https://aub.ie/MilitaryREACH-Inderstrodt2024

Inderstrodt, J., Stryczek, K. C., Vargas, S. E., Crawford, J. N., Hooker, T., Kroll-Desrosiers, A. R., Marteeny, V., Wallace, K. F., & Mattocks, K. (2024). Facilitators and barriers to breastfeeding among veterans using Veterans Affairs maternity care benefits. Women's Health Issues. Advance online publication. https://doi.org/10.1016/j.whi.2023.12.005

This mixed-methods study used responses from women Veterans participating in a larger longitudinal study to identify facilitators and barriers to breastfeeding. Women Veterans (N = 329) completed semi-structured interviews with closed- and open-ended questions at 3 months postpartum to assess their breastfeeding behaviors and the factors they considered when deciding whether to breastfeed. While pregnant, 71.7% of participants indicated that they intended to breastfeed, and 96% initiated breastfeeding after the birth of their baby. Four key themes emerged regarding mothers’ decisions to breastfeed: 1) the health of the baby and mother, 2) the mother’s ability to breastfeed, 3) early postnatal experiences, and 4) cost and convenience.

https://doi.org/10.1016/j.whi.2023.12.005

Parents
Veterans

Multiple branches
Air Force
Army
Coast Guard
Marine Corps
Navy

Veteran

Veteran

Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Middle age (40 - 64 yrs)
Thirties (30 - 39 yrs)

Qualitative Study
Cross-Sectional Study
Secondary Analysis

Inderstrodt, Jill, Stryczek, Krysttel C., Vargas, Sara E., Crawford, Jennifer N., Hooker, Taylor, Kroll-Desrosiers, Aimee R., Marteeny, Valerie, Wallace, Kate F., Mattocks, Kristin

Introduction U.S. veterans of childbearing age represent one of the fastest growing populations using Veterans Affairs (VA) health care. The VA does not provide obstetric care directly but pays for VA-enrolled veterans to obtain outside obstetric care. The VA also provides maternity care coordination (MCC) services, including lactation support. Breastfeeding benefits mothers and babies; however, previous research shows that veteran mothers quit exclusive breastfeeding earlier than the American Academy of Pediatrics and World Health Organization recommendation of 6 months. This study aimed to understand facilitators and barriers to breastfeeding among a cohort of veterans who used VA maternity care benefits. Methods Qualitative data from an open-ended question from a national sample of postpartum veterans using VA pregnancy benefits were coded using deductive and inductive content analysis within a matrix framework. Quantitative data were used to contextualize the responses. Results Four themes emerged from the data: (1) impacts on health of baby/mother; (2) the ability to breastfeed; (3) early postnatal experiences breastfeeding; and (4) cost/convenience. Among those who responded to the open-ended breastfeeding question (329/669), most participants (n = 316; 96%) attempted breastfeeding their current baby. Respondents who did not initiate breastfeeding or who discontinued breastfeeding earlier than planned cited diverse reasons. These included low milk supply, poor latch, nipple pain, mental health factors, and low confidence in their ability to continue breastfeeding. Participants cited the MCC program as a facilitator to breastfeeding, and non-VA hospital experiences were mentioned as barriers. Conclusion Veterans in this cohort of 329 veterans who responded to an open-ended breastfeeding question wanted and attempted to breastfeed; however, barriers such as lactation challenges and unsupportive health care providers made it difficult to continue the practice. As the MCC program grows to include more lactation professionals, MCCs may address barriers such as lactation challenges and unsupportive non-VA health care providers. Further program development should focus on addressing these challenges prenatally.

Article
REACH Publication

breastfeeding, maternity care coordination, MCC, mothers and babies

https://www.sciencedirect.com/science/article/pii/S1049386723002165

Research Summary

  June 2024