Document Type

Theses, Ph.D


Available under a Creative Commons Attribution Non-Commercial Share Alike 4.0 International Licence



Publication Details

Successfully submitted for the Award of Doctor of Philosophy (Ph.D) to the Technological University Dublin, June, 2010.


Despite research consistently demonstrating the benefits of breastfeeding, Ireland has one of the lowest rates of breastfeeding in Europe with rates at discharge from hospital being 45% (Health Research and Information Division, 2009). Increasing emphasis is being placed on the role of health professionals in promoting and supporting breastfeeding (Sikorski et al., 2003). Little data are available in Ireland regarding health professionals’ perspectives on breastfeeding and women’s experience of professional support. The research consisted of two phases, a mixed methods study exploring health professional support for breastfeeding and an evaluation of an intervention to raise awareness of breastfeeding amongst health professionals and the general public. The mixed methods study consisted of a quantitative cross-sectional survey which investigated different aspects of community health professionals’ (n=256), knowledge and attitudes towards breastfeeding, their self efficacy in dealing with breastfeeding issues and issues around breastfeeding education. This was followed by two qualitative studies, one of which explored the issues for health professionals, in both the community and hospital setting (n=58) in providing support for breastfeeding, and, the other of which examined women’s (n=22) experience of professional support for breastfeeding in the first year postnatally. Grounded theory methods (Strauss & Corbin, 1990) guided data collection and analysis in both qualitative studies. A cross-sectional mixed methods study was also conducted to evaluate the role of forum theatre in creating awareness of breastfeeding. In summary, the quantitative study identified significant differences (p=0.001) as to whether respondents felt they had sufficient skills to provide breastfeeding support, with 82% of PHNs, 54% of GPs and 32% of practice nurses agreeing with this. Interest in attending training about breastfeeding in the next year was assessed and GPs were the least likely to want to attend. The qualitative study with health professionals identified the key issues in professional support for breastfeeding. Health professionals were found to have different levels of ‘ownership’ towards breastfeeding and this affected their level of engagement with the subject. Barriers to providing support were also identified such as having a lack of time, conflicting information and lack of confidence in supporting breastfeeding. The qualitative study of women’s experience of professional support demonstrated that breastfeeding is not something that a woman simply decides to do or not but that instead she needs to navigate through ‘the world of breastfeeding’ which was defined by the woman’s own world, the medical world and the world of support. The evaluation provided preliminary evidence for the potential of using forum theatre to change attitudes to breastfeeding and also for its use in training health professionals. This study has provided a greater understanding of professional support for breastfeeding. In order that women are adequately supported both in the antenatal and postnatal periods, health professional education around breastfeeding needs to be addressed and also alterative forms of support such as peer support on postnatal wards should be considered.