Anderson T The misleading myth of choice: the continuing oppression of women in childbirth. MIDIRS. 2002; 12:(3)405-7

Cloherty M, Alexander J, Holloway I Supplementing breast-fed babies in the UK to protect their mothers from tiredness or distress. Midwifery. 2004; 20:(2)194-204

2012. (accessed 23 July 2014)

London: HMSO; 1993

London: DH; 2004

Dykes FLondon: DH; 2003

Dykes FSheffield: Women's Informed Childbearing and Health Unit, School of Nursing and Midwifery, Faculty of Medicine. University of Sheffield; 2004

Dykes F In: Hunter B, Deery R (Eds). Basingstoke: Palgrave Macmillan; 2009

Finigan V Breastfeeding - the great divide: The controversy as seen through a midwifery lens. MIDIRS. 2004; 14:(2)227-31

Freire PNew York: Continuum; 1981

Furber CM, Thomson AM The emotions of integrating breastfeeding knowledge into practice for English Midwives: A qualitative study. Int J Nurs Stud. 2008; 45:(2)286-97

Hamlyn B, Brooker S, Oleinikova K, Wands SLondon: TSO; 2002

Helling P, Howes C Breastfeeding knowledge and Practice of Pediatric Nurse Practitioners. J Pediatr Health Care. 2004; 18:(1)8-14

Henschel D, Inch SHale: Books for Midwives Press; 1996

Jamieson L In: Henderson C, Jones K (Eds). London: Mosby; 1997

Lipsky MNew York: Russell Sage Foundation; 1980

Martin EMilton Keynes: Open University Press; 1989

Minchin M Artificial feeding and risk: the last taboo. Practising Midwife. 2000; 3:(3)18-20

MacArthur C, Jolly K, Ingram L, Freemantle N, Dennis CL, Hamburger R, Brown J, Chambers J, Khan K Antenatal Peer Support Workers and Initiation of Breast Feeding: Cluster Randomised Controlled Trial. BMJ. 2009; 338

London: National Institute for Health and Clinical Excellence; 2006

Palmer G, Kemp SLondon: Mosby; 1996

Rapley G Breastfeeding: Pressure and guilt. Practising Midwife. 2001; 4:(2)

London: RCM; 2002

London: RCM; 2012

Wickham S In: Stewart M (Ed). Edinburgh: Books for Midwives Press; 2004

Wilson-Clay B Clinical use of silicone nipple shields. Journal of Human Lactation. 1996; 12:279-85

Woolridge MW, Baum JD, Drewett RF Effect of a traditional and a new nipple shield on sucking patterns and milk flow. Early Hum Dev. 1980; 4:(4)357-64

Geneva: Family and Reproductive Health, Division of Child Health Development. WHO; 1998

The role of the midwife in breastfeeding: Dichotomies and dissonance

02 August 2014
Volume 22 · Issue 8


Promoting and supporting breastfeeding is an integral part of the role of the midwife. These aspects of the role, however, can cause dilemmas and conflict for midwives. Conflicts arise from how midwives acquire their knowledge of breastfeeding, which if used inappropriately can disempower breastfeeding women. Promotion of breastfeeding can cause dissonance between providing informed choice and what midwives see as coercion. The issue of time can greatly undermine midwives support for breastfeeding mothers and the dichotomies between evidence-based practice and experiential/personal experiences can result in inappropriate care being provided for breastfeeding mothers. Midwives can overcome some of the conflicts within their role by gaining more knowledge of breastfeeding, learning the art of good communication and by reflecting personal experiences.

The role of the midwife in breastfeeding is extensive and includes relaying knowledge about the subject, promoting, encouraging and supporting breastfeeding mothers, complying with policies and practices, and importantly, practising in a professional manner. Although at first glance these aspects of the role appear simple and straightforward, when considered in more depth, this is often not the case. There are inherent problems associated with all the above aspects of the role because of the competing paradigms, ideals or models affiliated to breastfeeding. This article will examine each of the above aspects of the midwives role and discuss suggestions for the way forward.

The dichotomies and dissonances associated with the midwives' role in breastfeeding became evident when undertaking a study in 2006 looking at midwives' experiences of breastfeeding on a personal, educational and professional level. In the study 12 midwives were interviewed from a small maternity unit in Nottinghamshire. From these interviews, a questionnaire was formulated and 711 where distributed to six maternity units in the North of England. Four hundred and ten questionnaires were returned giving a response rate of 57.8% (Battersby, 2006). Some of the findings from this study will be incorporated within this paper to enhance the discussion.

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