Support of breastfeeding by health professionals: integrative review of the literature

Almeida, Jordana Moreira de; Luz, Sylvana de Araújo Barros; Ued, Fábio da Veiga

doi:10.1016/j.rpped.2014.10.002

Brasil

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• Rev. paul. pediatr. 33 (3) • Jul-Sep 2015 • https://doi.org/10.1016/j.rpped.2014.10.002 linkcopy

Support of breastfeeding by health professionals: integrative review of the literature

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Abstract

Objective: To review the literature in order to evaluate how health professionals promote and support breastfeeding.

Data sources: Studies from the following databases were retrieved: Scopus, PubMed, MEDLINE, Lilacs, SciELO, Web of Science and Cumulative Index to Nursing and Allied Health Literature (Cinahl). The descriptors “breastfeeding”, “professional role” and “patient care team” were used in the research. The review was limited to articles in Portuguese, Spanish, and English published between 1997 and 2013.

Data synthesis: The search retrieved 1396 studies, 18 of which were selected for being directly relevant to the main question. The review showed that breastfeeding is a challenge for health professionals, regardless of their specialization, as they have to face a demand that requires skill and sensibility, for which they are not prepared. Health professionals have considered breastfeeding a purely instinctive and biological act. Moreover, it is noticeable that many of them possess theoretical expertise on the subject, but lack the practical skills.

Conclusions: Health professionals need to be better trained to work on promoting breastfeeding, whether by health and medical schools or by healthcare administrators, in order to consolidate multiprofessional teams committed to maternal-infant health.

KEYWORDS Breastfeeding; Professional role; Patient care team

Author/year of publication	Study type	Level of evidence¹¹	Study summary
Martins et al.⁴ (2009)	Qualitative Descriptive	IV	Breastfeeding practice success depends on how health professionals deal with women and their families.
Dykes¹²(2006)	Qualitative Descriptive	IV	Inaccurate advice in relation to breastfeeding by professionals is repeatedly referred to with regard to hospital practices.
Moran et al.¹³ (2006)	Systematic Review	III	While health professionals positively influence breastfeeding women, they can also be a source of negative support.
Yaman et al.¹⁴ (2004)	Cross-sectional descriptive	IV	The level of knowledge of health professionals about breastfeeding does not necessarily favor the practice with their own families.
Barclay et al.¹⁵ (2012)	Ecological exploratory	III	Although the health professional plays an important role in the initial stimulus to breastfeeding, this is not the only influence, and external stimuli (family, society, etc.) must be taken into account.
Brow et al.¹⁶ (2011)	Qualitative Descriptive	IV
Caminha et al.¹⁷ (2011)	Cross-sectional descriptive	IV	Health professionals must be willing to share their knowledge with the family of the nursing woman and form a social network to provide support.
Marques et al.¹⁸ (2010)	Narrative Review	IV	The social network of the nursing mother, which includes health professionals, is able to interfere with the decision to breastfeed through different attitudes.
Marinho et al.¹⁹ (2004)	Cross-sectional descriptive	IV	Nurses showed more positive attitudes than doctors and professors in relation to breastfeeding.
Watkins et al.²⁰ (2010)	Integrative Review	IV	Women often report receiving little information about the act of breastfeeding by health professionals, including their own physicians.
Caldeira et al.²¹ (2007)	Cross-sectional descriptive	IV	Physicians show that they still have little scientific support to address more complex issues and fail to offer adequate support to mothers with greater difficulties in breastfeeding.
Silvestre et al.²² (2009)	Qualitative descriptive	IV	Mothers report that they do not receive enough support to breastfeed, or assign blame to a professional, instead of themselves.
Gökçay et al.²³ (1997)	Qualitative descriptive	IV	Breastfeeding practices are the result of hospital dynamics, which also includes the health team attitudes.
Manzini et al.²⁴ (2002)	Qualitative Phenomenological	IV	Breastfeeding in the first hour of life should be encouraged by professionals, who need to support this cause, thus becoming child-friendly.
Meier et al.²⁵ (2013)	Case study	IV	Breastfeeding is still not prioritized, when compared to other nutritional therapies in the Neonatal Intensive Care Units.
Araújo et al.²⁶ (2007)	Qualitative descriptive	IV	It is important to carry out periodic training of health professionals to support nursing mothers, in all their dimensions of “being a woman”.
Hoddinotta et al.²⁷ (2007)	Qualitative Phenomenological	IV	The involvement of a multidisciplinary team in the implementation of breastfeeding support can be more effective than an expert approach.
Aiken and Thomson²⁸ (2013)	Qualitative Phenomenological	IV	Professional counseling is helpful to enhance the woman's self-esteem and confidence in her ability to breastfeed.

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