Responsive, Cue-Based Breastfeeding: Exploring Public Health Nurses' Perceptions

Supporting responsive, cue-based breastfeeding (RCBBF) (i.e., baby-led) is considered best practice for promoting maternal-infant attachment and reducing an infants’ obesity risk. RCBBF recognizes the reciprocal relationship between the maternal-infant dyad. Public health nurses (PHNs) are exposed to mixed messaging and we do not know how they enact RCBBF in practice. This study used interpretive description to explore PHNs’ perceptions of RCBBF. Semi-structured interviews were conducted online. One overarching theme, bound by trust, and three sub-themes were identified: disrupted trust (informational disruption and maternal mistrust), building trust (education and responsiveness to maternal needs), and maintaining trust (varying degrees of trust). Participants’ perceptions of RCBBF were filtered through a lens of trust that could be limited or enhanced. When disrupted, trust was limited, when built, it was enhanced, and when threatened, it was maintained. These findings are significant in beginning to understand the clinical application of RCBBF, but more research is needed.