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Breastfeeding Experiences and Barriers among Mothers with Perceived Insufficient Milk Supply

Cousins, Trisha (2020) Breastfeeding Experiences and Barriers among Mothers with Perceived Insufficient Milk Supply. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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BACKGROUND. Mothers with perceived insufficient milk supply (PIMS) are more likely
to wean breastfeeding early and face many barriers throughout their breastfeeding journey
compared to woman with adequate milk supply. Understanding how PIMS influences mothers’
breastfeeding duration will help health care practitioners better support and guide mothers to
breastfeed longer.
OBJECTIVES. This study aimed to better understand the experiences and barriers faced
by mothers with PIMS living in Southwestern, Pennsylvania.
METHODS. Participants included 26 women (>=18 years old, English-speaking, living in
Southwest Pennsylvania), with healthy term singleton infants between one month and 24 months
of age, who have breastfed, and had PIMS while breastfeeding. During fall 2019, participants took
part in four, 60-90 min focus groups moderated by the primary investigator and attended by an
assistant moderator. Sessions were audio-recorded and transcribed verbatim. Mothers completed
a survey reporting their demographic and breastfeeding/pregnancy history. Transcripts and
assistant moderator notes were coded and analyzed using the constant comparison method to
identify overarching themes and patterns in the data. The quantitative data analysis was primarily
descriptive, assessing percentages or means and standard deviations for participant demographics
and pregnancy/breastfeeding history.
RESULTS/CONCLUSIONS. All mothers were between the ages 18-44 years old, with
54% of the mothers between the ages of 25-34 years old. Focus group discussions revealed four
overarching themes related to PIMS barriers and supports rooted in the Social Ecological Model
(SEM) on the individual, interpersonal, organizational, and societal/community levels. Findings
from this study highlighted specific education and support needs of mothers with PIMS in
Southwestern, Pennsylvania. Results could be used to improve training of future dietitians, practice
of current health professionals, and breastfeeding outcomes for local moms. Specific implications
for practice include the need to increase PIMS screenings for mothers with referrals to local
resources and support groups, providers should adopt a client-centered approach tailored to each
mothers’ goals and experiences, and include lactation in Registered Dietitian Nutritionist training
to expand their scope of practice.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairRoss,
Committee MemberGibbs,
Committee MemberDemirci,
Date: 2 September 2020
Date Type: Publication
Defense Date: 12 June 2020
Approval Date: 2 September 2020
Submission Date: 24 July 2020
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 76
Institution: University of Pittsburgh
Schools and Programs: School of Education > Health and Physical Activity
Degree: EdD - Doctor of Education
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Breastfeeding, Lactation, Milk Supply
Date Deposited: 02 Sep 2020 14:55
Last Modified: 02 Sep 2020 14:55


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