Exploring the mother's perception of latching difficulty in the first days after birth : an interview study in an Italian hospital

OBJECTIVES: to explore Italian mothers' perception of latching difficulty in the first days postpartum. Latching difficulty is the only qualitative item included in the Breastfeeding Assessment Score (BAS) that has proven to be a valid instrument to identify women at risk of early breast-feeding cessation. DESIGN AND SETTING: a phenomenologic-hermeneutic study was conducted at the Mangiagalli Clinic, Milan, Italy. PARTICIPANTS: fifteen women who received a BAS <8 (indicating an early breast-feeding cessation risk) were interviewed before discharge, and later by phone, for member checking. FINDINGS: six main themes emerged from the interviews: (1) Breast feeding can be difficult due to both the mother and newborn, and encountered problems are mainly physical. (2) Women have developed different strategies to overcome latching difficulties. (3) Early breast feeding, even if difficult, is mostly related to positive feelings. (4) Breast-feeding sustains the child-mother relationship. (5) Mothers have already developed constructive theories about human colostrum, breast milk and artificial milk. (6) Receiving integrated health-care support and education is fundamental to overcome early breast-feeding problems. CONCLUSIONS: the interviews suggest that although mothers experience difficulties during early breast feeding, positive feelings seem to prevail over the negative ones, and mothers have already developed strategies to overcome their latching problems. Receiving support is fundamental, but this must be consistent among health-care professionals. IMPLICATIONS FOR PRACTICE: when evaluating the BAS item 'latching difficulty', midwives should consider that difficulties are primarily related to physical problems. Furthermore, to sustain lactation, mothers should be helped to elicit their experience of early breast feeding, as it can be extremely satisfying, even when difficulties in latching the babies occur.