Is being resolute better than being pragmatic when it comes to breastfeeding? Longitudinal qualitative study investigating experiences of women intending to breastfeed using the Theoretical Domains Framework

J Public Health (Oxf). 2017 Sep 1;39(3):e88-e94. doi: 10.1093/pubmed/fdw073.

Abstract

Background: In the UK, initiating then discontinuing breastfeeding before two weeks post-partum is common. The aim of this longitudinal qualitative study was to explore which psychosocial factors may influence discontinuation.

Methods: A sample of 10 pregnant women intending to breastfeed were recruited. A longitudinal qualitative design was used to capture views prior to and two weeks following birth. Semi-structured interviews were conducted underpinned by the Theoretical Domains Framework to explore a comprehensive list of psychosocial factors.

Results: Four women discontinued breastfeeding at the time of the second interview. Pre-partum differences were identified between maintainers and discontinuers; discontinuers appeared to have stronger intentions to breastfeed based on their self-determination, self-confidence and perception of fewer barriers to breastfeeding. Post-partum, discontinuers highlighted how they felt physically unable to carry on; their feeding experiences elicited negative emotions and pain. Negative emotions appeared to be exacerbated by original breastfeeding beliefs and advice given by healthcare professionals.

Conclusions: The women in this study who discontinued breastfeeding showed less cognitive flexibility, which appeared to exacerbate post-partum emotional distress, when they encountered difficulties. Women with strong intentions and self-determination might benefit from support in anticipating potential barriers and identifying ways of overcoming them.

Keywords: Theoretical Domains Framework; breastfeeding; interviews; longitudinal; pregnant women; qualitative.

MeSH terms

  • Adult
  • Breast Feeding / psychology*
  • Breast Feeding / statistics & numerical data
  • Female
  • Humans
  • Intention*
  • Interviews as Topic
  • Longitudinal Studies
  • Personal Autonomy
  • Psychology
  • Qualitative Research
  • Self Concept
  • Young Adult