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Obese Women'S Experiences Breastfeeding And Health Professionals' Experiences Providing Breastfeeding Care

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Abstract

Obese women breastfeed for a shorter time than normal-weight women, but little is known about how obese women experience breastfeeding or how health professionals (HPs) experience providing breastfeeding care for them. Also, problems have been identified in breastfeeding care in previous research, but little is known about how women and HPs experience receiving and providing breastfeeding care across the continuum. Two qualitative studies were conducted in upstate New York. Thirty-four HPs who provided care during different periods of the continuum each participated in a single qualitative interview. Twenty-two normal-weight and obese women were followed longitudinally with serial interviews from pregnancy through postpartum. Interviews were audio-recorded, transcribed, and qualitatively analyzed using ATLAS.ti software. Peer-debriefing, and member-checking enhanced validity. Among HPs, obesity was not a salient risk factor for poorer breastfeeding outcomes, although nearly all HPs identified physical or psychosocial challenges they perceived as more common among obese women. HPs' own challenges in providing breastfeeding care for obese women emerged; caring for obese women were perceived as more time-consuming and more physically 3   demanding. Among women, obese mothers experienced more physical, medical, and social challenges for breastfeeding. Some challenges were unique to obesity, such as management of neonatal hypoglycemia, while others were exacerbated by obesity, such as positioning. HPs described breastfeeding care for all women as disjointed across the continuum with "no captain of the ship." This was attributed to HPs' lack of time and skills, gaps in care, and reliance on others to provide breastfeeding care. Women described analogous experiences receiving breastfeeding care, calling it a "gray area" for care. Women also believed their HPs were "in favor of" breastfeeding, but felt inadequately supported stating that HPs' "actions speak louder than words." This research identified key challenges experienced by obese breastfeeding women and the HPs who provide them with breastfeeding care. We suggest intervention strategies to address these challenges in each period of the continuum. Additionally, this research identified that both HPs and women perceived breastfeeding care as disjointed and inadequate. Improving skills among HPs and increasing access to breastfeeding care among women may positively affect women's breastfeeding experiences. 4

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2015-08-17

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Keywords

breastfeeding; obesity; health professional

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Union Local

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Rasmussen,Kathleen Maher

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Wethington,Elaine
Cassano,Patricia Ann
Devine,Carol M

Degree Discipline

Nutrition

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Ph. D., Nutrition

Degree Level

Doctor of Philosophy

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Government Document

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dissertation or thesis

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