Breastfeeding as a balancing act – pregnant Swedish women’s voices on breastfeeding

Abstract

Background: Breastfeeding provides health benefits to both women and children. The rationale behind an individual woman's decision to breastfeed or not can depend on several factors, either independently or in combination. The aim of the current study was to explore attitudes towards breastfeeding among pregnant women in Sweden who intend to breastfeed. Methods: Eleven mothers-to-be, one of whom had previous breastfeeding experience, participated in the study. The women were interviewed either by telephone or face-to-face during late pregnancy, with the aim of exploring their attitudes towards breastfeeding. A semi-structured interview-guide was used, and the transcripts of the interviews were analyzed using thematic analysis. The social ecological model of health is the theory-based framework underpinning this study. The model provides a comprehensive approach to understanding the factors that influence breastfeeding intention. Results: When interviewed during pregnancy, women described breastfeeding as a balancing act between societal norms and personal desires. The women perceived a societal pressure to breastfeed, however it was accompanied by boundaries and mixed messages. This perceived pressure was balanced by their own knowledge of breastfeeding, in particular their knowledge of other women's experience of breastfeeding. When envisioning their future breastfeeding, the women made uncertain and preliminary plans, and negotiated the benefits and drawbacks of breastfeeding. There was a wish for individual breastfeeding support and information. Conclusions: Pregnant Swedish women perceive their future breastfeeding as a balancing act between societal norms and personal desires. These findings suggest that while discussing breastfeeding during pregnancy, it could be of interest to collect information from pregnant women on their knowledge of breastfeeding and from where they have gained this knowledge, since stories from family and friends may make them question their own capacity to breastfeed. A thorough review of the woman's experiences and attitudes of breastfeeding is important in order to offer the best evidence-based breastfeeding support. Trial registration: Ethical approval for the study was obtained from the Regional Ethical Review Board in Uppsala (Dnr: 2017/256).

Bodies get in the way: breastfeeding and gender equality in Swedish handbooks for new parents

“…Research on the embodied practice of breastfeeding to date is extensive, especially in medical research, where it is often focused on the benefits of breastfeeding (Victora et al, 2016) and on breastfeeding support for women (Cato, Sylvén, Henriksson, & Rubertsson, 2020). Feminist research on breastfeeding in the humanities and social sciences has charted the cultural histories of breastfeeding (Sjöblad, 1997;Yalom, 1997), and explored public breastfeeding discourses (Åström, 2015;Sällivaara, 2019;Wolf, 2010aWolf, , 2010b, typically raising questions about gendered power relations (Badinter, 2011;Friedman, 2009;Wolf, 2010b).…”

“…In recent years, the environmental-friendly and hence sustainability-oriented aspects of breastfeeding have also been foregrounded. 9 Swedish health care recognizes that while producing breastmilk is physiological, breastfeeding is also a learned behaviour influenced by cultural attitudes (Cato et al, 2020) as well as by hospital routines and support from caregivers (Amningsguiden, 2008;Kylberg, Westlund, & Zwedberg, 2018). As part of the work to promote breastfeeding all expecting parents are informed about breastfeeding during pregnancy.…”

“…Breastfeeding support, which begins immediately after birth by placing the newborn skin to skin with the mother (Widström et al, 2011), ideally continues during post-partum care, first in hospital, later during home visits by midwives where the entire family is involved, and in infant health clinics (Sw. barnavårdscentralen). During antenatal care visits midwives are encouraged to promote breastfeeding by giving information and asking whether mothers intend to breastfeed based on expectations and previous experience (Cato et al, 2020). 10 Since partner support influences the decision as well as the duration of breastfeeding, and mothers feel more capable and confident when partners are supportive and actively involved in breastfeeding (Bar-Yam & Darby, 1997;Grandahl, Stern, & Funkquist, 2020), fathers/partners are also invited to such information sessions.…”

“…On the other hand, more recent research has shown that longer shared parental leave-which signals "gender-equal parenthood"is associated with longer duration of breastfeeding in Sweden, and that partners who were knowledgeable about breastfeeding were less prone to view breastfeeding as an obstacle to gender equality (Grandahl et al, 2020). 11 Hence, official policy and health care organization of breastfeeding information and support promote breastfeeding on the grounds of evidence-based health outcomes, women who give birth are generally inclined to attempt breastfeeding as a primary feeding alternative for infants (Cato et al, 2020), and information and education for parents-to be is relatively gender-inclusive. Taken altogether, this can be interpreted as a powerful official pro-breastfeeding discourse, sanctioned by national (and international) authorities.…”

A qualitative analysis of factors influencing infant and young children feeding perceptions and practices, of working mothers, in London Borough of Ealing

“…Resulting in the breastfeeding rates remaining low, compared to other high-income countries (WBTI, 2016). For example, compared to Scandinavian countries, like Norway and Sweden where 80% and 78% of mothers respectively are still breastfeeding at six months (Häggkvist et al, 2010;Cato et al, 2020). Scotland has increased its breastfeeding rates since they implemented a National Infant Feeding Strategy, with 100% of hospitals implementing the UNICEF BFHI Ten Steps and resources being allocated to support mothers (UNICEF UK, 2021).…”