"At the End of the Day, My Goal is to Help People Feed Their Babies Human Milk": A Qualitative Exploration of the Pumping Attitudes of Lactation Care Providers

Background: Parents who express milk by pumping often feel this is judged as inferior to direct breastfeeding by healthcare providers, leaving parents feeling unsupported. Healthcare provider attitudes can influence decisions about human milk feeding directly at the chest. Yet, there is a gap in knowledge regarding lactation care provider attitudes about pumping. Research Aim: To explore the attitudes and feelings of lactation care providers about pumping. Method: A qualitative descriptive design was utilized. Researchers conducted semi-structured interviews with a convenience sample of 15 lactation care providers in the United States, recruited via social media. Data were analyzed using thematic analysis. Results: Four themes emerged: (1) I Support You, (2) But It's Not the Same, (3) Frustration with Social Media, and (4) Changing Perspectives. Participants held positive attitudes toward pumping as a tool to meet human milk feeding goals. They strived to provide judgement-free support but stressed the importance of setting realistic expectations and sharing the difference in benefits and work between direct breastfeeding and pumping. Providers held negative attitudes about the portrayal of pumping on social media. The participants' perspectives were that, while there has been stigma surrounding pumping in the past, views are changing. Conclusion: Lactation care providers strive to provide judgement-free support for pumping, but communicating challenges about pumping may be perceived negatively by parents. More research is needed on lactation care provider education on pumping, interventions to reduce bias, and how these affect providers' pumping beliefs, attitudes, and provision of judgement-free delivery of care.