'POPPATA DIFFICOLTOSA' NELL'ALLATTAMENTO AL SENO:QUALE ESPERIENZA DAL PUNTO DI VISTA DELLE MADRI ITALIANE.UNO STUDIO QUALITATIVO

Introduction Many professional organizations recommend breastfeeding for the first 6 months due to the numerous benefits it has for mother and child. The mother’s breastfeeding experiences in the early postpartum period, are crucial in deciding to continue it. It is important to identify, in the first days after childbirth, women who send messages that are likely to early stop breastfeeding. Many women have said to have breastfeeding difficulties in the first days after birth. Several studies (Mozingo et al,2000; Hauck et al, 2002; Kong e Lee, 2004; Nelson, 2006) have explored the motivation of early breastfeeding cessation but little is known on what "breastfeeding difficulty" really means for women. Aim of the study The aim of this qualitative study was to understand what does "latching difficulty" mean for the Italian mothers. Exploring this meaning could consent to correctly utilize Breastfeeding Assessment Score, in which the investigation of “latching difficulty” is comprised. In addition, further investigation of this topic is aimed to understand how healthcare professional could help women with latching difficulties. Methods The women who received a Breastfeeding Assessment Score (BAS) (Hall et al, 2002) less than 8, and reported “latching difficulties”, were invited to participate in the study. With purposive sampling we recruited 15 women, 48-72 hours after childbirth. We conducted semi-structured interviews which were tape-recorded and verbatim transcribed. The transcripts were read and analyzed using the fenomenologic - ermeneutic approach. Results "Latching difficulty" is related to issues including both mother’s and infant’s difficulties. Nipple-pain and infant’s sleepiness were the most reported difficulties. In spite of these difficulties, the sensation related to breastfeeding was “happiness” when the baby sucked the breast, but concern and anxiety were common too. The women reported more impediment in overcoming the breastfeeding difficulty when there was an idealization of breastfeeding, during pregnancy. The analysis resulted in the emergence of six themes, sixteen category and fifty-nine labels. The six themes was the “breastfeeding can be difficult due to the mother or the newborn”, “breastfeeding can generate positive and negative experiences”, “breastfeeding change/not change the relationship between infant and mother, who is still favoured by rooming-in”, “the mothers have developed theories about colostrum, breast milk, breastfeeding and infant formula”, “the women have developed different strategies to overcome difficulties and continue during breastfeeding”, “support during breastfeeding is very important to continue breastfeeding”. Conclusion This study enriches the theoretical framework in understanding the dynamics that can contribute to early failure of breastfeeding in Italy. Practical relevance Understanding the meaning of the item “latching difficulty” consents to a more correct interpretation of the BAS (Hall et al, 2002) by the Italian midwives and allows a more accurate identification of the mothers who need support and education during breastfeeding Research implications Since this is a qualitative study, more research is needed to understand the “latching difficulty” in the Italian environment and in other cultures.