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      Either ‘ a blessing in disguise’, or ‘ I couldn’t get help,’: Australian and Aotearoa NZ women’s experiences of early infant feeding during COVID-19

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          Abstract

          Background

          To manage the COVID-19 pandemic, public health restrictions and a rapid pivot to telehealth occurred. Peripartum services were significantly affected by a strained infrastructure. Decreased face to face access to health services and support affected maternal experiences and confidence internationally, yet little was reported with the Australian and Aotearoa New Zealand context.

          Aim

          To explore the early parenting and infant feeding experiences of new mothers from Australia and Aotearoa New Zealand in the context of a pandemic.

          Methods

          An interpretive qualitative approach and thematic analysis obtained an in-depth understanding of the experiences of 27 mothers who gave birth during the first wave of the COVID-19 pandemic in 2020.

          Findings

          Australian and Aotearoa New Zealand women reported similar experiences, which varied contextually. Restrictions and requirements impacted favourably and unfavourably. Many women found the peace and space of social distancing an unexpected benefit and were proud of their achievements, whilst others shared feelings of isolation and distress. Some women felt they instinctively did what they needed to do. Experiences correlated with differing levels of self-efficacy.

          Discussion

          While many women relished the freedom from social obligations when faced with feeding challenges, there was general dissatisfaction with the level of support available. Care was fragmented, and health care needs were unmet, impacting feeding and parenting decisions and mental health.

          Conclusion

          Access to timely and appropriate professional support is an important factor in establishing breastfeeding and developing parenting confidence, particularly in the context of a pandemic and should be a health policy priority.

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          Most cited references33

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          Sample Size in Qualitative Interview Studies: Guided by Information Power

          Sample sizes must be ascertained in qualitative studies like in quantitative studies but not by the same means. The prevailing concept for sample size in qualitative studies is "saturation." Saturation is closely tied to a specific methodology, and the term is inconsistently applied. We propose the concept "information power" to guide adequate sample size for qualitative studies. Information power indicates that the more information the sample holds, relevant for the actual study, the lower amount of participants is needed. We suggest that the size of a sample with sufficient information power depends on (a) the aim of the study, (b) sample specificity, (c) use of established theory, (d) quality of dialogue, and (e) analysis strategy. We present a model where these elements of information and their relevant dimensions are related to information power. Application of this model in the planning and during data collection of a qualitative study is discussed.
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            Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect.

            The importance of breastfeeding in low-income and middle-income countries is well recognised, but less consensus exists about its importance in high-income countries. In low-income and middle-income countries, only 37% of children younger than 6 months of age are exclusively breastfed. With few exceptions, breastfeeding duration is shorter in high-income countries than in those that are resource-poor. Our meta-analyses indicate protection against child infections and malocclusion, increases in intelligence, and probable reductions in overweight and diabetes. We did not find associations with allergic disorders such as asthma or with blood pressure or cholesterol, and we noted an increase in tooth decay with longer periods of breastfeeding. For nursing women, breastfeeding gave protection against breast cancer and it improved birth spacing, and it might also protect against ovarian cancer and type 2 diabetes. The scaling up of breastfeeding to a near universal level could prevent 823,000 annual deaths in children younger than 5 years and 20,000 annual deaths from breast cancer. Recent epidemiological and biological findings from during the past decade expand on the known benefits of breastfeeding for women and children, whether they are rich or poor.
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              Health promotion by social cognitive means.

              This article examines health promotion and disease prevention from the perspective of social cognitive theory. This theory posits a multifaceted causal structure in which self-efficacy beliefs operate together with goals, outcome expectations, and perceived environmental impediments and facilitators in the regulation of human motivation, behavior, and well-being. Belief in one's efficacy to exercise control is a common pathway through which psychosocial influences affect health functioning. This core belief affects each of the basic processes of personal change--whether people even consider changing their health habits, whether they mobilize the motivation and perseverance needed to succeed should they do so, their ability to recover from setbacks and relapses, and how well they maintain the habit changes they have achieved. Human health is a social matter, not just an individual one. A comprehensive approach to health promotion also requires changing the practices of social systems that have widespread effects on human health.
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                Author and article information

                Journal
                Women Birth
                Women Birth
                Women and Birth
                Australian College of Midwives. Published by Elsevier Ltd.
                1871-5192
                1878-1799
                26 November 2022
                26 November 2022
                Affiliations
                [a ]School of Nursing, Midwifery and Public Health, University of Canberra, Locked Bag 1, Canberra, ACT 2617 Australia
                [b ]College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia
                [c ]Deakin University, School of Nursing and Midwifery, 1 Gheringhap St., Geelong, Vic. 3227 Australia
                [d ]Liggins Institute, The University of Auckland, Aotearoa, New Zealand
                [e ]The University of Queensland, School of Nursing, Midwifery & Social Work, Brisbane, QLD 4072 Australia
                [f ]School of Nursing and Midwifery, Monash University, Peninsula campus, McMahons Rd, Frankston, VIC 3199 Australia
                [g ]Department of Health Practice, Ara Institute of Canterbury, New Zealand
                [h ]Institute of Health and Wellbeing, Federation University, Mt Helen Campus, Australia
                [i ]Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
                Author notes
                [* ]Corresponding author at: School of Nursing, Midwifery and Public Health, University of Canberra, Locked Bag 1, Canberra, ACT 2617, Australia.
                [1]

                ORCID iD: 0000-0002-2386-8457.

                [2]

                Twitter: @ct_kgraham.

                [3]

                ORCID iD: 0000-0002-7214-4383.

                [4]

                ORCID iD: 0000-0002-0842-4655.

                [5]

                Twitter: @MartisRuth.

                [6]

                ORCID iD: 0000-0003-1900-0038.

                [7]

                Twitter: @Lauren_Kearney7.

                [8]

                ORCID iD: 0000-0003-0299-6537.

                [9]

                ORCID iD: 0000-0003-0880-0566.

                [10]

                Twitter: @ReaDaellenbach.

                [11]

                ORCID iD: 0000-0002-6119-9477.

                [12]

                Twitter: @HelenHall_mid.

                [13]

                ORCID iD: 0000-0002-6647-620X.

                [14]

                Twitter @ProfLindaSweet.

                [15]

                ORCID iD: 0000-0003-0605-1186.

                Article
                S1871-5192(22)00349-3
                10.1016/j.wombi.2022.11.003
                9699799
                a503cd4e-bda2-41bd-a279-2ed0baa825ab
                © 2022 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 3 June 2022
                : 9 November 2022
                : 10 November 2022
                Categories
                Original Research

                covid-19,parenting,breastfeeding,infant feeding,self-efficacy,australia,new zealand

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