Table 4 Analytic coding framework with definitions
Barriers to breastfeeding | |
CODE | DESCRIPTION |
Physical barriers | |
Pain during/after breastfeeding | Pain and/or soreness associated with latching, positioning, engorgement, biting/teething of infant, medical reasons/other whilst breastfeeding either initiating/during/after breastfeeding/expressing milk. |
Lack of milk | Perceptions of lack of milk, weight gain of infant, failure to thrive, sleep patterns, strategies to address milk supply issues. |
Illness and medical conditions | Pre-existing and/or new medical conditions/infections/illnesses/medications that impact ability to breastfeed, medical advice to stop/reduce breastfeeding. |
Psychological Barriers | |
Stress and coping with breastfeeding | Perceptions of stress towards breastfeeding, coping strategies and mechanisms to address levels of stress, impact of stress on mother/infant/other. |
Sense of failure to breastfeed | Guilt, blaming self, disappointment, remorseful, depression, impact on self/attachment with infant/others from not initiating or stopping breastfeeding. |
Pressure from important others | Feeling pressured to introduce formula, cease breastfeeding from partners/husbands, immediate family (i.e., mothers, mother-in-law), healthcare professionals, friends, other for health/emotional reasons. |
Embarrassment | |
Stigma of breastfeeding in public/in front of family | Embarrassment, feeling uncomfortable to breastfeed in front of others (public/ friends/family/other), fearful of other’s reactions to breastfeeding, disapproval from others (public/family/friends/other). |
Time and convenience | |
Competing responsibilities | Managing competing responsibilities including other children/childcare/other caring responsibilities, work, household chores, time for self/partner/other. |
Time to breastfeed | Expressing, time taken to latch/feed, duration of feeding and impact this has on daily life. |
Convenience of bottle feeding | Convenience and ease of bottle feeding (formula) versus breastfeeding at home/public/work/other, sharing responsibility of feeding, reduced pressure to be sole person to feed infant. |
Facilitators to breastfeeding | |
CODE | DESCRIPTION |
Cultural traditions and practices | |
Cultural traditions and expectations related to breastfeeding | Attitudes, beliefs and behaviours of important others and those around you, influential traditions, practices and cultural values towards breastfeeding, normalisation of breastfeeding. |
The role of religious beliefs in breastfeeding | Religious beliefs, maternal religion, religious endorsement of breastfeeding, religious beliefs of the importance of breastfeeding. |
Positive perceptions towards breastfeeding | |
Perceived benefits of breastfeeding | Perception of advantages of breastfeeding for mother/infant/other includes physical and emotional health, bonding and attachment. |
Perceived importance of breastfeeding | Value and worth of breastfeeding to infant/mother/other (short and longer term). |
Perseverance | |
Motivation to breastfeed | Willingness to breastfeed, a desire to breastfeed and succeed in breastfeeding. |
Confidence to breastfeed | Belief in own ability to breastfeed and/or overcome difficulties and obstacles to breastfeed, determination, empowerment. |
Flexible approaches to feeding | |
Involvement of fathers/others in breastfeeding | Involving fathers/others in feeding infant, expressing, sharing breastfeeding/breastmilk among mothers. |
Division of responsibilities to feeding | Sharing responsibilities of feeding, care for infant. |
Support from Healthcare Professionals/ Breastfeeding services | |
Practical advice, support and reassurance | Types of services/support accessed related to infant feeding/breastfeeding, healthcare professional led, peer led, Mode of delivery (face to face, telephone, online), adherence to advice. |
Relationship with healthcare provider | Experience with healthcare professional, rapport, quality of relationship, quality of communication, trust, support. |
Continuity of care | Mothers perception of quality of care across time, level of follow up and longer-term support provided, ongoing relationship with healthcare professionals and/or services, |
Consistency of advice | Consistency of breastfeeding advice across healthcare professionals and/or services. |
Access to support and breastfeeding services | Knowledge and awareness of services, barriers to access, ease of access, cultural sensitivity. |