Hi Lara,
I knew someone would pick up on this!  I used "compliance" in the subject line as this term appears in the literature, along with discussions fo whether "adherence" or other terms are more appropriate.  So it helps when a literature search is done, including the lactnet archives. In addition, the period I researched had an advice environment where the advice was prescriptive, the setting hierarchical, the givers of advice were repeatedly described by interviewees as "authoritarian", and mothers were expected to obey. (That's why they were reluctant to admit not following specific advice.)
I mentioned this research by way of suggesting further research, in today's more interactive approach to providing advice, with different souces of breastfeeding support and advice such as IBCLCs and LLL. Of course, mothers don't live in a vacuum and are exposed to more than one source of information. So studies need to include this factor in their design.
Regards,
Virginia

Dr Virginia Thorley, OAM, PhD, IBCLC, FILCA
Private Practice Lactation Consultant & Historian
Brisbane, Queensland, Australia

Date:    Tue, 23 Apr 2013 13:59:57 +0800
From:    Lara <>
Subject: Re: How much do mothers heed our advice? Compliance issues

vgthorley <[log in to unmask]> wrote:

> My research examined mothers' experience of infant-feeding advice during a
> period when advice was very prescriptive and, because mothers were
> reluctant to admit to disagreeing, the health services and politicians
> believed (incorrectly) that attendance equated with compliance. - Thorley
> V. Accounts of infant-feeding advice received by mothers: Queensland,
> Australia, 1945-1965. Nursing Reports 2012; 2(2). Available at
> http//www.pagepressjournals.org/index.php/nursing/view/262
> 
> If anyone is looking for a research topic, perhaps you might consider
> examining these issues in other settings. It would be interesting, for
> instance, to see studies on lactation consultant (IBCLC) services, or on
> counselling by mother-support groups such as LLL and ABA, or peer
> counsellors. Studies such as these would give points of reference for
> comparing and improving how we work with mothers and their babies.


Aside: I think it is useful to move on from talking about "compliance",
and toward talking about "adherence". "Compliance" entails hierarchy,
and orders given from a superior to an inferior. "Adherence" is about
sticking to a plan, and doesn't imply any authoritative commands. 

This little change can inflect the conversation quite differently: it
stops being about obedience, and starts being about a whole lot of other
things, like collaboration and autonomy and persistence. I think it's
also all tied up with the difference between healthcare provider
centrism and client centrism.

Lara Hopkins

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