The Experience of Being the First to Breastfeed in a Family: An Interpretative Phenomenological Analysis

Abstract

The benefits of breastfeeding for mother and baby are well established; however, only 37.5% of Scottish women are currently breastfeeding at six to eight weeks with less than 1% breastfeeding exclusively for six months, as recommended by UK and international health policy. Family influence is amongst the socio-demographic factors which affect breastfeeding initiation and duration and women who were not breastfed themselves are 25% less likely to initiate breastfeeding. While there is a growing body of literature which seeks to understand breastfeeding by exploring the perspectives of breastfeeding mothers, no studies can be found describing the experience of making a different feeding choice from that of one’s family-of-origin, nor of the potential impact of this decision on relationships with them. As such, this study exploring the experience of being the first in your family to breastfeed is novel. The aim of the study was to investigate the experience and meaning of being the first person to breastfeed in a family. Consequently, areas explored included women’s experience of initiating and sustaining breastfeeding when they have no immediate family history of breastfeeding, how women make sense of their decision to breastfeed and their understanding of how their decision has affected their relationships. A methodological development in the form of an Infant Feeding Genogram was used to record relevant demographic and family information and semi-structured interviews with fourteen women obtained in-depth narratives. Interpretative phenomenological analysis (IPA) was used as an approach and to analyse the data. Following the completion of idiographic analysis, cross participant analysis was undertaken and four superordinate themes emerged: Breaching Family and Social Norms; Volitions and Imperatives; Unprepared for the Challenge; and A Sacrifice but Worth It. Within these superordinate themes, 13 themes were identified and articulated. Findings from this research were synthesised to provide an account of how women experience being the first to breastfeeding in a family, make sense of their decisions and the impact this has on their relationships with their family. This provides an understanding of women’s experience in an original context, and the contextualising within the existing literature generates commonalities and highlights differences between the experience of this group of breastfeeding women and the wider cohort. The findings of this research inform recommendations for practice at both an individual and public health levels, and have implications for policy makers, health professionals and breastfeeding support organisations. It is asserted that policy makers and the health service need to acknowledge the unanticipated consequences of some current breastfeeding discourses associated with health promotion practices, and take a mother and family focussed approach to breastfeeding that acknowledges women’s embodied experience, which often includes breastfeeding difficulties. A mother and family centred approach can identify and adapt to women’s support needs in their own particular context, which may include very limited community and family support for their decision.