Rahim, Norsyamlina Che Abdul
(2021)
Development of a practice model for induced lactation in Malaysia.
PhD thesis, Universiti Sains Malaysia.
Abstract
Induced lactation is a method of stimulating breast milk production in women
who have not undergone pregnancy. In Malaysia, its awareness has progressively
increased with the practice of adoption. Therefore, this study aimed to explore the
experience of practitioners, women experiencing and undergoing induced lactation
and their support persons, and Malaysia's practice model of induced lactation. Data
collection took place in five states based on regions in Malaysia [South (Johor),
Central (Selangor), North (Penang), East (Kelantan), and East Malaysia (Sabah)]
from December 2015 to June 2017. Three approaches were used for this multiple
case study, include semi-structured interviews, structured surveys, and document
review. The results were presented and described according to the respondents’
characteristics. Data saturation was achieved after interviewing a total of 69
respondents [practitioners (n=23); women (n=23); and support persons (n=23)]. The
interviews were consented to, audio-recorded, and transcribed verbatim, followed by
identification of emerging themes. The verbatim transcripts were managed using
ATLAS.ti 8.0 software. Meanwhile, data from the questionnaires were stored in
Microsoft Excel. A descriptive analysis was initially utilized. Three themes raised
from practitioners were (i) description of practice; (ii) care plans for clients; and (iii)
quality and effective continuity of care for the women, which correlate to a
successfully induced lactation. Data analysis also revealed three themes related to women’s decision to induce lactation included (i) main motivation factors for
undergoing the induced lactation process; (ii) the key challenges for women during
the process of induced lactation; and (iii) the factors affecting successful adoptive
breastfeeding. The support person’s perception of induced lactation indicates two
themes (i) a positive attitude towards the induced lactation process; and (ii)
accepting, learning, and implementing the support role. The online survey distributed
for support persons (n=23) showed that the main factors that motivated them was “to
achieve mahram status (five times feeding)”. This result was congruent with the
thematic analysis. The researcher gathered a record of induced lactation programs in
hospitals, case notes, instructional material, breastfeeding modules and related
government circulars. Based on study findings and literature searches, a Practice
Model of Induced Lactation was recommended to predict the outcome of induced
lactation practice in Malaysia. Three basic foundations make up this model are
Government Policy, Human Capital, and Equipment. These three foundations are
necessary foundations that are believed to be related to each other and influence the
induced lactation practice among practitioners, women, and support persons either
from a positive or negative perspective. This practice model plays an important role
in ensuring the safe and effective implementation of the induced lactation protocol in
order to increase the rate of breastfeeding success rate in Malaysia.
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