Background
Methods
Demographic variables | n (%) median [IQR] mean ± SD |
---|---|
Maternal variables | |
Age, years | 30.5 ± 4.8 |
Maternal educational level | |
Higher education | 154 (51) |
Upper secondary school or less | 116 (49) |
Primipara | 159 (59) |
Mothers not born in Sweden | 16 (6) |
Vaginal birth | 152 (56) |
Multiple birth | 32 (12) |
Gestational age at birth, weeks | 34 [2] |
Exclusive breastfeeding | |
at discharge | 230 (85) |
8 weeks after discharge | 171 (63) |
6 months after birth | 75 (28) |
Partial breastfeeding 12 months after birth | 39 (15) |
Analysis
Results
Navigating smoothly
When breastfeeding was experienced as smooth, mothers felt a harmony in life when breastfeeding. Breastfeeding was described as a way to rest and calm down as well as a period of relaxation for both the mother and infant. In such harmonious breastfeeding situations, the mothers also felt a sense of wellbeing, tranquillity and security in breastfeeding.It feels very good; breastfeeding provides great closeness and attachment, which gives me a great inner satisfaction as a parent. Now, after 6 months, I am so used to breastfeeding. In addition, my son eats more efficiently now, so it feels more practical to quickly and easily feed him compared with before, when you breastfeed all the time. SK5 (GA 36+2, breastfed exclusively at 6m)
Despite concerns about breastfeeding that some mothers experienced during pregnancy, it was a relief for many that everything worked well regarding breastfeeding. Breastfeeding seemed to be a smooth way of being with the infant and thus strengthened the mother’s confidence in parenting. This situation was characterized by simply being a breastfeeding mother without experiencing any problems or difficulties. Breastfeeding was integrated into the mother’s life in an embodied way.For me, breastfeeding is usually a quiet and harmonious moment - an opportunity to sit down and relax a little extra. SK59 (GA 34+3, breastfed exclusively at 6m and partially at 12m)
Mothers also felt grateful and were strengthened by the positive bodily response of their breastfeeding. Pride in succeeding with breastfeeding was awakened, and breastfeeding was a privilege to experience. Happiness emerged because breastfeeding went smoothly and was pain free. Mothers also reported amazement over the body’s ability to produce enough breast milk for the infant to thrive, as there was often an inherent apprehension that this would not happen.It feels very good to be able to breastfeed, and it works very well most of the time. SU38 (GA 35+5, breastfed exclusively at 8w and partially at 6m and 12m)
Mothers were proud of their ability to manage breastfeeding and grateful for the closeness and growing love that breastfeeding provided. One mother of twins was proud that she managed to breastfeed her infants for 6 months, and she often breastfed the infants together. The positive breastfeeding experiences was etched in the mother’s memory after she ceased breastfeeding. Another mother wrote; I felt happy and satisfied every time I nursed my son; it was a good feeling that I will not forget. K67 (GA 34 + 5, ceased breastfeeding at 5 months).Breastfeeding my child makes me proud; closeness and love grow between us. When I breastfeed her, we make eye contact and small talk, so I never get tired of breastfeeding her. I love breastfeeding her; I couldn’t replace this breastfeeding time with anything else. K45 (GA 31+0, breastfed exclusively at discharge and partially at 8w, 6m and 12m)
The mothers also described breastfeeding as a gift to the infant. Breastfeeding gave the mothers a lovely feeling, and it was satisfying to provide the infant with nutrition and protection, which was perceived as being the best possible start. It was described as “awesome” and “beautiful” when the infant became satisfied by being breastfed.To breastfeed my child is pure love. I get the chills in my body when I think about ceasing breastfeeding (in some years or so) because I like it. It is our moment. SK67 (GA 31+5, breastfed exclusively at 6m)
I give my child the best she can get nutritionally. She gets security and comfort when she lies at the breast. We have a nice emotional contact. Ö71 (GA 35+6, breastfed exclusively at 6m and partially at 12m)It is a great gift to give to your child. It is convenient to always have the food with you. F23 (GA 34+0, ceased breastfeeding at 8 months)
Navigating with a struggle
The struggle could also be over one’s own bodily performance or impairment. Mastitis, breast pain and/or a low milk supply (both perceived and actual) or maternal illnesses can disrupt breastfeeding, which can lead to stress, anxiety and frustration.It has been tough when my daughter just fell asleep at the breast. She has not received the whole meal at the breast. My milk dried up when she did not suck hard enough. (I) express milk and feed by bottle, and the feedings have taken a lot of time and effort. Ö19 (GA 32+2, ceased breastfeeding at 11 months)
Struggling with breastfeeding may also be associated with having too much milk and thus being confronted with extreme bodily changes in the breasts. Such bodily changes in the breast may in some cases be experienced as very trying and, in some cases, these changes of the breast can be perceived as disgusting.I had pain from one breast during breastfeeding ever since he was small. I had candida in the milk ducts and sore nipples in the first 3 months, so it has been difficult, but I do not want to stop breastfeeding. Ö60 (GA 36+2, ceased breastfeeding at 9 months)
Breastfeeding was sometimes seen as an exhausting situation that caused the mothers to experience stress. Furthermore, feelings of failure, of being solely responsible, being insufficient or incapable were also expressed. These feelings sometimes led to disappointment and frustration that breastfeeding did not work out as expected. Breastfeeding was reported by some mothers to be mentally tough and unpredictable; moreover, the need to always be close to the infant and the inability to leave was tiring for some mothers. Some mothers wanted to share infant feeding with the father, and some did so.Now, afterwards, I see that initially my child was “just” weight gain. Everything was about gaining weight, and the only thing I saw was the child's needs (nutritional needs) - not the CHILD, not the interaction through movements and smiles, just weight. It (breastfeeding) became “mechanical” - food - weight. No one saw my little child. F99 (GA 33+0, partially breastfed 8w)
The worst thing I have experienced. I felt really bad due to all the stress and pressure about breastfeeding and the idea that it (breastfeeding) would be “the best” option. Bottle-feeding is a pure dream in comparison. Breastfeeding is not free; it is the most costly thing I have experienced. I lost myself completely. SU68 (GA 33+3, partially breastfed 8w)
Navigating in ambiguity
Expressing breast milk or using nipple shields and bottles are aids that can either help or hinder breastfeeding. Mothers described milk expression as frustrating and difficult. However, they also reported pride in having expressed milk for their infants when they later managed to breastfeed their infants directly at the breast. Some mothers continued to express milk to provide the infant with their breast milk when the infants could not breastfeed directly at the breast.I had problems with breastfeeding in the beginning and felt that it (breastfeeding) started to be associated with anxiety. After about 3 months, things turned around, and now I love to breastfeed. SU23 (GA 36+4, breastfed partially at 8w and exclusively at 6m)
“It has been hard, sometimes painful, and it was necessary to express a lot of milk. When it (breastfeeding) worked well (most of the time), it has provided moments of closeness with my baby”. T40 (GA 33+0, ceased breastfeeding at 9 months)
Bottles were reported by some mothers to interfere with breastfeeding. These mothers reported that after introducing bottles, the infant preferred the bottle over the breast, which led to the cessation of breastfeeding. Bottles and formula feeding were, in some situations, also described as a rescue when breastfeeding had been tough or did not work. The switch to bottle-feeding facilitated maternal well-being in some cases.It (breastfeeding) is not as smooth as I thought from the beginning when I have used a nipple-shield because my child is unable to suck otherwise. T20 (GA 33+1, ceased breastfeeding at 7 months)
When navigating breastfeeding with ambiguity, changing track was one way to find one’s own way in the breastfeeding situation. Changing track means that breastfeeding was initiated but, after discovering an unwillingness, not feeling well or feeling uncomfortable, the mothers ceased breastfeeding. Feeling “disgusting” or “like a cow” was also reported. For these mothers, breastfeeding felt wrong, they ceased breastfeeding and even regretted that they had started to breastfeed.Breastfeeding didn't suit me, and it was the best decision for me and my family to start giving formula. I felt bad when breastfeeding. SU61 (GA 32+6, fully formula fed at 8w)
I thought I would be a mom who would like to breastfeed, but the opposite turned out to be true. F11 (GA 35+6, breastfed exclusively at 8w and had ceased before 6m)