Wilma Otten, Ilona Wildeman, Kim Kranenborg, Caren Lanting, Sylvia van der Pal
Published in:
TNO Child Health
The Netherlands
Sylvia van der Pal,; Wilma Otten,

10 design elements for breastfeeding information and support

The World Health Organization advises mothers to exclusively breastfeed their newborn babies for at least 6 months. In the Netherlands, a recent assessment of breastfeeding practices showed that 69% of the mothers start breastfeeding after birth. After one week this number declines to 58%, and to 47% after a month. At 6 months only 19% of babies are still breastfed.

Low rates of sustained breastfeeding are linked to challenges many mothers encounter during the first weeks, such as pain during breastfeeding or concerns about milk production. As a result, many mothers don’t stick to the breastfeeding aspirations and goals they set during or even before pregnancy. Mothers of newborns in the Netherlands indicated that they did not always get, or experience, the support they needed from care professionals, or know where to get breastfeeding guidance, especially after the support from maternity care ended. In this context, 10 design-elements for breastfeeding information and support were developed in collaboration with mothers of newborns and professionals.

These design-elements include the following recommendations: A) to define and adjust breastfeeding information to 1) the target audience and 2) the phase of breastfeeding, B) to address 3) personal breastfeeding attitudes or expectations, 4) personal breastfeeding wishes or goals, 5) possible actions and 6) good examples, C) to take into account, 7) the partner and broader social environment, 8) the basic needs of the baby, 9) the health care system, and D) to consider 10) the form of support. Elements 3, 4, 5, and 6 were based on behavior change theories on how to transfer from “knowing” to actually being motivated and perform and sustain breastfeeding.

Health organizations and professionals were encouraged to apply the 10 design-elements when providing (online) information and support to pregnant women and mothers of newborns about breastfeeding. For example, Centering Pregnancy, a new form of group care for pregnant women led by midwives, recently used the 10 design-elements. During Centering Pregnancy group sessions, pregnant women are encouraged to openly discuss both the advantages and challenges of breastfeeding and how they might overcome the latter. The group sessions have shown to have a positive effect on the uptake of breastfeeding. Centering Pregnancy has now recently applied the 10 design-elements in visual breastfeeding conversation cards, to help encourage discussions of solutions for breastfeeding-related challenges and activities that pregnant women can perform to prepare for breastfeeding.