Significant others, situations and infant feeding behaviour change processes: a serial qualitative interview study

BMC Pregnancy and Childbirth

Leone CA Craig¹  Kirsty Darwent³  Jane Britten³  Pat Hoddinott²  Rhona J McInnes³ 

[1] Division of Applied Health Sciences, Public Health Nutrition Research Group, Polwarth Building, Foresterhill, University of Aberdeen, Aberdeen AB25 2ZD, UK;Work carried out at the Health Services Research Unit; University of Aberdeen, 3rd Floor, Health Sciences Building; Foresterhill, Aberdeen AB25 2ZD, UK;School of Nursing, Midwifery & Health, University of Stirling, Stirling FK9 4LA, UK

关键词: Person-centred care;    Qualitative;    Behaviour change;    Infant feeding;   

Others  :  1138026
DOI  :  10.1186/1471-2393-13-114

 received in 2012-12-13, accepted in 2013-05-09,  发布年份 2013

【 摘 要 】

Background

Exclusive breastfeeding until six months followed by the introduction of solids and continued breastfeeding is recommended by the World Health Organisation. The dominant approach to achieving this has been to educate and support women to start and continue breastfeeding rather than understanding behaviour change processes from a broader perspective.

Method

Serial qualitative interviews examined the influences of significant others on women’s feeding behaviour. Thirty-six women and 37 nominated significant others participated in 220 interviews, conducted approximately four weekly from late pregnancy to six months after birth. Responses to summative structured questions at the end of each interview asking about significant influences on feeding decisions were compared and contrasted with formative semi-structured data within and between cases. Analysis focused on pivotal points where behaviour changed from exclusive breastfeeding to introducing formula, stopping breastfeeding or introducing solids. This enabled us to identify processes that decelerate or accelerate behaviour change and understand resolution processes afterwards.

Results

The dominant goal motivating behaviour change was family wellbeing, rather than exclusive breastfeeding. Rather than one type of significant other emerging as the key influence, there was a complex interplay between the self-baby dyad, significant others, situations and personal or vicarious feeding history. Following behaviour change women turned to those most likely to confirm or resolve their decisions and maintain their confidence as mothers.

Conclusions

Applying ecological models of behaviour would enable health service organisation, practice, policy and research to focus on enhancing family efficacy and wellbeing, improving family-centred communication and increasing opportunities for health professionals to be a constructive influence around pivotal points when feeding behaviour changes. A paradigm shift is recommended away from the dominant approach of support and education of individual women towards a more holistic, family-centred narrative approach, whilst acknowledging that breastfeeding is a practical skill that women and babies have to learn.

【 授权许可】

   
2013 McInnes et al.; licensee BioMed Central Ltd.

【 图 表 】

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