The thesis deals with the use of Omaha system in lactation counselling. At present time the care of newborns realized through general practitioners is minimal. Therefore, the connection of community nursing related to shorter time of hospitalization of both mother and her newborn child is vital. Lactation counselling is closely connected to the obligatory documentation of provided care. Omaha system is considered as a suitable standardized terminology for community nursing. The thesis dealt with the analysis of Omaha system, lactation counselling, the issue of breastfeeding as a whole and the legislation related to nursing documentation in the theoretical part. The main aim of the research is the implementation of Omaha system in lactation counselling. Three main goals were set in the thesis. The first one was to map the differences between the care provided by lactation counsellors with and without medical qualification. The second goal was to describe the way of administration of breastfeeding mothers by the counsellors. The third goal was to elaborate and evaluate the documentation according to Omaha system in the field of lactation counselling provided by counselors with a qualification. To achieve the goals of this thesis quantitative-qualitative method of data collection was used. The method of questioning through a non-standardized questionnaire was selected for quantitative research. The qualitative part of the research was based on the use of semi-structured in-depth interview method. The third part of the research is represented by the content analysis of Omaha system. The qualitative part of the research was processed with open coding method. The research question was answered through the analysis of the interviews. The respondents in this research are represented by lactation counselors. The first research file is represented by counselors both with and without qualification. The second research file includes counselors with medical qualification only. The questionnaire research was realized through an electronic questionnaire. The interviews were conducted with six lactation counselors with a medical qualification. The questionnaire research shows differences in the counselling provided by the counselors with and without a qualification which supports H1. The official documentation for counselling is used by a few respondents and mainly by the ones with a qualification. The good thing is that most counselors record data about mothers and breastfeeding. Next, it seems that the unofficial documentation of counselors includes problems and solutions description. The results show that H2 has not been supported. However, it is good that almost half of the respondents are interested in using a standardized documentation for counselling. Next, the counselors with a qualification do not use standardized taxonomy of nursing problems. The results show that only two counselors with a qualification have a contract with an insurance company. Most of them do not cooperate with a podiatrist or gynecologist. The most troubling issues for them are lack of time and missing contracts with an insurance company. Most of them think that longer hospitalization of mothers does not have a better effect on the quality of breastfeeding. Moreover, the interviews with the counselors with a medical qualification show that the newly created documentation of Omaha system has been processed thoroughly and clearly. They consider it more time demanding, which could be a problem because of the lack of time caused by the financial situation of mothers or because of insurance companies. The output of tis thesis is a newly created documentation for lactation counselors and lactation centers based on Omaha system which allows a more effective way of providing lactation counselling.

Bakgrund: Amning har många hälso-, ekonomiska och ekologiska fördelar för barn, föräldrar och samhället, men amningsstatistiken sjunker och beror ofta på otillräckligt amningsstöd. Syfte: att undersöka BVC-sjuksköterskors möjligheter och hinder för amningsrådgivning. Metod: Denna studie genomfördes med Critical Incident som metod. Sex bvc-sjuksköterskor i Sverige intervjuades om sina erfarenheter av att ge amningsrådgivning. Resultat: Resultatet delades in i två huvudincidenter utifrån syftet -Möjligheter och Hinder, med flera beteenden som kunde påverka incidenterna. Under Möjligheter kunde ses lyhördhet för kvinnans behov, att kunna ge enklare rådgivning och att ha tid för detta samt att kunna söka stöd hos andra. Beteenden som var hindrande för amningsrådgivning var bristande lyhördhet för kvinnans behov, att inte ha tillräckligt med djupare kunskaper eller tid, att inte samverka eller ha föräldraförberedande kurser. Konklusion: För att skapa möjligheter för individanpassad amningsrådgivning läggs stor vikt vid sjuksköterskans lyhördhet för kvinnan och barnets behov, förståelse för de förväntningar kvinnan har på amningen och att ha goda kunskaper samt tid. Hindrande för amningsrådgivningen är bristande lyhördhet för kvinnans behov, svårigheter att ge evidensbaserad information samt dåligt med tid. Samverkan mellan verksamheterna och att inte följa riktlinjer är en förbättringspotential för att stärka amningsrådgivningen. / Background: Breastfeeding has many health-, economical and ecological benefits for child, parents and society, but statistics of breastfeeding are declining and are often due to insufficient breastfeeding support. Aim of the study: to examine child health care nurses’ possibilities and hindrance for breastfeeding counselling. Method: This study was conducted using Critical Incident as a method. Six child healthcare nurses in Sweden were interviewed about their experiences of providing breastfeeding advice. Results: The result was divided into two main incidents based on the aim, - possibilities and hindrance, with several behaviours that could affect the incidents. Under Possiblities a sensitivity for the woman’s needs, to be able to give simple breastfeeding advice, having time to give it and look for support when needed was seen. Behaviours that was a hindrance for breastfeeding counselling was a lack of sensitivity for the woman’s and child’s needs, to not have deeper knowledge or time, to not cooperate with others or not provide preparatory courses for parents. Conclusion: To create possibilities for individual breastfeeding counselling a sensitivity for the woman’s and child’s needs is essential, to have an understanding of the expectations the woman has and to have enough knowledge and time. Hindrance for breastfeeding counselling is a lack of sensitivity for the woman’s needs, difficulties to give evidence based information and not enough time. Cooperation between the different facilities and to follow the recommendations are potentials for improvement to strengthen the breastfeeding counselling.