Question 3
The authors in this article noted that several modifiable psychosocial determinants, including self-efficacy, maternal beliefs and attitudes, prenatal intentions, stage of change, and perceptions about benefits and barriers, have been shown to be associated with the duration of breastfeeding. Do you think that these determinants are potential targets of interventions to change behavior? Explain.
posted by Anna @ 8:07 AM
14 comments
14 Comments:
I think that these determinants are potential targets of interventions to change behavior because if medical professionals can find a way to influence these determinants in a positive way, witout offending clients/patients, then surely the duration of breastfeeding would be modified to fit current recommendations as a result of the influenced determinants. For example, if maternal beliefs and attitudes toward breast feeding were targeted through multiple education sessions on benefits of breast feeding, then the duration of breast feeding would likely change (increase) if the education sessions were developed/taught/received effectively.
Since my rotation at WIC last spring I realized just how beneficial breastfeeding is not only for the baby but also for the mother. I do think that we can change behaviors if we target certain psychosocial determinants. Focusing on the perceptions of benefits and barriers, if we could get pregnant women to see the unlimited amounts of benefits to breastfeeding, it could change behaviors. Although it is hard to change a mom's beliefs, with enough patience and education, it is possible. The main issue I think with breastfeeding is that moms are simply uneducated about it. If they knew how much better it was for their child, it would change their feelings towards it. There are so many misconceptions about breastfeeding, and the major reason women stop breastfeeding is because they believe they are not making enough milk. If we could educate new moms that naturally moms do produce everything the baby needs, we could get mothers to lengthen their duration of breastfeeding.
I think that these are all potential targets for intervention. I believe that depending on the person each one might be easier to address than others. With beliefs and attitudes it would be very important to sit down with the client or patient and address the source or reasoning behind their conclusions. I think giving education and resources that are appropriate to the patient or client interventions may be successful.
Steph,
I agree that it is very important to target women while they are still pregnant to discuss the importance of breastfeeding and what their feelings are about it before they would actually start breastfeeding. It is important to be ahead of the game with something this important.
I absolutely think that these determinants are potential targets of interventions to change behavior. Although it is not always going to be easy to change mom's beliefs and attitudes, I think educating on the benefits of breastfeeding before baby arrives is the best way to change these behaviors. There are numerous benefits to both mom and baby with breastfeeding and I don't think that all women are aware of these. I think that it would be beneficial to let expecting moms talk with someone who has actually been through the breastfeeding experience to help her talk through the barriers she may be expecting which are making her unsure about breastfeeding. Tips from a peer that has been through it are sometimes more convincing than the research or advice from a health care professional.
Steph,
I have seen the exact thing that you are talking about here at my WIC rotation, too. It seems like if mom is willing to breastfeed, the main reason that she ends up stopping or supplementing with formula is because she thinks her milk supply is inadequate. By the time we see her at WIC, she has already stopped breastfeeding, and at that point, isn't able to start back up. Giving more education to pregnant moms about this issue and others like it before the baby comes would hopefully clear up some of moms concerns and give her the confidence to breastfeed for longer.
I absolutely think that many of these determinants could be potential targets of intervention. If the patient is given proper education on what to expect when weaning, scientific evidence to back up the benefits of breastfeeding and possible risk factors for children who are weaned too early, then a behavior change could definitely occur. The parents need to be convinced that the action they take is the right thing to do for their child and targeting these attitudes and perceptions can really help the behavior change process and hopefully keep mothers from weaning too early.
Steph Hyett-
It's awesome that you got such a benefit from working at WIC. Since working there, you seemed to have developed some knowledge that could potentially help you modify a mother's behavior and help her breastfeed for a longer period of time!
I think several of these factors could be areas for change. Their perceptions about benefits/barriers could be addressed through educational sessions because its likely they just don't know some of the benefits (and also the harm) from using formula over milk. I think their self-efficacy could also be addressed since they may just not know what to do, but if they are taught properly and can see its not too hard, they will be more likely to do ahead and continue these new behaviors.
Rachel-
I think it is important that you mentioned to actually teach mothers how to do it. It is one thing to give education, but to actually show them how to breastfeed, and like you said, show they it is not that hard, will really help persuade the mother to breastfeed. Good point!
Yes I do. If a dietitian is able to recognize a particular attitude/behavior as being typical of one of the determinants stated above, than they can use intervention strategies that have been successfully done in the past. For example, if a dietitian sees that a new mother views one or more situations in their life as being an enormous barrier in their life, but the situation is one that can actually be easily resolved, then the dietitian can help the woman find strategies to overcome the barriers and in turn change their behavior.
To both Stephs -
I have not had the chance to work at WIC, or with breastfeeding mothers at all. I find it interesting that the mothers often think that their milk supply is inadequate. I wonder where these beliefs originate. I will keep an eye out for that if I ever work with this population in the future.
Of course these determinants can be addressed - prenatal care, prenatal care, prenatal care! Every single woman who is pregnant for the first time should be required to have several weeks worth of prenatal education, and then should get a refresher course for subsequent pregnancies. I cannot imagine having my children without the series of classes I attended prior to giving birth. The trouble is that such care is not necessarily available to all women, and this is tragic. Good prenatal care also allows for others to be present, too (typically it's the husband but what if a young pregnant woman was able to bring in her own mother, too - then 2 generations would get new information about the benefits of breastfeeding!).
Nicole -
It's very easy to think that your breast milk supply is inadequate - it's because you can't see it and you can't measure it. It's really hard if you are actually breast feeding to know how much your baby has ingested. (This is different, of course, if you are feeding breast milk through a bottle.)
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