Breastfeeding significantly impacts on the health of the population; however, few babies are breastfed for more than a few weeks. Nine out of ten women who stop breastfeeding early say they stopped before they intended to. The most common reasons given for premature breastfeeding cessation can be resolved given proper instruction and support. However, women have consistently identified a lack of breastfeeding knowledge in their communities, and a mainly inadequate support service from health care professionals. The potential of the internet to instruct, support and motivate women to breastfeed has been reported in recent research, and may be one approach to more effectively supporting women who wish to breastfeed for a longer period of time. Online health seeking behaviour is particularly prevalent amongst pregnant women and approximately three out of ten new mothers are turning to the internet for breastfeeding support. The online environment offers a diverse range of breastfeeding resources but little is known about this phenomenon. The literature in the area is sparse and supports the need for further research. The aim of this study was to understand women's experience of using the internet to support breastfeeding. A mixed methods approach was selected and this incorporated a triangulated exploratory sequential design beginning with a tentative concept analysis to identify antecedents, attributes and consequences of online breastfeeding support. Following ethical approval, these tentative components were tested in the second phase of the study through unobtrusive observation of an online discussion forum. Subsequent analysis of online interactions between 510 individuals over a three month period, alongside an additional nine month tracking period to ascertain consequences, provided further clarity about this phenomenon. This resulted in crystallisation of an evolving concept that was validated and further developed in the third phase through online interviews with twelve women who had previously sought or offered breastfeeding support online. This research offers a conceptual model which suggests that online breastfeeding support is a sophisticated, effective mother to mother breastfeeding support system where women can choose to adopt the role of observer, seeker or supporter at various stages of their breastfeeding experience. New information has been obtained about specific types of breastfeeding support sought online, and how more experienced mothers work together in this virtual environment to co-construct menus of tailored support for those seeking help. The key component identified in this naturally occurring phenomenon of online breastfeeding support, is that it is self perpetuating - based on the generalised reciprocity of mothers who return with experiential knowledge and a willingness to reciprocate the support they received. These findings have implications for breastfeeding support strategies which should consider promotion of online resources found to be effective by breastfeeding women as well as incorporation of this sustainable woman centred model in future developments of online breastfeeding support. This study has made a number of recommendations relating to theory, practice, technology and research including consideration of further testing of this model.

This thesis reports the results of qualitative research using ethnographic methods to explore the experiences of women who have breastfed long-term. Data collection methods included participant observation in three breastfeeding support groups, face-ta-face interviews and online asynchronous interviews using email. A clear contribution to new knowledge has been demonstrated in a number of areas. Knowledge has been furthered by presenting in-depth, rich findings about the experience of an under-researched group in a sensitive area. Placing these within the context of a cross-disciplinary perspective and by using insider research methods has strengthened their authenticity and credibility. The Social-Ecological Model is used both to structure a review of relevant literature and to underpin the thesis as a whole, demonstrating the complex social and cultural contexts within which women breastfeed long-term. Findings, from a group of strong-willed and determined women show that breastfeeding long-term is a rewarding but challenging commitment, often undertaken in the absence of societal support. Theoretical concepts of liminality, stigma and taboo are explored within the thesis and used as a lens through which to view the findings from the study. Previous work using these concepts to think about breastfeeding is drawn on and developed to further understanding of the experiences of long-term breastfeeding.

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Background: Breastfeeding is a key public health issue, conferring benefits associated with both infant and maternal health. Despite an increasing research base about what helps or hinders breastfeeding, there is a dramatic drop in breastfeeding prevalence within the first six weeks following birth. The reasons that mothers give for stopping breastfeeding suggest that few mothers gave up because they planned to. This would appear to suggest that there is a gap between women's experiences of breastfeeding and professional practice to promote, support and increase duration. Methodology: Using an interpretive phenomenological methodology this study was designed to capture mothers' own interpretations of their experiences of breastfeeding. In-depth interviews with 22 women from the city and surrounding areas of Lincoln were conducted and analysed. Findings: Analysis of the data from interviews with 22 primiparous and multiparous mothers resulted in the emergence of three main overarching themes: reality shock, illusions of compliance and tensions. Sub-themes Included idealised expectations, incessant demands, onus of responsibility, playing the game, breaking the rules, surveillance and scrutiny, conflicts and contradictions, and cultural constructs. Conclusions: The findings from this study revealed that women were ill-prepared for the realities of breastfeeding and for most women the shock of this experience was overwhelming. Those women who struggled to establish breastfeeding did so in silence. They tried to hide their vulnerabilities rather than admit that they were not coping. A lack of peer and family support, combined with the rigid and inflexible approach espoused by health care professionals, led to the perception that exclusive breastfeeding was an unrealistic and unattainable ideal. This has clear implications for practice and policy.

Breastfeeding has health benefits for mothers and babies. An action research project was undertaken to improve knowledge of breastfeeding and implement evidence based practice, that of uninterrupted skin-to-skin contact between mother and baby at birth. The beliefs underpinning the project were informed by critical inquiry, dialectics and feminist theory. Data was collected by means of field notes, participant observation, focus groups and semi- structured interviews. Analysis during the project using critical reflection was ongoing and collaborative, feeding back into the action research cycles, so guiding the changes. Before successful change in practice can occur, practitioners need to be convinced of its value, involved in the change process and facilitated to incorporate it into practice. Hospitals tend to reinforce the power of professionals by their adherence to historical routines and institutionalised practices which lead to compliance thus hindering change. The strategic use of power by midwives was apparent, constructing people's world view, thus reinforcing the power structure. Empowerment of women and midwives was necessary to the success of the project by education, support, role modelling, strategies for remembering and the active participation of midwives. Theories of change were used to illuminate challenging issues from the project. Early contact between mother and baby at birth is an area generating a large volume of literature. Skin-to-skin contact was disrupted by technology, time limits and the social norm of separation. Interviews with women and midwives allowed a deeper insight into the experience of skin-to-skin contact, giving more value to the change. Further issues to emerge were the implications of separation, the social construction of time, embodied praxis and love. Recommendations are made for the more effective action research approach to implementing change, and personal empowerment as the basis for improving the experience of birth.

Two-thirds of UK mothers begin breastfeeding, but many soon stop. Although breastfeeding benefits health, infant feeding is influenced by social and attitudinal factors. Study one prospectively investigated the attitudes and experiences of 514 women. Past experience predicted which multiparae would stop by six weeks. Manual social class and considering bottle feeding did so for primiparae. Perceived insufficient milk was the commonest reason for stopping. Study two, a randomised trial of support from breastfeeding counsellors, recruited 720 women. At four months, 46.1% (143/310) intervention and 42.3% (131/310) control women breastfed (Chi\(^2\)=0.942, P=0.33); 73.9% (229/310) vs 79.4% (246/310) gave bottle feeds (Chi\(^2\)=2.60, P=0.11). Survival analysis confirmed that differences between intervention and control women's partial and full breastfeeding duration were not significant (P=0.45 and 0.15 respectively.) Significantly fewer intervention women felt they had insufficient milk. Qualitative analysis of women’s comments revealed they wanted better information, practical help with positioning, effective advice, encouragement and their feelings acknowledged. Women valued counselling, but their feeding behaviour changed little, which may reflect the strength of social influences and that not all mothers contacted the counsellors postnatally. Practical support in the early postnatal period is important. Counselling may increase women's confidence in breastfeeding and producing enough milk.

Thesis (MPH. ) --University of Limpopo, 2014 / The aim of this study was to determine the knowledge and practices of mothers with regard to exclusive breastfeeding in the Mahwelereng Local Area of the Waterberg District, Limpopo Province. A quantitative study was conducted by using a researcher-administered structured questionnaire at six clinics in the Mahwelereng Local Area. A simple random sampling method was used to select the hundred and seventy five mothers who had babies of less than six months old from whom data was collected. Data was analysed with the assistance of the statistician by using the SPSS software program. Data is presented applying descriptive and inferential statistics. Less than half (74; 42.3%) of the responding mothers were practising exclusive breastfeeding despite the fact that 137 (78.3%) of them were given information about exclusive breastfeeding. There is an association between knowledge of exclusive breastfeeding (Chi-Square= 14.039; Sig=0.000 p<0.05) and exclusive breastfeeding practice. There is no association between exclusive breastfeeding practice and HIV status (Chi-Square=2.444; Sig=0.118; p>0.05). Challenges that mothers faced in relation to practising exclusive breastfeeding were work-related, school-related, health-related, pressure from family to mix-feed, and a lack of knowledge. However, 42.9% of the respondents indicated that they did not have any challenges with regard to the practice of breastfeeding. It was, therefore, recommended that one-on-one counselling about exclusive breastfeeding needs to be intensified and maternity leave should be extended to six months. The majority of respondents showed adequate knowledge of what exclusive breastfeeding was because they were counselled about breastfeeding although they were not practising it. Key words: Exclusive breastfeeding, mothers, knowledge, practices, mix-feeding.

The purpose of the study was to determine if mothers who breast-feed their babies for nine months and longer experience problems when weaning. This research also determines the type of problems and weaning practices used by those mothers. In this descriptive study, data was collected from 150 mothers by means of questionnaires and interviews. The subjects were mothers who breast-fed their children for nine months or longer, who attended antenatal and postnatal clinics at Coronation Hospital. Reasons for weaning were inter alia the belief that the baby was old enough to be weaned. The results revealed that 42 (31,34%) of the respondents experienced problems during weaning. The problems included, among others, guilt feelings in the mother. Mothers use harsh methods of weaning such as sending a child away to a relative. There is minimal involvement of health workers in the health education of mothers on weaning. / Health Studies / M.A. (Nursing Science)

Cette thèse en analyse du discours a pour objectif l'analyse comparative et l'analyse critique du discours sur l'allaitement dans deux communautés ethnolinguistiques différentes : la France et l'Allemagne. La question à l'origine de notre recherche est la suivante : choisir d'allaiter est-il réellement un choix ou les femmes suivent-elles le chemin tracé par les auteurs ? Nous avons réuni un corpus composé de brochures institutionnelles et de guides parentaux. Dans notre travail, nous avons relevé la façon dont les auteurs de ces guides et brochures se placent dans leur discours ainsi que les arguments qu'ils mettent en avant afin de convaincre les femmes d'allaiter. L'étude des caractérisations du lait et de l'allaitement dans notre corpus de textes franco-allemands nous a permis de montrer que ces auteurs laissent peu de place au choix d'allaiter même si cette absence relative de choix ne se traduit pas de la même manière dans les deux communautés ethnolinguistiques étudiées. / The objective of this thesis in discourse analysis is a critical and comparative analysis of discourses about breastfeeding in two different ethnolinguistic communities: France and Germany. The original research question is: is the option of breastfeeding a real choice or do women follow the path lined up by authors ? We gathered a corpus composed of institutional booklets and parent's manuals. In our research, we have considered how the authors of these guides and booklets are positioning themselves in their discourses and the arguments put forward to convince women to breastfeed. The study of milk and breastfeeding characterizations in our corpus of French and German texts has allowed us to show that these authors leave little opportunity to choosing breastfeeding, even if this lack of choice is translated in a different way in the two ethnolinguistic communities studied.

The purpose of the study was to determine if mothers who breast-feed their babies for nine months and longer experience problems when weaning. This research also determines the type of problems and weaning practices used by those mothers. In this descriptive study, data was collected from 150 mothers by means of questionnaires and interviews. The subjects were mothers who breast-fed their children for nine months or longer, who attended antenatal and postnatal clinics at Coronation Hospital. Reasons for weaning were inter alia the belief that the baby was old enough to be weaned. The results revealed that 42 (31,34%) of the respondents experienced problems during weaning. The problems included, among others, guilt feelings in the mother. Mothers use harsh methods of weaning such as sending a child away to a relative. There is minimal involvement of health workers in the health education of mothers on weaning. / Health Studies / M.A. (Nursing Science)