Google Scholar 

  18. Madhoun LL, Crerand CE, Keim S, Baylis AL. Breast milk feeding practices and barriers and supports experienced by mother–infant dyads with cleft lip and/or palate. Cleft Palate Craniofac J. 2020;57(4):477–86.

    PubMed  Google Scholar 

  19. Lewis E, Kritzinger A. Parental experiences of feeding problems in their infants with Down syndrome. Down Syndr Res Pract. 2004;9(2):45–52.

    Google Scholar 

  20. Barros da Silva R, Barbieri-Figueiredo MD, Van Riper M. Breastfeeding experiences of mothers of children with down syndrome. Compr Child Adolesc Nurs. 2019;42(4):250–64.

    PubMed  Google Scholar 

  21. Banta-Wright SA, Kodadek SM, Houck GM, Steiner RD, Knafl KA. Commitment to breastfeeding in the Context of Phenylketonuria. J Obstet Gynecol Neonatal Nurs. 2015;44(6):726–36.

    PubMed  Google Scholar 

  22. McFadden A, Gavine A, Renfrew MJ, Wade A, Buchanan P, Taylor JL, et al. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev. 2017;2(2):CD001141.

    PubMed  Google Scholar 

  23. Darbyshire P. Understanding caring through arts and humanities: a medical/nursing humanities approach to promoting alternative experiences of thinking and learning. J Adv Nurs. 1994;19(5):856–63.

    CAS  PubMed  Google Scholar 

  24. Wikström BM. Works of art: a complement to theoretical knowledge when teaching nursing care. J Clin Nurs. 2001;10(1):25–32.

    PubMed  Google Scholar 

  25. Freeman LH, Bays C. Using literature and the arts to teach nursing. Int J Nurs Educ Scholarsh. 2007;4(1):15.

    Google Scholar 

  26. Zazulak J, Sanaee M, Frolic A, Knibb N, Tesluk E, Hughes E, et al. The art of medicine: arts-based training in observation and mindfulness for fostering the empathic response in medical residents. Med Humanit. 2017;43(3):192–8.

    PubMed  Google Scholar 

  27. Rieger KL, Chernomas WM. Arts-based learning: analysis of the concept for nursing education. Int J Nurs Educ Scholarsh. 2013;10(1):53–62.

    Google Scholar 

  28. Schaefer MR, Wagoner ST, Young ME, Madan-Swain A, Barnett M, Gray WN. Healing the hearts of bereaved parents: impact of legacy artwork on grief in pediatric oncology. J Pain Symptom Manage. 2020;60(4):790–800.

    PubMed  Google Scholar 

  29. Hookway L, Lewis J, Brown A. The challenges of medically complex breastfed children and their families: a systematic review. Matern Child Nutr. 2021;17(4):e13182.

    PubMed  PubMed Central  Google Scholar 

  30. Carney G, Bruce D. Is it time for “baby-friendly” pediatric hospitals? Infant Child Adolesc Nutr. 2011;3(4):190–2.

    Google Scholar 

  31. Holaday B, Karipis TA, Spicer M. A survey of pediatric nurses’ knowledge about breastfeeding. J Pediatr Nurs. 1999;14(3):193–200.

    Google Scholar 

  32. McLaughlin M, Fraser J, Young J, Keogh S. Paediatric nurses’ knowledge and attitudes related to breastfeeding and the hospitalised infant. Breastfeed Rev. 2011;19(3):13–24.

    PubMed  Google Scholar 

  33. Brewer TL. Pediatric nurses’ knowledge and attitudes regarding the provision of breastfeeding support in a pediatric medical center. Clin Lact. 2012;3(2):64–8.

    Google Scholar 

  34. Colaceci S, Giusti A, Chapin EM, Bettinelli ME, De Angelis A, Zambri F, et al. E-learning to improve healthcare professionals’ attitudes and practices on breastfeeding. Breastfeed Med. 2017;12(10):629–36.

    PubMed  Google Scholar 

  35. Mastandrea S, Fagioli S, Biasi V. Art and psychological well-being: linking the brain to the aesthetic emotion. Front Psychol. 2019;4(10):739.

    Google Scholar 

  36. Renfrew MJ, Dyson L, McCormick F, Misso K, Stenhouse E, King SE, et al. Breastfeeding promotion for infants in neonatal units: a systematic review. Child Care Health Dev. 2010;36(2):165–78.

    PubMed  Google Scholar 

  37. Blesa M, Sullivan G, Anblagan D, Telford EJ, Quigley AJ, Sparrow SA, et al. Early breast milk exposure modifies brain connectivity in preterm infants. Neuroimage. 2019;184:431–9.

    PubMed  Google Scholar 

  38. Quigley M, Embleton ND, McGuire W. Formula versus donor breast milk for feeding preterm or low birth weight infants. Cochrane Database Syst Rev. 2019;7(7):CD002971.

  39. Bergman NJ, Linley LL, Fawcus SR. Randomized controlled trial of skin-to-skin contact from birth versus conventional incubator for physiological stabilization in 1200-to 2199-gram newborns. Acta Paediatr. 2004;93(6):779–85.

    CAS  PubMed  Google Scholar 

  40. Moore ER, Bergman N, Anderson GC, Medley N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2016;11(11):CD003519.

    PubMed  Google Scholar 

  41. Johnston C, Campbell-Yeo M, Disher T, Benoit B, Fernandes A, Streiner D, Inglis D, Zee R. Skin-to-skin care for procedural pain in neonates. Cochrane Database Syst Rev. 2017;2(2):CD008435.

  42. Gupta N, Deierl A, Hills E, Banerjee J. Systematic review confirmed the benefits of early skin-to-skin contact but highlighted lack of studies on very and extremely preterm infants. Acta Paediatr. 2021;110(8):2310–5.

    PubMed  Google Scholar 

  43. Eggink BH, Richardson CJ, Malloy MH, Angel CA. Outcome of gastroschisis: a 20-year case review of infants with gastroschisis born in Galveston, Texas. J Pediatr Surg. 2006;41(6):1103–8.

    PubMed  Google Scholar 

  44. Wong KY, Job C, Anstey S. Patients’ stories in healthcare curricula: learning the art of healthcare practice with patients. J Furth High Educ. 2020;44(6):729–38.

    Google Scholar 

  45. Menninghaus W, Wagner V, Hanich J, Wassiliwizky E, Jacobsen T, Koelsch S. The distancing-embracing model of the enjoyment of negative emotions in art reception. Behav Brain Sci. 2017;40(e347):1–63.

    Google Scholar 

  46. Baniyamin N, Nazri AF. Art for healthcare: a review of artists and their ideations. Cult Syndr. 2020;2(2):124–37.

    Google Scholar 

  47. Snyder K, Malhotra B, Kaimal G. Team value and visual voice: Healthcare providers’ perspectives on the contributions and impact of Art therapy in pediatric hematology/oncology clinics. Arts Psychother. 2021;75:101808.

    Google Scholar 

  48. Ganske I, Khoshbin S, Katz JT. Teaching healthcare professionals to see. Am J Med Genet C Semin Med Genet. 2021;187(2):130–3.

    PubMed  Google Scholar 

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LH conceptualised and wrote the manuscript. The author(s) read and approved the final manuscript.

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LH is a paediatric nurse, specialist children’s public health nurse, IBCLC and PhD student researching the needs and challenges of medically complex breastfed children in the paediatric setting.

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Correspondence to Lyndsey Hookway.

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Hookway, L. Using art to raise awareness of breastfed children with medical complexity. Int Breastfeed J 17, 47 (2022). https://doi.org/10.1186/s13006-022-00488-3

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Keywords

  • Breastfeeding
  • Paediatrics
  • Art
  • Healthcare professionals