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      ‘I thought it would keep them all quiet’. Women's experiences of breastfeeding as illusions of compliance: an interpretive phenomenological study

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          Abstract

          Aims

          To explore the experiences of breastfeeding women.

          Background

          There is a plethora of data demonstrating that human breast milk provides complete nutrition for human infants. While the rate of initiation of breastfeeding in the United Kingdom has shown a steady increase in the last 25 years, rates of exclusive breastfeeding in the early weeks and months over the same time period have shown only marginal increases. This study was designed to extend current knowledge around breastfeeding experiences, decisions and behaviours.

          Design

          Qualitative, interpretive phenomenological approach.

          Methods

          Data were collected between July 2009–January 2010 through in-depth interviews with 22 women from a city in the East Midlands where the prevalence of breastfeeding has showed a decreasing trend. Data were collected between 3–6 months after the birth of their youngest baby.

          Findings

          Analysis of data uncovered a key theme: illusions of compliance. The findings revealed that women's breastfeeding behaviours were socially mediated. They adopted a good mother image by conforming to the moral obligation to breastfeed immediately after their babies were born. Those women who struggled to establish breastfeeding tried to hide their difficulties rather than admit that they were not coping.

          Conclusion

          This study provides insights into women's infant feeding decisions and behaviours, building on understandings of ‘good mothering’ in the wider literature. Importantly we highlight some of the previously unknown strategies that women employed to portray themselves as calm, coping and in control when in reality they were struggling and not enjoying breastfeeding.

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          Most cited references44

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          Predictors of breastfeeding duration: evidence from a cohort study.

          To report the duration of breastfeeding among a population of Australian women and to identify factors that are associated with the duration of full breastfeeding to 6 months and any breastfeeding to 12 months. Participants were 587 women who were recruited from 2 maternity hospitals in Perth and completed a baseline questionnaire just before or shortly after discharge from the hospital. Women were followed up by telephone interview at 4, 10, 16, 22, 32, 40, and 52 weeks postpartum. Data collected included sociodemographic, biomedical, hospital-related, and psychosocial factors associated with the initiation and the duration of breastfeeding. Cox's proportional hazards model was used to identify factors that were associated with the risk for discontinuing full breastfeeding before 6 months and any breastfeeding before 12 months. At 6 months of age, fewer than one half of infants were receiving any breast milk (45.9%), and only 12% were being fully breastfed. By 12 months, only 19.2% of infants were still receiving any breast milk. Breastfeeding duration was independently, positively associated with maternal infant feeding attitudes and negatively associated with breastfeeding difficulties in the first 4 weeks, maternal smoking, introduction of a pacifier, and early return to work. Relatively few women achieved the international recommendations for duration of full and overall breastfeeding. Women should receive anticipatory guidance while still in the hospital on how to prevent or manage common breastfeeding difficulties and should be discouraged from introducing a pacifier before 10 weeks, if at all. Improved maternity leave provisions and more flexible working conditions may help women to remain at home with their infants longer and/or to combine successfully breastfeeding with employment outside the home.
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            Researching lived experience : Human science for an action sensitive pedagogy

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              Breast feeding.

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                Author and article information

                Contributors
                Role: Assistant Professor in Midwifery
                Role: Assistant Professor
                Role: Emeritus Professor of Midwifery
                Journal
                J Adv Nurs
                J Adv Nurs
                jan
                Journal of Advanced Nursing
                Blackwell Publishing Ltd (Oxford, UK )
                0309-2402
                1365-2648
                May 2015
                08 December 2014
                : 71
                : 5
                : 1076-1086
                Affiliations
                Division of Midwifery, School of Health Sciences, The University of Nottingham UK
                Faculty of Medicine, School of Health Sciences, Queen's Medical Centre, Nottingham University UK
                Division of Midwifery, School of Health Sciences, Faculty of Medicine, University of Nottingham, Queen's Medical Centre UK
                Author notes
                Correspondence to R.L. Spencer: e-mail: rachael.spencer@ 123456nottingham.ac.uk
                Article
                10.1111/jan.12592
                4406391
                25482589
                3d6e5073-1e81-48a2-832c-a882913eb920
                © 2014 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

                History
                : 03 November 2014
                Categories
                Research Papers
                Original Research: Empirical Research – Qualitative

                Nursing
                breastfeeding,experiences,infant feeding,interviews,midwives/healthcare professionals,qualitative approaches

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