The study objective was to identify demographic, medical, and health behavior factors that predict breastfeeding initiation in a rural population with low breastfeeding rates. Participants were 2323 women who experienced consecutive deliveries at 2 hospitals, with data obtained through detailed chart review. Only half the women initiated breastfeeding, which was significantly associated with higher levels of education, private insurance, nonsmoking and non-drug-using status, and primiparity, after controlling for confounders. Follow-up analyses revealed that smoking status was the strongest predictor of failure to breastfeed, with nonsmokers nearly twice as likely to breastfeed as smokers and with those who had smoked a pack per day or more the least likely to breastfeed. Findings reveal many factors placing women at risk for not breastfeeding and suggest that intervention efforts should encourage a combination of smoking cessation and breastfeeding while emphasizing that breastfeeding is not contraindicated even if the mother continues to smoke.

Många kvinnor betraktar amning som det naturligaste sättet att ge sitt nyfödda barn föda. Mödrar får information av sjukvården att bröstmjölk innehåller all näring som det nyfödda barnet behöver samt antikroppar som skyddar barnet mot de vanligaste barnsjukdomarna. Det är inte alla kvinnor som kan amma i dagens samhälle och detta kan leda till att känslor väcks hos den nyblivna mamman som under graviditeten tänkt amma men som sedan inte kunnat göra det. Syftet med studien var att utifrån bloggtexter beskriva mödrars upplevelser av amningssvårigheter under de första sex månaderna efter barnets födelse. Studien har en kvalitativ metod med en induktiv ansats. Data samlades in genom blogginlägg samt kommentarer från femton olika bloggar och analyserades sedan med hjälp av en kvalitativ innehållsanalys. I resultatet framkom två kategorier: ”Leva upp till samhällets normer och attityder” samt ”Det professionella stödet i amningsrådgivning”. Kategorierna bildade sedan temat: ”Mödrars kamp att kunna balansera krav och förväntningar på amningen”. Utifrån denna studie kan personal som arbetar med mödrar och amningsrådgivning på olika vårdenheter, få ökad kunskap om hur mödrar upplever amningssvårigheter. Studien kan ligga till grund för ändrade vårdrutiner samt att patientsäkerheten ökas. Det i sin tur kan bidra till att mödrar upplever mindre lidande i möte med hälso- och sjukvården. / Many women consider breastfeeding as the most natural way to give their newborn child nutrition. Mothers receive information from medical staff that breast milk contains all the nutrients that the infant needs and antibodies that protect the baby against common childhood diseases. Not all women can breastfeed in today's society and that could wake feelings in mothers that during the pregnancy has been thinking to breastfeeding but who involuntarily have been unable to do so. The aim of the study was to with blog texts describe mother’s experiences of breastfeeding difficulties in the first six months following the birth. The study was based on a qualitative approach with an inductive approach. Data were collected through blog posts and comments from fifteen different blogs and then analysed using qualitative content analysis. The results are based on two categories: “Living up to the norms and attitudes” and “Professional support in breastfeeding consulting”. These categories formed a theme: “Mothers struggle to balance between the requirements and expectations of breastfeeding”. Based on this study, the staff who work with mothers and breastfeeding consulting on various health care units enhance the understanding of how mothers experiencing breastfeeding difficulties. This furthermore could contribute to mother´s experiencing less distress interaction with health and medical care.