Abstract

There is abundant evidence of the benefits of breastfeeding. In the UK, supplementation in hospital has consistently been shown to be associated with shortened duration of breastfeeding. This paper reports on one theme that emerged from an ethnographic study that explored the expectations, beliefs and experiences of mothers and health professionals concerning supplementation of breastfed babies in an English maternity unit in 2002. It relates specifically to a subset of the data, ten mothers whose babies received at least one supplementary feed by nasogastric (NG) tube on the postnatal ward. Participant observation was carried out on the postnatal ward on day and night shifts and at weekends over nine months. Mothers, midwives, neonatal nurses, health care assistants and senior paediatricians were interviewed. Categories and themes were generated. The researchers’ constructs of ‘the essential method’, when the tube was the method needed for medical reasons, and ‘the chosen method’ when other methods of oral feeding should have been possible, emerged. The latter included time pressures and the avoidance of any form of oral activity that might perhaps make return to the breast more difficult. The data concerning the use of NG tubes for supplementation yielded the specific theme of parental distress. In the absence of evidence that supplementation by NG tube on the postnatal ward is associated with greater breastfeeding success than other methods, its use to avoid any form of ‘oral confusion’ should be discontinued. Its use primarily to save time should not be considered acceptable.