Table 8 Quotes from replies to the question: “Do you think there are any barriers that prevent a midwife from using a laid-back breastfeeding position with mothers? If so, please state”
THEME | QUOTE | ROLE |
|---|---|---|
LACK OF EDUCATION/KNOWLEDGE/TRAINING | “No training given on this position.” | Staff Midwife, 0–3 years qualified |
“My college education was lacking on breastfeeding. Everything I know and feel confident in comes from personal experience of breastfeeding or outsourced education. I don’t think there’s enough breastfeeding education in college.” | Midwifery Student Intern | |
“Lack of education/training. Not one of the ‘traditional’ positions taught.” | Clinical Midwife Manager, 10 + years qualified | |
LACK OF TIME/STAFF SHORTAGE | “It takes time for a baby to latch by themselves in this position in my experience. Often, we are under time pressure to make sure that baby has had a first feed (I work in delivery) and so you are more hands on in order to ensure that this has happened.” | Staff Midwife, 0–3 years qualified |
“Time! On delivery suite there is very little time to aid the establishment of breastfeeding, and often following the birth experiences women have there, there is little time to try more than one position. The attitude is “get the baby on the breast and get the woman out of here” which is very sad and frustrating as a midwife” | Clinical Midwife | |
“Breastfeeding in general can be difficult to support on busy/understaffed wards, which often do not seem to encourage breastfeeding.” | Manager, 7–9 years qualified2nd year Student Midwife | |
LACK OF EXPERIENCE/CONFIDENCE | “Personally, I have very little experience with this position and wouldn’t feel confident suggesting it to mothers.” | 3rd year Student Midwife |
“Midwives’ confidence using this position (is a barrier).” | Clinical Midwife Manager, 7–9 years qualified | |
LACK OF AWARENESS/POPULARITY | “It’s not the ‘norm’ – you don’t see it often, so you don’t think to suggest it.” | 2nd year Student Midwife |
“Not in the media/not what women see on TV, etc.” | Staff Midwife, 10 + years qualified | |
CULTURAL/TRADITIONAL PRACTICES | “Remaining as hands off as possible” (is difficult) | Staff Midwife, 7–9 years qualified |
“Easier for mum to attach, but harder for midwife to assist baby with latch.” | Staff Midwife, 10 + years qualified | |
OTHER INFLUENCES | “C-section. I often had women say the babies’ feet were hurting them post incision.” | 3rd year Student Midwife |
“Pain after LSCS/Instrumental can impact positioning and also lead to greater tiredness.” | Staff Midwife, 0–3 years qualified | |
“I am a student and my preceptors have never mentioned this position. As a student we don’t feel we have the authority to suggest a “new” technique to mothers.” | 1st year Student Midwife | |
MATERNAL ISSUES | “Mother’s hesitation.” “Large breasts.” “Many mothers are afraid of it.” “Mother’s unwillingness.” “Not confident if the baby can breathe (mother worries). Is the mother confident in this particular position?” “Lack of awareness on the part of the mother.” | Midwifery Students |
“Mothers are unfamiliar with it.” “Baby not willing to latch, mother’s flat nipples, anxious mother.” “Mum’s anatomy (inverted/flat nipples or large breasts) requires other positions which are easier for baby to latch on.” “Mums’ lack of knowledge of this breastfeeding position.” “Anxious mothers.” “Mothers’ confidence in their own bodies and handling baby.” “Some mothers are afraid of not seeing what the baby is doing, especially if the mother has larger breasts.” | Midwives |