Prosser, H 2011, ‘It just seemed the most natural thing to do, but it was such hard work’: decision-making surrounding breast/bottle feeding among parents living in a deprived area where breastfeeding rates remain low , in: 43rd BSA Medical Sociology Group Annual Conference, 14-16th September 2011, University of Chester. (Unpublished)

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Abstract

It is well established that breastfeeding reduces child mortality and promotes child health and development. The World Health Organisation recommends exclusive breastfeeding for the first six months of life. Women in low socioeconomic status (SES) groups are less likely to initiate and continue breastfeeding. Increasing the take-up and duration of breastfeeding is a key priority for tackling health inequalities. This study aimed to gain a better understanding of the decision-making processes underlying infant feeding choices among parents of new babies living in a deprived area in England where breastfeeding rates remain low. Purposive sampling was used to select mothers who: were currently breastfeeding; were formula feeding and had never breastfed; breastfed initially but ceased by 8 weeks. Semi-structured interviews, conducted with 44 mothers and 25 fathers, explored parents’ rationales for their feeding choice and the facilitating and constraining factors for breastfeeding initiation and continuation. While findings suggest positive attitudes towards breastfeeding, irrespective of infant feeding practice, decision-making around infant feeding was the outcome of a multifaceted negotiation occupying factors internal to the individual, socio-cultural knowledge, organisational and structural factors, the external environment and mothers’ sense of agency and control. While it is clear that there is a need to confront social norms and societal attitudes towards breastfeeding, a key message for local service commissioners and providers, is that the decision to breastfeed (both to initiate and to continue) is strongly influenced by parents’ interactions with health services and health professionals at key sites and times along the antenatal/postnatal pathway.

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