Improving UK breastfeeding duration:salutogenic evaluation of English regional success to codevelop community-based breastfeeding support intervention

问题是什么？母乳喂养有助于保护母亲和婴儿的健康，世界卫生组织建议婴儿在六个月大之前只喝母乳，母乳喂养与固体食物一起持续至少两年。尽管80%的母亲在婴儿出生时母乳喂养，但许多人在最初的几天或几周内就停止了母乳喂养，这意味着英国是世界上母乳喂养率最低的国家之一。除了影响健康结果外，许多妇女在停止母乳喂养时还没有做好准备，这种经历会对她们的心理健康产生负面影响。因此，了解如何更好地支持母乳喂养的母亲是很重要的，但是，尽管已经做了大量的研究来了解母乳喂养的障碍，但很少有人关注如何更好地支持母乳喂养。英国一些地区的母乳喂养率比其他地区高得多，如果我们能更好地理解这种情况发生的原因，我们也可以改变对其他地区的支持。其中一个例子是北萨默塞特地方政府，那里的母乳喂养率在英国是最高的。这包括贫困地区，那里的母乳喂养率通常较低。我们的项目将探索北萨默塞特郡正在发生的事情，帮助母亲延长母乳喂养时间。我们将利用这些信息为英国其他地区提供指导，以帮助母亲实现母乳喂养的目标。我们如何理解北萨默塞特的成功？为了了解什么在北萨默塞特行之有效，我们将与该地区有母乳喂养和母乳喂养支持经验的人交谈。这将包括工作人员和母乳喂养同伴支持者（接受过如何支持母乳喂养培训的母亲），并对当地母亲进行调查。除此之外，我们还将研究当地的政策和数据，并在北萨默塞特郡的一个大城镇韦斯顿超级马雷（Weston-Super-Mare）呆上一段时间，看看环境是如何支持母乳喂养的。如何处理这些发现？当我们有了我们认为在北萨默塞特行之有效的初步发现时，我们将与从事公共卫生工作的人、母乳喂养同伴的支持者和来自英国其他地区（即：不是来自北萨默塞特）的母亲分享，看看他们是否认为这些想法也能在他们的地区很好地帮助改善母乳喂养。这是因为有时在一个地区支持健康行为的事情可能在其他地区不起作用，因为地区不同，生活在那里的人也不同。我们将列出不同地区的人们认为对支持母乳喂养很重要的所有事情，并与英国负责设计母乳喂养支持的人分享这个工具。我们希望这一工具将在未来用于改善母乳喂养支持的项目。出于这个原因，我们也会询问我们的参与者，他们认为成功母乳喂养的标准应该是什么样子。应该仅仅是有多少妇女在母乳喂养婴儿，还是应该包括更广泛的指标，比如她们感到得到了多大的支持，以及她们对母乳喂养婴儿的时间有多高兴？

What is the issue? Breastfeeding helps to protect the health of mothers and babies and the World Health Organization recommends that babies just have breastmilk until they are six months old, with breastfeeding continuing alongside solid food for at least two years. Although 80% of mothers breastfeed their baby when they are born, many stop in the early days and weeks meaning that the UK has some of the lowest breastfeeding rates in the world. As well as affecting health outcomes, many women are not ready to stop breastfeeding when they do and this experience can negatively affect their mental health. Understanding how to better support breastfeeding mothers is therefore important, but although lots of research has been done to understand the barriers to breastfeeding very little has been undertaken to focus on what works well to support them. Some areas in the UK have much higher breastfeeding rates than others and if we better understood why this is happening, we could change support in other areas too. One example of this is North Somerset Local Authority which has some of the highest breastfeeding rates in the UK. This includes in areas of deprivation, which usually have lower breastfeeding rates. Our project will explore what is happening in North Somerset that helps mothers to breastfeed for longer. We will use this information to create guidance for other areas around the UK to try to help mothers meet their breastfeeding goals. How can we understand success in North Somerset? To understand what is working well in North Somerset, we will speak to those with experience of breastfeeding and breastfeeding support in the area. This will include staff and breastfeeding peer supporters (mothers who have had some training in how to support breastfeeding) and carry out a survey of local mothers. Alongside this, we will examine local policies, data and spend time in Weston-Super-Mare, a large town in North Somerset, to see how the environment supports breastfeeding. What will be done with the findings? When we have our initial findings of what we think works well in North Somerset we will share them with people who work in public health, breastfeeding peer supporters and mothers from the rest of the UK (ie: not from North Somerset) to see whether they think these ideas would also work well in their areas to help improve breastfeeding. This is because sometimes things that work well to support health behaviours in one area might not work well in other areas due to areas being different and having different people living there. We will make a list of all the things that people in different areas agree are important for supporting breastfeeding and share this tool with those in charge of designing breastfeeding support in the UK. We hope that this tool will be used in the future for projects to improve breastfeeding support. For this reason we will also ask our participants what they think a measure of successful breastfeeding should look like. Should it simply be how many women are breastfeeding their baby or should it include wider measures such as how well supported they feel and how happy they are with how long they breastfed their baby for?