Open Journal of Nursing, 2011, 1, 51-58 OJN
doi:10.4236/ojn.2011.13007 Published Online December 2011 (http://www.SciRP.org/journal/OJN/).
Published Online December 2011 in SciR es. http://www.scirp.org/journal/OJN
Mother’s need of support and their expectations of the BVC
nurse at the first home visit—an interview study
Margareta Wilss on1,2, Annsofie Adolfsson2,3
1Primary Health, Mariestad, Sweden;
2School of life Sciences, University of Skövde, Skövde, Sweden;
3Department of Obstetrics and Gynecology, Skaraborg Hospital, Skövde, Sweden.
Received 14 May 2011; revised 3 August 2011; accepted 28 November 2011.
ABSTRACT
One of the main priorities of the child healthcare
services in Sweden is a home visit by the Child Health
Care (BVC) nurse to newborn babies and their
parents. It is essential that the BVC nurses have a
comprehensive knowledge of the parent’s need of
support and their expectations as new parents in
order to be able to fulfill their needs. The aim of this
study was to describe what type of support the
mothers of infant children are in need of and what
their expectations are of the BVC nurse when it is
time for the home visit from the nurse. In this
qualitative study twelve women were interviewed
within one to two weeks after delivering a baby. The
transcripts were analyzed using qualitative content
analysis. The study shows that mothers who have
previously given birth to children feel more secure in
their parental role compared to what they expe-
rienced as first time mothers. The findings include
that first time mother’s experienced uncertainty in
their new role as a mother and caring for a baby.
Parents seek support from the BVC nurse and they
expect her behavior and attitude towards them to be
friendly and professional. The fact that she is privy to
personal knowledge of the family gives the parents a
feeling of security when they conta ct the child h ealth-
care center for various reasons. The mother’s need
for support to develop as a parent and to feel secure
in the parental role was a reoccurring theme in the
interviews and became the theme of the study.
Keywords: Mother’s; Support; Expectations; Child
Health Nurse; Home Visit
1. INTRODUCTION
Becoming a mother is one of the most important life
changing events that a woman will experience during
the course of her life. The new and sudden respon-
sibility that the woman experiences for the newborn
infants needs can feel very demanding and overwhelm-
ing. In the process of this change in life women find
new roles in being a mother and are forced to say
goodbye to their old lifestyles. Coming home from the
delivery ward with the newborn infant is an emotional
event and this is when the mother initially becomes
acquainted with the nurse from the child healthcare
center (BVC—barnavårdscentral in Swedish). The first
contact with the BVC nurse in the Swedish healthcare
system normally is in the form of a home visit by the
BVC nurse which is one of the highest priority tasks of
the agency. The motivation for this visit is to create a
good relationship between the new parents and the
agency, in order to provide the parents with the nece-
ssary support and information that they will need in
raising their child. Research has revealed that some of
the mothers are not entirely satisfied with the support
that they received from the BVC nurses [1]. One reason
is that the nurses were leading the conversation regard-
less as to whether the meeting was being conducted at
the BVC or at the home of the new parents [2]. An
important service that the BVC provides is to validate
the parents in their own ability as parents. To accomp-
lish this requires knowledge about what new parents
expect from the BVC nurse.
The goals of BVC have developed into minimizing
the mortality rate and the reducing of sickness and
handicaps among newborn infants and children. The
goals also include diminishing the parental stress that is
associated with the newborn child experience and they
include creating a supportive environment that is con-
ducive to raising children [3]. The goal of the BVC
should be to educate and enable families to learn to rely
upon their own resources [4]. The BVC has established
that all parents of newborn infants are offered a home
visit with a BVC nurse within a week after the child

M. W ilsson et al. / Open Journal of Nursing 1 (2011) 51-58 52
has been taken home from the hospital [4]. The results
of this home visit evidence that sixty percent of the
mothers and ninety-six percent of the nurses feel that
the first meeting with the BVC should take place in the
home of the family [5,6]. The nurses maintain that the
home visit is important because it helps to establish a
relationship between the BVC and the family and it
gives the BVC a reliable image of the families living
conditions and environment [7].
A woman becomes a mother when she gives birth to
her baby but finding her role as a mother is another
thing. Modern times have further complicated the pro-
cess of motherhood that was for ages handed down to
the woman from her mother and the generations of
mothers before her [8]. In modern times women may
find themselves more dependent upon the social ser-
vices and support provided by the BVC nurses. The
aim of this study was to describe what type of support
mothers of infant children are in need of during the
home visit from the BVC nurse and what their expec-
tations are of the BVC nurse.
2. METHOD
In this study twelve telephone interviews were ana-
lyzed using a qualitative content analysis approach
about the experiences and expectations of the home
visit with BVC nur ses by the moth ers of infan t chi ldren .
The approach of the method used was inductive and the
transcript interview data was analyzed with as little
bias as possible [9]. It was the arbitrary events and the
seemingly insignificant details from the transcripts of
the interviewee’s live world experiences that took on
the larger meaning in the data’s findings [10].
2.1. Participant Selection
The participants for this study were recruited with the
assistance of midwives from their patients who had re-
cently given birth. After the midwife was informed of
the study by the researcher, she approached and informed
the newborn mothers both orally and with written infor-
mation about participation in the study. The partici-
pants all came from the same general geographic area
and received their healthcare under the umbrella of the
same providers. Both men and women were invited to
participate as the parents in the study but none of the
men elected to participate. Both first time mothers and
mothers of multiple children were invited to participate.
When the family went home from the hospital with their
infant baby they were visited by the midwife and given
an information sheet about the study and they were pro-
vided with a consent form. If they signed the consent
form and they agreed to participate, their form was for-
warded to the resear cher who in turn contacted them and
made arrangements to conduct the telephone interview.
The exclusion criteria included those mothers and in-
fants who experienced complications and also those
candidates that did not speak Swedish. Twelve appli-
cants were accepted into the study and of these, three of
the women were first time mothers and nine of the
women had previously given birth. The accepted par-
ticipants ranged in age from 25 to 37 years and all of
them were living together with the father of the child.
2.2. Data Collection
The collection of data was accomplished through the
telephone interviews with the twelve mothers that were
selected as participants. When the interviewees were ap-
proved for the study they were contacted by telephone
an appointment was set for the interview. The interviews
themselves were taped from the telephone conversation
using the loudspeak er on the p hone. Before in itiating th e
interview, the interviewee was informed that her par-
ticipation was strictly voluntary and that she may at any
time discontinue her participation. The actual interview
consisted of two questions. The first question was, “Can
you describe what support you are in need of as the
mother of a newborn child?” The second question was,
“What expectations did you have of the BVC nurse
when she came to your home for the first visit?” The
interviewer asked follow up question s if she felt that the
answers needed to be developed further in order to give
a better explanation towards the aim of the study. The
interviews lasted an average of fifteen minutes and they
were listened to carefully and transcribed literally. After
ten interviews were completed and transcribed, an addi-
tional two interviews were done in order to assure that
there was no additional information required for the
study [11].
2.3. Data Analysis
The interviews were analyzed based on qualitative con-
tent analysis according to Graneheim and Lundman [9].
Each of the interviews came to represent one unit of the
analysis. Each unit was read through several times and
the answers to the two interview questions represented
the two resulting domains of the parent’s need of support
and the parent’s expectations of the BVC nurse. Meaning
bearing units were then identified and further condensed.
Through further abstraction from the condensed meaning
bearing units a higher level of logic is assigned to them
with the use of a code. From this process twelve sub-
categories evolved and were further organized into five
categories which were more comprehensive. The cate-
gories are developed in order to answer the questions
about what the women in the study are experiencing in
their new found role as a mother. Through a combination

M. W ilsson et al. / Open Journal of Nursing 1 (2011) 51-58 53
of the categories on an interpretive level the studies
theme is identified (Table 1) [9].
3. FINDINGS
The theme contains five categories and twelve subcate-
gories. The two domains and the subcategories are only
shown here in the chart of the results and not in text of
the study.
3.1. Confirmation as a Mother
All of the participants in the study spoke of their need
and of a desire for their confirmation as a parent. Some-
times the emotions and experiences associated with being
a newborn’s mother were so overwhelming that the
women expressed a need to talk to someone outside of
the family. It was i mportant for th e women to believ e th at
they were doing the right thing in their caring for their
infant children. Women who experienced difficulties
associated with the breast feeding of their baby were in
particular need of confirmation that they were an ade-
quate mother. Their confirmation included the knowledge
that their baby was feeling and developing equally as
well as those babies that were being nursed by their
mothers.
“I wanted someone to tell me that the baby felt abso-
lutely alright even though it was not being breastfed.”
(Interview 2)
“I need confirmation because I have never had a baby
before…and therefore it is difficult to know if I am doing
the right thing or the wrong thing.” (Interview 8)
All of the interviewed mothers, regardless of whether
they had children previously, wanted to receive confir-
mation that their baby was healthy, gaining weight and
that the baby’s behavior and development was normal.
When the baby was sick the mothers generally sought
out the BVC nurse for advice and support because they
felt it was advantageous to discuss the situation with
someone that had specific knowledge about their child
and the family.
“I needed to know that the baby’s development was on
schedule and it was comforting to know that the BVC
nurse was there to confirm it…the baby was growing
and eating as it should…it was important to know that
the baby looked normal…all of this was a bit over my
head since it was my first child.” (Interview 9)
These women also needed the support and confirma-
tion of their partners and in timate circle when they were
under pressure or felt excessive stress in their new role
as a mother.
3.2. Knowledge
The mothers of newborn infants seek knowledge in dif-
ferent ways. The nurses and midwives from the maternity
hospital and the BVC are important sources of infor-
mation, as are other people in the women’s intimate circle
of acquaintances. Books and periodicals are also impor-
tant sources of information for the newborn’s mothers.
Reading is one of the activities all of the women shared
in common in prepari n g f or their roles as a mother.
“I read everything…every magazine that exists that
has to do with being a newborn’s mother.” (Interview
12)
Table 1. Overview of the domains, the subcategories, the categories and the theme derived from the data analysis of twelve inter-
views with the mothers of newborn infants.
Domain Subcategory Category Theme
Finding their identity as mother
Competence as parents
Newborns’ development and health
Confirmation as a mother
Seeking knowledge
Newborns’ physical needs Knowledge
Feeling inadequate as a moth er
Stress with parenthood
Difficulties in breast f eeding
Vulnerability as a mother
Mother’s need of support
Feeling comfortable in the parent role Experience helps to create security
Treatment by nurses
Creating security
Mother’s e x pectations
of BVC nurses
Source of knowledge
Professional support
Developing as a mother and to feel
confident in the paren t role

M. W ilsson et al. / Open Journal of Nursing 1 (2011) 51-58 54
“I needed a tremendous amount of information about
becoming the mother of an infant…there are so many
questions.” (Interview 5)
The advice and knowledge that they sought was
primarily that of a practical nature. They were chiefly
concerned about things that affected the welfare and
health of their infant baby such as breast feeding, about
how much the child should be eating and bowel move-
ments, regarding how much the child should sleep, how
to bath the baby, the child’s navel, how to properly dress
the child under different weather conditions and even in
which position the baby should be laying when it was
sleeping.
“I could have her living at home with me. I wasn’t
even sure how my baby’s poop should look…it looked
watery and gold which looked strange to me…it cer-
tainly did not look like anything I was familiar with. I
didn’t know how much my baby should be peeing…
should I be compensating liquid for the amount that they
peed. I felt like there was a huge void of information
about the simplest things…it took a long time to develop
a routine where I was comfortable in knowing what to
expect in my baby’s habits and behavior. I needed a lot
of support.” (Interview 11)
Since there is so much information for the mothers of
newborn infants and this information does not always
agree, it is important for the mother to form her own
opinion.
“I usually listen and search around a bit…I try to use
a little common sense in order to form my own opinion
about different issues.” (Interview 5)
3.3. Vulnerability as a Mother
The results of the interviews revealed the magnitude of
what a life changing event it is to become a newborn’s
mother for the first time an d how much of an adjustment
it requires in the woman’s lifestyle. This new profound
change and adjustment to parenthood is an incredible
responsibility fo r the parents of the newborn infant. On a
day to day basis, newborn’s mothers find it difficult to
interpret and react to the signals that their child is
creating and some newborn’s mothers have a very diffi-
cult time with this. They found this to be psychologically
trying of them and as a result would questio n themselves
as a woman and their ability to be a mother. Motherhood
certainly gave the interviewees a lot to think about in
terms of new emotions, feelings and the resulting reac-
tions. One of the women felt afterwards that she was in
need of psychological support as a result of being a first
time mother.
“So then for the first time I felt I needed help with
breast feeding and everything else for that matter…to
have some support and someone to talk to would have
been nice. It wasn’t everything that I thought it would be
to be a mother…I felt that it was really tough…a tough
adjustment, to say the least. To go from not being a mo-
ther, to being a mother is a giant step...this really felt to
be emotionally trying and challenging, so I felt that I
was probably in need of psychological support.” (Inter-
view 2)
When a woman does not have an adequate supply of
milk in order to breast feed the infant, it can leave her
feeling inadequate as a mother. One of the interviewees
described her experience as suffering and this was com-
pounded when the demands and expectations of her sur-
roundings made it more complicated. She felt that the
ability to breast feed reflected on her competence as a
mother. Her confidence as a mother sank when she did
not have enough m i lk t o breast feed her baby.
“Some mothers seem to have as much milk as the baby
could possibly need or want while I felt nothing in my
breasts…that’s not easy to deal with. But if I cannot do
what I am supposed to do right from the beginning…no t
being able to give my baby my milk…this gave me a bad
conscience right from the start. I felt that I was a terrible
mother becaus e I coul d n ot feed my ba by. ” (Interview 6)
The women’s preparation to be a mother before par-
enthood involved building up certain expectations and
sometimes these expectations did not correspond with
the reality of the situation they met when the child was
born. In their pursuit of knowledge about the impending
parenthood, women often read of the attachment be-
tween mother and child that was associated with the act
of breast feeding. This knowledge could be a source of
worry for those women that encountered difficulties
when they tried to breast feed their baby and it did not
work as it should. They were concerned that the baby
would experience complications as a result of the inabil-
ity to breast feed. These women sought advice and
knowledge about h ow to conn ect wi th the ir b ab y w itho ut
breast feeding.
“In becoming a mother everything should go accord-
ing to the manual but it doesn’t…everything should go
as it says it will in a ll of the motherhood literatu re but it
doesn’t always end up like that. All that I read talked
about how breast feeding creates such a bond between
the baby and the mother…breast feeding protects the
baby from this and that…and how it does this and
that…breast feeding seems to be so important for the
baby. It was really tough when it did not go so well and
everything that I read said that so much was riding on
successful breast feeding. It was really psychologically
devastating to me when it did not work that way.” (In-
terview 2)
Lack of experience and knowledge made the mothers
feel vulnerable and created a sense of insecurity within

M. W ilsson et al. / Open Journal of Nursing 1 (2011) 51-58 55
them. One mother described it as a panicky feeling. The
concerns were primarily that the infant would not get
enough to eat and concerns that the infant would meet
with a sudden death. Not all of the interviewees felt the
need to tell the BVC nurses their deeper, inner feelings
that they were experiencing as a mother. One woman
wondered if this was something the BVC nurses co u ld or
would understand about her.
“Lacking in confid ence in my a bility to be a mother…i t
was sad, but I was managing and thinking about things.
But this isn’t anything that I cared to talk about with the
nurses because I wasn’t so sure that they would under-
stand me.” (Interview 6)
Several of the mothers expressed their feelings as
sorrowful when the breast feeding did not work for them.
Mothers carry this sorrow with them for a long time
wondering if thing s may have b een better or different for
the baby if the breast feeding had been successful.
“If the breast feeding had worked from the begin-
ning…maybe there would have been better bonding be-
tween the baby and me in another way. Everything in the
back of my h ead blamed my la ck of ability to b reast feed
and it isn’t written anywhere that an infant that does not
breast feed can still form this attachment with the
mother and have a good life.” (Interview 2)
3.4. Experience Helps to Create Security
Several of the women spoke of their insecurity regarding
the period of time that they spent getting to know their
baby and how to interpret the signals that the baby was
giving them. They were saying that it took time to get
used to the new routines revolving around their new in-
fant child and to feel secure in the new roll of being a
parent.
“My baby was born in September and it was probably
sometime after Christmas, in January, when I actually
began to feel somewhat comfortable with things…I felt
more grounded with the mother role and began to get
used to our routines and to feel a bit more in control of
our lives again.” (Interview 11)
Women that had other children previously, experienced
less need of support than first time mothers. The already
possessed the knowledge and experience needed to plan
ahead and foresee eventual problems and the complica-
tions that go with infant children. The more experienced
mothers felt more security in their role as mothers and
about how their b odi es fu nct i oned .
“Looking back I think that I made many small mis-
takes with my first born and I learned from them…per-
haps I should do things differently or perhaps I learned
about what it is the baby needs. This time I feel more
secure in myself and how my body functions as a mo-
ther.” (Interview 11)
Mothers that have previously born children learn how
to be secure and they can risk standing on their own
opinions and insight. They can clearly picture and deter-
mine how it is that they want it to be with the new baby.
With more experience, these mothers were not as vul-
nerable or influenced by their immediate environment.
These more experienced mothers were not as susceptible
to the stress and pressure that the first birth mothers were.
“This time when I was certain that if the breast feed-
ing was not working there wasn’t any reason to pursue
it…I did not feel any pressure this time…I already de-
cided that if it doesn’t work, I am not go ing to fight with
it…I will just use the bottle and this was a simple solu-
tion to all of it.” (Interview 2)
3.5. Professional Support
The results of the interviews show that these mothers
who were interviewed, expected to be provided with
competent and professional nurses. The newborn’s mo-
thers had a large need to be treated with respect and
understanding. To be seen as a parent by the nurses and
to have the child seen by the nurses was very important
for the mothers when they visited the BVC nurses. One
mother proposed th at the BVC nurses shou ld do an inter-
view with each mother in order to get an impression
about how the mother felt abou t br east f eed ing th eir b ab y.
One f inding f rom the study was that the women felt that
the BVC nurse should have an ample amount of time for
each of their appointments and the nurse must exhibit a
high degree of competence.
The women need clarity and honesty about their role
as mothers from the nurses. It was important for the
mothers that were not breast feeding their babies to not
feel pressure from the BVC nurses and to be treated with
respect and understanding. Some mothers felt that the
nurses should not be so fixated on the fixed concept of
the baby’s rate of growth. Women who had children pre-
viously generally felt more confid ence in th e BVC nurses
compared with the first time they gave birth. The more
personal contact that they had with the nurse the better
they felt about their relationship. If the nurse had been
present for her earlier children it was a big help to pro-
mote a healthy relatio nship between the mother and nurse.
The importance of a healthy and trusting relationship is
more critical for all of the parties concerned when the
child becomes sick or in case of an accident and other
unforeseen circumstances.
“The difference that I noticed with th e BVC nurses af-
ter I had my second and third babies was that they
seemed to of developed more trust in my judgment and
ability.” (Interview 12)
“Not everybody has the same life situation and possi-
bilities…such things are a big variable from family to

M. W ilsson et al. / Open Journal of Nursing 1 (2011) 51-58 56
family…so maybe it’s not such a bad idea to have an
interview…a discussion with one another so that they
can get an idea about my feelings about breast feeding
and other things for example…this is a good starting
point for them to advise us about child raising and infant
care.” (Interview 7)
Most of the women were able to secure a satisfactory
and secure relationship with their representative of the
BVC nurses. The nurse was someone that the mothers
felt they could call upon to get trustworthy advice from
and to discuss different situations with regard to the
baby’s health and wellbeing. Generally, she was a source
of information that could give guidelines and to help
determine if there were other options for the mothers in
different situations that the mothers were not so secure in
making their own decision. It was a comfort to the
mothers to know that they could turn to the BVC nurse
for reliable help and to know that the nurses were easy to
get in contact with. The stru cture that the relationship the
BVC nurse developed with the mothers helped them to
feel secure in knowing that the nurse was monitoring the
vaccination records for example, and monitoring other
required scheduled visits as well. It is a great comfort to
the mothers to know that they can rely upon the midwife
for support in their first days at home and that they can
call her at any time.
“It was a big source of comfort for me to know that I
was going to get help on a regular basis with regular
checking and monitoring…if something was going to be
wrong someone would be there to help me…I really
needed that. Having the midwife and the BVC nurse visit
me in the home was really comforting…it was all that I
could have hoped for.” (Interview 5)
The mothers of newborn infants expect that the nurses
from the BVC have a lot of knowledge and understand-
ing about all of the details that surround the delicate pe-
riod of raising an infant. They expect her to have the
resources to provide them with answers if she cannot
initially come up with an an sw er h erself. When the nurse
is dispensing advice or knowledge to the mothers and
parents, it should be on the basis of their individual
needs and the needs of their family. Some mothers ex-
pressed some dissatisfaction that they had not been given
some concrete advice from the BVC nurse. If the nurse
cannot give solid advice to their questions, some mo-
thers tend to question their competence in future situa-
tions.
4. DISCUSSION
Qualitative telephone interviews were selected as the
medium to describe the experiences of parents in their
live world situations. Only the women’s interviews in
this study were used to collect the information and data
because of the manner in which the participants were
selected. Because of this omission in the selection pro-
cess the masculine or father’s point of view is missing
from the study.
The mothers of more than one child that participated
in the study compared th eir experiences with the birth of
their later babies with the birth of their first one. Some-
times their answers about their expectations of the BVC
nurse’s first home visit seemed to be mixed and influ-
enced with their previous experiences with their other
babies.
The study shows that women need h elp and support in
their development as mothers in order to feel more se-
cure in their roles as a parent [12]. This was revealed in
their expectations of the BVC nurse’s first home visit
which was usually done when the infant was between
one and two weeks old. The expectations of the first
time mother differed from the expectations of the moth-
ers of more than one child. All of the mothers expected
to get confirmation of their baby’s health and develop-
ment during this first time visit in the ho me by the BVC
nurse. First time mothers tended to need more confirma-
tion that they were taking proper care of their infant
which is con- firmed by Mercer’s “Becoming a Mother
Theory” [8].
The mothers of newborn infants are constantly seek-
ing out information regarding their role as a mother. The
interviewees revealed that they sought this information
by questioning their friends, relatives and healthcare
personnel. Books, magazines and other periodicals were
also cited as sources of information. Interestingly enough,
no mention of the internet was cited by these interview-
ees as being a source of information [12].
All of the mothers were not aware of the use of milk
substitute instead o f breast feeding. Some o f the mothers
were not aware that if they had insufficient milk to feed
their baby that they could supplement the breast milk
with the milk substitute. According to the Ministry of
Health in Sweden, there are regulations and guidelines
for the BVC nurse to follow in order to inform the
mothers about breast feeding [13]. These guidelines give
the nurse accurate and suitable information for each in-
dividual situation to those that are responsible for feed-
ing the baby, including the mother and the father or oth-
ers. When the mothers were unable or not interested in
breast feeding their baby they were referred to the nurs-
ing staff or some other close party of the mother’s, re-
garding the source of the milk substitute and where to
obtain it because the marketing of milk substitute is
regulated by the International Code of Marketing of
Breast Milk substitutes. Advertising of the milk substi-
tute cannot be aimed at expectant or new parents [14].
Barclay, et al., [15], has studied the transformation

M. W ilsson et al. / Open Journal of Nursing 1 (2011) 51-58 57
that expectant mothers go through in their newfound role
as a mother and found that feelings of insecurity, stress
and grief are common during the early period as a new
mother. With time, mothers in their new maternal role
had a more positive and constructive attitude towards
motherhood and the routines associated with the role,
which enabled them to feel more in harmony with their
children. The transition into motherhood is a gradual
change in some respects as sometimes the mothers longed
for the time in the past before they were mothers, when
they were free to move about in their lives without being
burdened with a child. There were feelings of guilt that
were associated with these longings.
The mothers in our study expressed feelings of sad-
ness about their inability to breast feed their child and
interestingly, at times, the level of their grief approached
the level that women experience after suffering a mis-
carriage. Adolfsson [16] describes in her thesis about
women’s experience of miscarriage that the sadness
these women felt was about losing the fetus that was
supposed to grow into the child that they had dreamed
and fantasized about. The inability to enjoy the experi-
ence of breast feeding the baby had a similar effect on
the women’s feelings and emotional state as with the
loss of the fetus and her potential child. Women who
were unable to breast feed their babies also had a similar
need of support from healthcare personnel and their in-
timate circle of friends and family as did the women in
Adolfsson’s study of women’s experience of miscarriage.
The level of disappointment and discouragement that the
women experienced when they were incapable of breast
feeding further demonstrates the necessity of accurate
and individually tailored information with respect to
each woman’s needs and desires. Many women associate
being able to breast feed with being a good and compe-
tent mother and when th ey are unable to do so they often
feel a sense of inadequacy [16].
The interviewees in this study felt pressure to breast
feed. This pressure may have been a result of the moth-
ers reading about the benefits of breast feeding, or their
perceived expectations from the healthcare system or
from their friends and family. This perceived pressure on
the part of the mothers can make it difficult for the BVC
nurses to balance their care and treatment for the moth-
ers, while trying to promote breast feeding and still re-
maining sensitive to the woman in order that she does
not feel further challenged or possibly insulted. Kylberg
et al. [13] emphasizes that it is important that the staff
avoids all moralizing about breastfeeding.
Other sources include the United Nations article 24 of
1989, regarding the Convention on Children’s Rights
and the Innocenti Declaration (1990, 2005), [17]. These
documents provide the BVC nurses with the guidelines
that they should assume in their role as support to the
mothers of newborn infants regardless of whether they
are breast feeding their child or using milk substitute.
Breast feeding and the difficulties that are associated
with it are exhibited in all of the categories that comprise
the domain of this study which is that mothers are in
need of support. This confirms that this is a significant
problem and has a number of different aspects as it re-
lates to the mother and the child. All first time mothers
were in need of some assistance when it came to the
practical health and hygiene aspects of raising a child.
Some of these concerns include how much clothing the
child should wear for different weather conditions, how
often the child should be bathed and how to properly
bath it, and how much and how often the child should
eat. This is confirmed by Mercer in her “Becoming a
Mother Theory in Nursing Practice” [8]. In her theory,
she relates how first time mothers are constantly seeking
information to help them shape their experience and cre-
ate their identity as a mother. Mercer contends that it
may take up to four months for a woman to find herself
comfortable in her new role as a mother.
The mothers related in their interviews th at they had a
need to be seen and confirmed by the BVC nurses in
their new circumstances and their new role as a mother.
The mothers of more than one child related that they
needed more support from the BVC nurses with the birth
of their first child, but they did not necessarily feel they
got what they needed from them. According Fägerskiöld,
et al., [18] the most important aspect of the meeting be-
tween the BVC nurse and the new mother is that the
nurse is prepared to be op en an d willing to share the n ew
feelings and the experience that goes with being a
mother. The study by Fägerskiöld revealed further that
most of the mothers were content with the support they
got from the BVC nurses, but even so there were still
mothers who were not completely satisfied with their
treatment and felt that they were poorly treated. Accord-
ing to Fägerskiöld et al., this discrepancy may be ex-
plained by the fact that the mothers and the BVC nurses
come from different backgrounds and have had different
experiences from each other, which may account for
some of difficulties that they have in und erstanding each
other.
5. CONCLUSIONS
The mothers in the study expected the BVC nurses to be
friendly, pleasant and that they should be informative
and competent with regard to the questions the mothers
had about their role of being a mother. The mothers ex-
pected the nurses to be resourceful if they could not pro-
vide an immediate answer to their questions. Because
the BVC nurse is required to strengthen the confidence

M. W ilsson et al. / Open Journal of Nursing 1 (2011) 51-58 58
of new parents in themselves and in their roles as parents,
the nurses need to know and understand just what it is
that the parents hav e for wishes for their child, and abou t
their capacity to be a parent and what their prior experi-
ences are.
The deficiencies that the interviewees related in their
interviews centered on the issue of breast feeding. The
women who were not able to breast feed their children
were found to be in need of extra support from the BVC
nurses. The BVC nurses need to be fully and compre-
hensively trained to disperse the pertin ent and necessary
information about milk substitutes and their training
should also enable them to relate to and provide support
to those mothers that have feelings of inadequacy as a
consequence o f not b ei n g a ble to breast feed their infant.
The findings that emerged from this study are consis-
tent with previous research and th is study was limited to
the period between one to two weeks after the birth of
the baby. The results of these interviews could be used to
help support BVC nurs es in their caring for women who
are new in their roles as a mother. This information
could also be applicable in other areas where people are
in need of support due to a significant or drastic change
in life style or to those that have experienced a life
changing event that alters their basic perception of
themselves.
One additional point needs to be made in the conclu-
sion of these results. If there has been one thing that has
been omitted from this study that could further clarify
some of the questions surrounding the mothers of new-
born babies need for support it would be the father’s
point of view. Perhaps it would be appropriate to inter-
view the fathers of these children for further perspective
and understanding.
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