MIDWIVES AND THE NECESSITY FOR COMPREHENSIVE AND ACCESSIBLE BREASTFEEDING EDUCATION IN BULGARIA

Assist. Prof. Daniela Lyutakova

Department of Healthcare University of Ruse “Angel Kanchev”

ORCID: 0000-0002-5876-2687

E-mail: dlyutakova@uni-ruse.bg

Prof. Ivanichka Serbezova

Department of Healthcare University of Ruse “Angel Kanchev”

ORCID: 0000-0002-1195-2512

E-mail: iserbezova@uni-ruse.bg

Abstract

The paper reviews existing challenges before midwifery care focused on breastfeeding and lactation. It also explores the need for comprehensive, evidence-based and modern education on breastfeeding medicine for future and for practicing midwives as evidenced by previous research. The aim of this study is to investigate the attitudes of midwives regarding the need for effective breastfeeding education, emphasizing the role of midwives in the puerperium period. The method applied includes a literary review and a survey that aims to clarify the self-assessment of the respondents. Conclusions point to the need for development of adequate and up-to-date training for postpartum care with a focus on breastfeeding and lactation, which is adapted to the specifics of a midwifery model of care founded on evidence-based medicine, is of utmost importance. The conducted study highlights the necessity to further explore obstacles to breastfeeding support and strategies to motivate Bulgarian midwives to invest more in it.

Keywords

Breastfeeding, Lactation, Breastfeeding Education, Postpartum Care, Midwifery Care

REFERENCES

Nedkova, V., Milanova, V., (2009). Benefits of Breastfeeding. (Оригинално заглавие: „Ползи от кърменето“, MedInfo), https://www.medinfo.bg/spisanie/2014/2/statii/polzi-ot-kyrmeneto-1631. (Accessed 15 April 2025)
Popivaniva, A., (2016). Skin to Skin Contact or About the Continuous Contact Between Mother and Baby. National Association Support for Breastfeeding (Оригинално заглавие: Контакт „кожа до кожа“ или за непрекъснатия контакт между майката и бебето след раждането). НАПК, URL: http://www.podkrepazakarmene.com/early-contact-878.html (Accessed 15 April 2025)
Rangelova, L., Duleva, V., Chikova-Iscener, E.,Dimitrov, P., National Centre of Public Health and Analyses, (2022). Risk Factors for the Health of Children at the Age of 1-6 Years. Bulgarian Journal of Public Health, Vol. 14, Book 2 Special Edition, p. 11-30 (Оригинално заглавие: Рискови фактори за здравето на децата на1-6 години) (Accessed 14 April 2025)
Ching, Constance et al. (2021). “Old Tricks, New Opportunities: How Companies Violate the International Code of Marketing of Breast-Milk Substitutes and Undermine Maternal and Child Health during the COVID-19 Pandemic.” International journal of environmental research and public health vol. 18,5 2381. 1 Mar. 2021 , doi:<10.3390/ijerph18052381> (Accessed 16 April 2025)
Dinwoodie K., Bramwell R., Dykes F., Lang S. & Runcieman A. (2000) The baby friendly breast-feeding management course. British Journal of Midwifery 8, 362-366. (Accessed on 16.04.2025).
Furber CM, Thomson AM. (2008) Breastfeeding practice in the UK: midwives' perspectives. Matern Child Nutr. 2008 Jan;4(1):44-54. doi: 10.1111/j.1740-8709.2007.00094.x. PMID: 18171406; PMCID: PMC6860633. (Accessed on 16.04.2025).
Hall Moran V., Dykes F., Edwards J. & Whitmore M. (2004) An evaluation of the breastfeeding support skills of midwives and voluntary breastfeeding supporters using the Breastfeeding Support Skills Tool (BeSST). Maternal and Child Nutrition 1, 241-249. (Accessed on 16.04.2025).
Moore ER, Bergman N, Anderson GC, Medley N. (2016). “Early skin-to-skin contact for mothers and their healthy newborn infants.” Cochrane Database of Systematic Reviews 2016, Issue 11. Art. No.: CD003519. <DOI: 10.1002/14651858.CD003519.pub4> (Accessed 12 April 2025)
Pramono A, Smith J, Bourke S, Desborough J. (2022) "We All Believe in Breastfeeding": Australian Midwives' Experience of Implementing the Baby Friendly Hospital Initiative. J Hum Lact. 2022 Nov;38(4):780-791. doi: 10.1177/08903344221106473. Epub 2022 Jul 6. PMID: 35792378. (Accessed on 16.04.2025).
Rm MS, Rn EW, Rn JL, Rm AB. (2019) The supporting role of the midwife during the first 14 days of breastfeeding: A descriptive qualitative study in maternity wards and primary healthcare. Midwifery. 2019 Nov;78:50-57. doi: 10.1016/j.midw.2019.07.016. Epub 2019 Jul 15. PMID: 31357116. (Accessed on 16.04.2025).
Smith JW, Tully MR. (2001) Midwifery management of breastfeeding: using the evidence. J Midwifery Womens Health. 2001 Nov-Dec;46(6):423-38. doi: 10.1016/s1526-9523(01)00206- 9. PMID: 11783690. (Accessed on 16.04.2025).
Swerts M, Westhof E, Bogaerts A, Lemiengre J. (2016) Supporting breast-feeding women from the perspective of the midwife: A systematic review of the literature. Midwifery. 2016 Jun;37:32-40. doi: 10.1016/j.midw.2016.02.016. Epub 2016 Mar 4. PMID: 27217235. (Accessed on 16.04.2025).
Wang T, Shang M, Chow KM. (2023) Effects of breastfeeding training programmes for midwives on breastfeeding outcomes: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2023 Apr 18;23(1):262. doi: 10.1186/s12884-023-05540-6. PMID: 37072728; PMCID: PMC10111770. (Accessed on 16.04.2025).
Webber E, Wodwaski N, Busch D. (2022) Breastfeeding and Human Lactation Curriculum Survey of Midwifery Programs in the United States. J Midwifery Womens Health. 2022 Sep;67(5):635-643. doi: 10.1111/jmwh.13367. Epub 2022 May 6. PMID: 35522123. (Accessed on 16.04.2025).
WHO, (2018). “WHO recommendations: intrapartum care for a positive childbirth experience.”, ISBN 978-92-4-155021-5. <URL: http://apps.who.int/iris/bitstream/handle/10665/43633/9241591544_eng.pdf?sequence=1>; (Accessed 12 April 2025)
Wissett L., Dykes F. & Bramwell R. (2000) Evaluating the WHO/UNICEF breast-feeding course. British Journal of Midwifery 8, 294-300. (Accessed on 16.04.2025).