Jill Inderstrodt PhD, MPH , Krysttel C. Stryczek MA , Sara E. Vargas PhD , Jennifer N. Crawford PhD , Taylor Hooker MS, CTRS, NBC-HWC , Aimee R. Kroll-Desrosiers PhD , Valerie Marteeny MS , Kate F. Wallace MPH , Kristin Mattocks PhD, MPH
{"title":"退伍军人使用退伍军人事务产科护理津贴进行母乳喂养的促进因素和障碍。","authors":"Jill Inderstrodt PhD, MPH , Krysttel C. Stryczek MA , Sara E. Vargas PhD , Jennifer N. Crawford PhD , Taylor Hooker MS, CTRS, NBC-HWC , Aimee R. Kroll-Desrosiers PhD , Valerie Marteeny MS , Kate F. Wallace MPH , Kristin Mattocks PhD, MPH","doi":"10.1016/j.whi.2023.12.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p><span>U.S. veterans of childbearing age represent one of the fastest growing populations using Veterans Affairs<span><span> (VA) health care. The VA does not provide </span>obstetric care<span><span><span> directly but pays for VA-enrolled veterans to obtain outside obstetric care. The VA also provides </span>maternity care coordination (MCC) services, including </span>lactation support. Breastfeeding benefits mothers and babies; however, previous research shows that veteran mothers quit </span></span></span>exclusive breastfeeding<span> earlier than the American Academy of Pediatrics<span> 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.</span></span></p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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 (<em>n</em><span> = 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.</span></p></div><div><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 3","pages":"Pages 309-316"},"PeriodicalIF":2.8000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Facilitators and Barriers to Breastfeeding Among Veterans Using Veterans Affairs Maternity Care Benefits\",\"authors\":\"Jill Inderstrodt PhD, MPH , Krysttel C. Stryczek MA , Sara E. Vargas PhD , Jennifer N. Crawford PhD , Taylor Hooker MS, CTRS, NBC-HWC , Aimee R. Kroll-Desrosiers PhD , Valerie Marteeny MS , Kate F. Wallace MPH , Kristin Mattocks PhD, MPH\",\"doi\":\"10.1016/j.whi.2023.12.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p><span>U.S. veterans of childbearing age represent one of the fastest growing populations using Veterans Affairs<span><span> (VA) health care. The VA does not provide </span>obstetric care<span><span><span> directly but pays for VA-enrolled veterans to obtain outside obstetric care. The VA also provides </span>maternity care coordination (MCC) services, including </span>lactation support. Breastfeeding benefits mothers and babies; however, previous research shows that veteran mothers quit </span></span></span>exclusive breastfeeding<span> earlier than the American Academy of Pediatrics<span> 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.</span></span></p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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 (<em>n</em><span> = 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.</span></p></div><div><h3>Conclusion</h3><p>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.</p></div>\",\"PeriodicalId\":48039,\"journal\":{\"name\":\"Womens Health Issues\",\"volume\":\"34 3\",\"pages\":\"Pages 309-316\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Womens Health Issues\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1049386723002165\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Womens Health Issues","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1049386723002165","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Facilitators and Barriers to Breastfeeding Among Veterans Using Veterans Affairs Maternity Care Benefits
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.
期刊介绍：
Women"s Health Issues (WHI) is a peer-reviewed, bimonthly, multidisciplinary journal that publishes research and review manuscripts related to women"s health care and policy. As the official journal of the Jacobs Institute of Women"s Health, it is dedicated to improving the health and health care of all women throughout the lifespan and in diverse communities. The journal seeks to inform health services researchers, health care and public health professionals, social scientists, policymakers, and others concerned with women"s health.
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