Rapid Mixed-Methods Assessment and Institutional Co-Design of Breastfeeding Support to Enhance Maternal Confidence in a Teaching Hospital in North India.

IF 2 4区医学 Q2 NURSING

Journal of Human Lactation Pub Date : 2026-08-06 DOI:10.1177/08903344261461891

Dilpreet Kaur, Rakesh Kumar, Inderdeep Singh Kochar

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引用次数: 0

Abstract

Background: Despite strong policy support, many Indian mothers discontinue breastfeeding early. Maternal confidence, rather than knowledge alone, predicts breastfeeding success, yet institution-based approaches to building confidence remain limited. We employed rapid mixed-methods research to identify barriers and co-design feasible support interventions within a teaching hospital.

Research aims: To identify barriers influencing breastfeeding confidence, quantify barrier prevalence and associations with maternal confidence, and co-design and pilot-test an institutionally feasible intervention through participatory stakeholder engagement.

Methods: This was a sequential mixed-methods study (November 2024-April 2025) at a teaching hospital in north-western India. Phase 1: Qualitative assessment (n = 47) through interviews and focus groups. Phase 2: Cross-sectional survey (n = 232) measuring breastfeeding self-efficacy (BSES-SF), barriers, social support, and depressive symptoms. Phase 3: Participatory co-design and micro-pilot (n = 26) of intervention integrated into hospital workflows.

Results: Qualitative analysis identified four barrier domains: early experiences (70%), social/family influences (62%), healthcare interactions (55%), and emotional well-being (48%). Survey findings: 63% reported milk supply concerns, 58% pain, 49% conflicting family advice. Mean BSES-SF = 46.2 (SD 9.8); 32% scored low confidence. Early difficulties (β = -5.8, p < 0.001), low social support (β = -4.1, p < 0.001), depression (β = -3.6, p < 0.001), and primiparity (β = -2.3, p = 0.005) were independently associated with lower confidence (R² = 0.41). Stakeholders prioritized three components: peer support (94% endorsement), provider communication tools (89%), and family counseling (83%). The micro-pilot demonstrated high acceptability (88%) and feasibility (median delivery time 7 min) with no additional staffing.

Conclusion: Teaching hospitals can rapidly identify breastfeeding confidence barriers and co-design contextually appropriate, low-cost interventions. This model offers a scalable pathway for strengthening breastfeeding support in resource-constrained settings.

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在印度北部的一家教学医院，母乳喂养支持的快速混合方法评估和机构共同设计提高了母亲的信心。

背景：尽管有强有力的政策支持，许多印度母亲仍过早停止母乳喂养。母亲的信心，而不是知识本身，预示着母乳喂养的成功，然而基于机构的建立信心的方法仍然有限。我们采用快速混合方法研究，以确定教学医院的障碍和共同设计可行的支持干预措施。研究目的：确定影响母乳喂养信心的障碍，量化障碍发生率及其与母亲信心的关系，并通过参与性利益相关者参与共同设计和试点测试一种制度上可行的干预措施。方法：这是一项连续混合方法研究（2024年11月- 2025年4月），在印度西北部的一家教学医院进行。第一阶段：通过访谈和焦点小组进行定性评估（n = 47）。第二阶段：横断面调查（n = 232）测量母乳喂养自我效能（BSES-SF）、障碍、社会支持和抑郁症状。阶段3：参与式共同设计和微型试点（n = 26），将干预措施纳入医院工作流程。结果：定性分析确定了四个障碍领域：早期经历（70%）、社会/家庭影响（62%）、医疗保健互动（55%）和情感健康（48%）。调查结果：63%的人表示担心牛奶供应，58%的人感到疼痛，49%的人不同意家人的建议。平均BSES-SF = 46.2 (SD 9.8)；32%的人信心不足。早期困难（β = -5.8, p < 0.001）、低社会支持（β = -4.1, p < 0.001）、抑郁（β = -3.6, p < 0.001）和初产（β = -2.3, p = 0.005）与较低的置信度独立相关（R2 = 0.41）。利益相关者优先考虑三个组成部分：同伴支持（94%认可），提供者沟通工具（89%）和家庭咨询（83%）。该微型试点在无需额外人员的情况下，具有很高的可接受性（88%）和可行性（平均交付时间为7分钟）。结论：教学医院可以快速识别母乳喂养信心障碍，并共同设计适合情境的低成本干预措施。该模式为在资源受限的环境中加强母乳喂养支持提供了可扩展的途径。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Human Lactation 医学-妇产科学

CiteScore

5.00

自引率

11.50%

发文量

100

审稿时长

6-12 weeks

期刊介绍： Committed to the promotion of diversity and equity in all our policies and practices, our aims are: To provide our readers and the international communities of clinicians, educators and scholars working in the field of lactation with current and quality-based evidence, from a broad array of disciplines, including the medical sciences, basic sciences, social sciences and the humanities. To provide student and novice researchers, as well as, researchers whose native language is not English, with expert editorial guidance while preparing their work for publication in JHL. In each issue, the Journal of Human Lactation publishes original research, original theoretical and conceptual articles, discussions of policy and practice issues, and the following special features: Advocacy: A column that discusses a ‘hot’ topic in lactation advocacy About Research: A column focused on an in-depth discussion of a different research topic each issue Lactation Newsmakers: An interview with a widely-recognized outstanding expert in the field from around the globe Research Commentary: A brief discussion of the issues raised in a specific research article published in the current issue Book review(s): Reviews written by content experts about relevant new publications International News Briefs: From major international lactation organizations.