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Breastfeeding Support Guided by Swanson's Theory of Caring

Miller, Carrie Westmoreland PhD, RN, CNE, CHSE, IBCLC; Wojnar, Danuta PhD, RN, MN, MED, IBCLC, FAAN

MCN: The American Journal of Maternal/Child Nursing: November/December 2019 - Volume 44 - Issue 6 - p 351–356
doi: 10.1097/NMC.0000000000000570

Purpose: Many women struggle with initiation of breastfeeding. The purpose of this study was to explore mothers' perceptions of care and support received from clinicians during breastfeeding initiation and the utility of Swanson's (1991) Theory of Caring to provide person-centered care to breastfeeding mothers and infants.

Study Design and Methods: Directed content of secondary analysis of data obtained from 11 women via in-person interviews at three time points: before birth, a week after giving birth, and 6 to 8 weeks after giving birth. All women were breastfeeding at the end of the study interview series. Swanson's Theory of Caring provided the theoretical framework for the analysis.

Results: Two overarching themes The Acts of Caring and The Lapses in Caring summarized women's experiences of care received during the initiation of breastfeeding. Five subthemes supported the Acts of Caring theme, and three subthemes supported the Lapses in Caring theme.

Clinical Implications: Although all study participants chose to breastfeed after hospital discharge and the majority felt well supported, some received care that was perceived as uncaring, unsupportive, or harmful. Providing breastfeeding support consistent with research evidence and underpinnings of Swanson's Theory of Caring may help women build trusting relationships with clinicians and feel confident in meeting their breastfeeding goals.

Swanson's Theory of Caring can be useful in developing caring methods of offering breastfeeding support to new mothers. In this study, discussions of new mothers about the breastfeeding support they received in the hospital are analyzed using the caring theory as a framework.

Carrie Westmoreland Miller is an Assistant Professor, Seattle University-College of Nursing, Seattle, WA. Dr. Miller can be reached via e-mail at

Danuta Wojnar is a Professor, Seattle University-College of Nursing, Seattle, WA.

The authors declare no conflicts of interest.

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