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

Citation

Jardine EE, McLellan J & Dombrowski SU (2017) 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. Journal of Public Health, 39 (3), pp. e88-e94. https://doi.org/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
breastfeeding; Theoretical Domains Framework; qualitative; longitudinal; pregnant women; interviews

Journal
Journal of Public Health: Volume 39, Issue 3