Support needs of breast-feeding women: Views of Australian midwives and health nurses

Objective: to explore the views of midwives and maternal-child health nurses regarding factors that influence breast feeding initiation and continuation, focusing on how support for women could be improved to increase breast feeding duration. Design: a focus group study. Setting: hospital or domiciliary (home visiting) midwives and community based maternal and child health (MCH) nurses in one region of Victoria, Australia. Methods: twelve MCH nurses and five midwives who provided supportive services to women in the immediate postnatal period attended one of three audio recorded focus groups. Thematic findings were identified. Findings: four key themes were: 'Guiding women over breast-feeding hurdles', 'Timing, and time to care'; 'Continuity of women's care' and 'Imparting professional knowledge'. Given the a pattern of hospital discharge of mother and infant on day one or day two after birth, participants thought the Liming of immediate postnatal breast-feeding support was critical to enable women to initiate and continue breast feeding. Community based MCH nurses reported time gaps in uptake of new mother referrals and time pressured face-to-face consultations. Both groups perceived barriers to continuity of women's care. Conclusions: health services subscribe to the Baby Friendly Health Initiative and government policies which support breast feeding, however providers described time pressures and a lack of continuity of women's care, including during transition from hospital to community services. Implications for practice: there is a need to examine administration of service delivery and how domiciliary and community nurses can collaborate to establish and maintain supportive relationships with breast feeding women. (C) 2014 Elsevier Ltd. All rights reserved.