Breastfeeding mothers’ experiences with community physicians in Israel: A qualitative study

Elia Blitman, Aya Biderman, Ilan Yehoshua, Limor Adler

Keywords: breastfeeding, primary care, qualitative research, ante-natal care, postpartum care

Background:
The guidelines of all leading professional organizations recommend providing adequate support and education regarding breastfeeding; yet many mothers feel that they receive inadequate information from their health care providers in the primary care setting.

Research questions:
To expand our understanding of the breastfeeding-related experiences of mothers with primary care physicians (PCPs).

Method:
In this qualitative study, we interviewed breastfeeding mothers in Israel in the first six months after delivery. The interviews were conducted between December 2020 and May 2021. We used thematic analysis to explore women’s attitudes and experiences with their PCPs regarding breastfeeding concerns.

Results:
We interviewed 13 women aged 24 to 37. We identified four main themes. The first of these was physicians’ inconsistent attitudes toward breastfeeding. Some were indifferent, while others related to breastfeeding solely in the context of infant development. Some were supportive, while others opposed breastfeeding. Several women revealed physicians’ inappropriate and disturbing attitudes to breastfeeding. The second theme was physicians’ lack of knowledge regarding medical treatment for breastfeeding issues. This theme included lack of knowledge, incorrect treatment of breastfeeding problems, and contradictions among HCPs. The third was mothers’ preference for alternative resources, including individualized breastfeeding counselling, maternity and childcare nurses, mothers’ groups (in person or online), and family and friends over medical treatment for breastfeeding problems. The fourth theme involved mothers’ suggestions for PCPs, which highlighted the importance of communication, prenatal physician-initiated dialogue on breastfeeding, expanding professional knowledge on breastfeeding, and increasing the availability of treatment for breastfeeding problems.

Conclusions:
The women in this study reported unsatisfactory breastfeeding support by PCPs and incorrect or inadequate treatment of medical problems related to breastfeeding. We believe that physicians should expand their knowledge on breastfeeding medicine and education programs for improving knowledge and skills in breastfeeding issues should be implemented throughout the medical training.

Points for discussion:
expanding knowledge in breastfeeding medicine

understanding patient' needs

qualitative studies as a good option for research in primary care