Cynthia asks if anyone knows of research looking at the relationship
between limiting visitors to mothers in hospital, and breastfeeding
outcomes.
I have never heard of anyone trying to examine this particular aspect
(have quite recently spent many hours with PubMed searching for
studies about breastfeeding duration), and I can't see how they could
do it either.  To do a controlled trial about the effects of visitors,
hey would have to keep all things equal except for the visits to
mothers while in hospital, and just recruiting would be a nightmare.
Any observational stuides would be loaded with confounders to the
point that most researchers would probably decide against attempting
to do them.

Institutions are so very different in how they treat mothers.
Traditions for what the role of visitors is, vary enormously from
place to place and from family to family. I can think of any number of
variables affecting how visiting might affect breastfeeding outcomes,
which would all have to be controlled for, if you did manage to get a
few thousand women signed up to participate in the study... Who the
visitors are and how the mother feels about breastfeeding while they
are present - not to mention whether she can receive them in a private
place wtihout getting out of bed or putting on clothing, or must meet
them in some common room,  and whether mother and baby are allowed to
be together while visitors are there or not... all such things would
need to be controlled for, and that is just the first few things that
come to my mind. You get the picture, right?

The studies that have been done to try to illuminate what
characterizes places where breastfeeding outcomes are very good, or
very bad, are what led to the renowned 'ten steps for successful
breastfeeding', the steps that form the core of WHO/Unicef-defined
'Baby Friendly' care.

In a culture where women feel uncomfortable breastfeeding in their own
homes if another woman is present, hospital visitors are unlikely to
improve outcomes. In cultures where the woman's support network is
expected to be there and cheer her on, bring her food, admire her
baby, and share wisdom and experience, limiting visitors would
probably make outcomes worse. Women from both kinds of cultures might
be sharing a room in the hospital, at least in my hospital.  It would
be like comparing apples to a five course meal to try to make sense of
it!

Rachel Myr
Kristiansand, Norway

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