Self‐conscious emotions and breastfeeding support: A focused synthesis of UK qualitative research

Abstract

Research on women's experiences of infant feeding and related moral discourse suggests that self‐conscious emotions may be highly relevant to breastfeeding support interactions. However, the emotional impact of receiving support has not been fully explored. The aim of this review is to re‐examine qualitative UK research on receiving breastfeeding support, in order to explore the role of self‐conscious emotions and related appraisals in interactions with professional and peer supporters. From 2007 to 2020, 34 studies met criteria for inclusion. Using template analysis to identify findings relevant to self‐conscious emotions, we focused on shame, guilt, embarrassment, humiliation and pride. Because of cultural aversion to direct discussion of self‐conscious emotions, the template also identified thoughts about self‐evaluation, perceptions of judgement and sense of exposure. Self‐conscious emotions were explicitly mentioned in 25 papers, and related concerns were noted in all papers. Through thematic synthesis, three themes were identified, which suggested that (i) breastfeeding ‘support’ could present challenges to mothering identity and hence to emotional well‐being; (ii) many women managed interactions in order to avoid or minimise uncomfortable self‐conscious emotions; and (iii) those providing support for breastfeeding could facilitate women's emotion work by validating their mothering, or undermine this by invalidation, contributing to feelings of embarrassment, guilt or humiliation. Those supporting breastfeeding need good emotional ‘antennae’ if they are to ensure they also support transition to motherhood. This is the first study explicitly examining self‐conscious emotions in breastfeeding support, and further research is needed to explore the emotional nuances of women's interactions with supporters.

Factors that influence women's engagement with breastfeeding support: A qualitative evidence synthesis

“…Most of the challenges women reported in our included studies were related to socio‐cultural context and collective belief patterns of the women's social networks, including their families. Our findings suggest that these impact extensively on engagement with breastfeeding support programmes and services which is in line with the literature (Amir et al, 2021 ; Kim et al, 2017 ; Leeming et al, 2022 ). Before a support programme is developed, conflicting norms and traditions about infant feeding between professionals and women need to be identified.…”

“…Before a support programme is developed, conflicting norms and traditions about infant feeding between professionals and women need to be identified. Programme developers and service providers should develop culturally sensitive support programmes and implementers of support need to be sensitive to socio‐cultural and personal backgrounds of each woman they offer their services to (Fewtrell et al, 2020 ; Leeming et al, 2022 ).…”

Breastfeeding Aversion Response (BAR): A Descriptive Study

“…8,9 It is therefore vital to better understand breastfeeding complexities from the perspective of breastfeeding women. 10 Strategies and policies are needed to support women in achieving their personal breastfeeding goals 11 and enable national health services to achieve the WHO targets. 12 Postpartum mental health difficulties have become more prevalent in recent years.…”

“…Global rates of infants fed with any breastmilk at age 6 months have only increased slightly in recent years, 6,7 as many women who intend to breastfeed report a lack of adequate support to achieve their breastfeeding goals 8,9 . It is therefore vital to better understand breastfeeding complexities from the perspective of breastfeeding women 10 . Strategies and policies are needed to support women in achieving their personal breastfeeding goals 11 and enable national health services to achieve the WHO targets 12 …”

The relationship between national cultural dimensions, maternal anxiety and depression, and national breastfeeding rates: An analysis of data from 122 countries

“…In such a setting, the provision of "responsive support" by a woman's husband or partner, intended to promote her sense of self-efficacy in breastfeeding, may be a more appropriate strategy (Davidson and Ollerton, 2020), as would. individual or group interventions aimed at improving breastfeeding self-efficacy (Leahy-Warren et al, 2017;Galipeau et al, 2018;Leeming et al, 2022). In collectivist societies, individual and family attitudes toward breastfeeding may be shaped by traditional beliefs and practices, and it is important that healthcare workers address these in a non-confrontational manner, even when these appear to be in opposition with scientific evidence (Bandyopadhyay, 2009;Newbrander et al, 2014).…”