Teaching Partners and Family How to Support ... - WordPress.com
Teaching Partners and Family How to Support Breastfeeding Janelle Durham, MSW, LCCE [email protected] Previously In a separate presentation, I address everything we know from the research about: How partners and grandmothers (plus other family, friends, co-worker) influence parents about whether to initiate breastfeeding and how long to nurse. Quick re-cap: The presence of a partner / father increases chance she will initiate BF. But if he then gets very involved in day-to-day baby care, her BF duration can actually go down because he ends up taking over some of the feeds. (Unless we specifically teach him how to support her in a way that supports breastfeeding!! Research shows we can absolutely increase initiation and duration by educating partners.) Having an involved grandma sadly reduces the duration of breastfeeding, and can reduce initiation, especially if grandma didnt breastfeed herself. (Again, unless we educate
grandma about current practices, benefits of breastfeeding, and how to support the parents in a way that promotes breastfeeding. Research shows we can absolutely increase initiation and duration by educating grandparents.) Read more at https://transitiontoparenthood.wordpress.com/2016/05/12/family-support-for-bf/ A New Model of Partner Support I will structure this presentation around a model presented by Sherriff, et al in Engaging and supporting fathers to promote breast feeding: A concept analysis, Midwifery, 2014 at www.midwiferyjournal.com/article/S0266-6138(13)00219-2/fulltext Used a literature review and focus groups to develop this model 5 defining characteristics of effective support; Each has antecedents things the family member needs before they can provide effective support and outcomes benefits for the BF relationship
Antecedents are our action items, outcomes are our motivation Specific Suggestions Around the scaffolding of Sherriffs conceptual model, I will include lots of concrete ideas for how we as perinatal professionals can help partners and family members provide effective support. My sources for these ideas include: Journal articles, as cited Breastfeeding parents and their partners Perinatal professionals (lactation consultants, doulas, and many more) My own experiences, personal and professional Antecedents:
Relevant info, targeted to them Consistent info, delivered to mom AND them Accessible delivery and opportunity to ask questions Families Need: Knowledge Outcomes Continued BF Increased knowledge of benefits / advocacy for BF
Decreased anxiety Increased ability to help w/ challenges Can be involved in discussions with HCP Perhaps a leaflet about breastfeeding aimed at fathers how they can support their partner. With photos of families and dads I wanted information on how to help my partner. There was nothing on that. Most of the information seemed to focus (Brown and Davies 2014)
on why breastfeeding was a good thing. There wasn't much on how to do it. I knew it was best but I wanted to know There was this poster how to support my wife with doing it. apparently trying to promote That information wasn't there. breastfeeding which told dads it was a good thing because The leaflets my wife got given they would get more sleep. It all said breast is best but they was awful not all dads are didn't say why. It was all a bit lazy and uninvolved which is basic. I wanted to know why so what I felt it was implying. I I knew why it was worth it!
wanted to help. Give Family Relevant, Consistent, Accessible Info Communicate with both BF breastfeeding parent and support partner(s). Ask both for questions and for input. All materials should include info for partners, and images of partners providing breastfeeding support. Targeted materials are most effective. Helpful to have websites, videos, written materials. (24/7) Follow-up info timed for predictable developmental hurdles. The information was all aimed I don't recall breastfeeding ever at my wife. What she could being discussed in front of me. eat, do, experience etc. I know she was the key player here but I felt that it was nothing to
do with me. When we went to antenatal classes they did a session on (Brown and breastfeeding. They sent all the Davies 2014) dads down the pub that night. One midwife turned to me and asked how I felt about feeding. It was great to be acknowledged in all of this. I'd want to know how to support my wife when she found it tough. When to know there is a problem and what to do. Not just why you should breastfeed.
Offer Relevant, Accessible Classes and Events Classes / groups at times partners can attend. Marketing says family members are welcome Marketing covers importance of partner knowledge of BF BF classes for partners only? Grandmothers Tea? [Grassley, et al 2012] Peer educators? Encourage questions and exploration of concerns Tell Them How to Help with Breastfeeding Help with Positioning How to Check Latch Track feeding times and diapers Help with supplementing Know when / how to get help. Go to LC appointment. Info about BF Challenges / Skills for How to Help Partners expect BF to be natural and easy. Normalize
predictable challenges. Dads / grandmas feel powerless to help with BF challenges. Need knowledge and skills. Weight gain / milk supply is a particular concern Informing men about problems and giving strategies to help, meant mom felt more supported at 6 weeks. (Tohotoa et al 2011) I could just give a bottle should not be first response! Its really hard to see someone you love struggling and not to be able to do anything. (Brown & Davies 2014) . My husband came with me to lactation consultant appointments, helped correct my daughter's
latch, and took care of me when I had a hard time nursing. He was very pro-breastfeeding and did everything he could to support me which helped me not give up. I successfully nursed her for 20 months which was hugely rewarding. (Facebook) We had a great antenatal teacher who did troubleshooting with us. How to solve this problem or that problem. I felt I could do something when things went wrong. (Brown & Davies 2014) He assisted me with the lactation consultant and would remind me later, because I would forget things. He observed and
made suggestions about positioning and attachment, which was good for both practical and moral support. (Tohotoa, et al, 2009) I thought it was going to be simple. They told us it was best for the baby so I didn't expect problems and then felt helpless. (Brown & Davies 2014) Antecedents: Desire to BF Positive attitude from influential others Health professionals who acknowledge importance of family
Culture that normalizes BF in public Families Need: Positive Attitude Outcomes Initiation and continuance of BF Confidence to BF in public Ability to challenge others negative attitudes Cultural acceptance of
BF as norm Attitude Boosters Benefits of BF For mom, baby, family, environment, etc. Formula is not equal or better. Is it more convenient? Specifically address benefits of exclusive BF. New information to most. [Tohotoa, et al 2011] Allow plenty of time to address worries Must address public breastfeeding Address sexuality / appearance of the breasts It did cause some arguments which I know wasn't fair. But I felt useless and like she didn't want me any more. I didn't see why she couldn't give him a bottle. (Brown and Davies 2014)
But he'd taken it in and when it was necessary, he's stepped up and pushed back the medical staff and said to them 'breast milk is best and that's what my baby's having.' And that meant the world to me. It's one of those situations where I could easily have come out of the general anaesthetic and gone. 'Crap, my baby's had formula for its first feed,' but it hadn't because Dad was on the ball, to say 'No (Tohotoa, et al 2009) At first I freaked out about her feeding in front of people. I couldn't stop thinking that she had her breast out in front of my father or my friends and that
they were getting an eyeful. Thankfully I grew up though and realized you couldn't really see anything and it was better than the screaming! (Brown and Davies 2014) Antecedents: Validation of moms decisions On-going involvement in discussions about decisions Families Need:
Involvement in Decision Making Outcomes Initiation and continuance of BF Confidence to maintain BF and overcome difficulties Natural transition to eating together as a family I don't want to know that it is best. I want to know why and specifically why so I can feel
we're making the right decision (Brown & Davies 2014) I would like be included in decisions that affect my son. Just because I can't feed him doesn't mean I'm not interested. (Brown & Davies 2014) I was determined to nurse to a minimum of 18 months. At 7 months, she was diagnosed with a severe food allergy, reacting to food via my breastmilk. My husband and I came to the decision that it was safest for her to wean. It was ABSOLUTELY the best decision to switch her to formula; she THRIVED on it! However, she turned 2 in February and I still deal with guilt. My husband is always encouraging and reassuring, reminding me that we did the best thing.
His words remind me that I haven't failed my daughter. (Facebook) Supporting Involvement in Decision-Making: Key Messages Final decision is hers, but she doesnt want to make it in isolation. Help research options and strategize When she has made decision, validate and support it! Moms perception of family attitudes toward BF have a huge influence on confidence / duration What if the breastfeeding parent wants to give up? Antecedents: Accept, learn, and implement support role in all other aspects of child care
and household tasks Anticipate and meet the needs of the mom Parental leave (availability) Families Need: Practical Support Outcomes Continuance of BF Bond between family member and baby Knowledge of and confidence in practical skills
Guiding Families in Options for Practical Support Take care of the baby do all but feed Need baby care skills Need to know how to watch for cues Need to know how to calm crying Offers time for bonding*. Dont give a bottle so mom can get a break. Take care of the babys things: pack diaper bag, do laundry, etc. Guiding Families in Options for Practical Support Take care of breastfeeding parent Feed her to feed baby. (Cook, hold the baby while she eats meals, bring snacks while shes nursing)
Create a nursing nest with everything she needs. Make sure its stocked before leaving home. (Add an insulated cup of coffee or tea!) Guiding Families in Options for Practical Support Take care of the house: groceries, dishes, trash, and so on Take care of outside responsibilities: make appointments, pay bills, communicate with family Practical Support In the context of the breastfeeding relationship!
Note: If this practical support is done without an intentional focus on supporting breastfeeding, especially if it includes offering bottles of formula, it could lead to her stopping breastfeeding sooner. But, if its done with that focus of supporting her so she can focus on nursing, it can prolong breastfeeding. During nighttime feeds, he changed diapers while I got ready. Not having to do everything in the middle of the night made me feel supported and not alone. My husband brought me snacks and pitched in to do the household chores that I would typically do Made me breakfast/coffee before
leaving even if I was sleeping. Brought me sandwiches, helped me wash pump parts (ended up pumping for the twins), brought me mother's milk tea, got up at night with me some nights. My hubby was in charge of cleaning.....and stinky diaper changes Facebook Antecedents: Being there physical presence, or Skype, calls, texts Affection,
encouragement, appreciation, acknowledgement of challenges / identity change, etc. Families Need: Emotional Support Outcomes Continuance of BF Feelings of pride and satisfaction Bond between mom and baby Bond between mom
and family Increased confidence for mom and decreased isolation Ensuring Partners Have Emotional Energy Acknowledge that breastfeeding and baby care can be emotionally challenging / draining for them too!! Validate the frustration, the jealousy, and the sense of powerlessness. Give the partner resources for support, tools for how to talk to mom about their feelings I joked my partner was permanently attached to another man. I was half joking but I did feel a bit put out which sounds
terrible now. When I said to a nurse I felt helpless, she said enjoy the break and laughed like it was nothing to do with me. He kept crying. All he wanted was feeding. Not much I could do which made me feel rubbish. Dads need: Information on relationship changes, hormonal changes of the partner and how best to support and handle those changes. Supporting your partner when she has problems like postnatal depression, no sex drive, changing hormones, crying/yelling/angry outbursts - learning to understand and support rather than chastise and think there is something wrong with your partner. (Tohotoa, 2009)
(Brown and Davies 2014) Guiding Families in Offering Emotional Support Presence. Appreciation. Encouragement on Hard Days Affection and Acts Of Kindness Acknowledge the mothers change in identity / role Just that encouragement, you know when your partner says you're doing a good job in those early days when you're feeding for 40 minutes or an hour, I found that really
helpful. Tohotoa 2009 Family support was great from my dad. He was always saying how proud he was I was breastfeeding. (Facebook) He got up during the night and gave me cuddles when I was in tears, and my nipples were cracked and sore and bleeding, that was really helpful. Tohotoa 2009 Dads need: A no bulls**t idea of what to expect and how to help even if that means doing nothing but being there with her and the baby. Tohotoa 2009
Your Interactions with Family In your work, when you encounter partners and other family, how WILL you interact with them? Treat them as a team. Include them in conversation as equals. AND talk about their unique and important influence on BF success Summary: How WILL you help families help moms? Increase Knowledge: Offer relevant, targeted, accessible info about how to help with BF and BF challenges. Enhance Positive Attitude: Share all the benefits of BF, address
worries, and encourage family commitment to BF. Involve Them in Decision Making: Welcome their questions and input, encourage them to help breastfeeding parent research and strategize. Encourage Practical Support: Teach them to care for baby (other than feeding), encourage them to take care of babys things, mom, house, outside duties Encourage Emotional Support: Acknowledge partners emotional challenges. Encourage them to offer their presence, appreciation, encouragement, affection.
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