A qualitative exploration of mixed feeding intentions in first-time mothers
Breastfeeding intention can predict breastfeeding behaviour and is influenced by theory of planned behaviour constructs. Despite associations with reduced breastfeeding duration, there is a lack of research to explore the intention to mixed feed infants.
This study aimed to explore the factors that influence pregnant women's intentions to mixed feed their first child.
Semi-structured interviews were conducted with four women pregnant with their first child who intended to mixed feed. An in-depth idiographic multiple case study approach grounded in a ‘subtle realist’ epistemology was used.
The interviews highlighted the importance of flexibility in feeding decisions, a perception of breastfeeding as restrictive and obstructive to normality and the presence of misinformation and unrealistic expectations about breastfeeding.
Women need to be informed and supported by professionals, peers, families and broader communities. Cultural narratives must be challenged to enable mothers to feel in control of feeding decisions and without the need to justify feeding activities to protect themselves from anticipated negative emotions.
The World Health Organization (WHO, 2020) recommends exclusive breastfeeding, which is defined as providing a child with breast milk as the only form of sustenance, for the first 6 months of life. Researchers on breastfeeding have largely distinguished between mothers who intend to exclusively breastfeed and those who do not, reporting that breastfeeding duration is shorter in those who decided to only ‘try’ breastfeeding out of a sense of obligation, when compared to mothers committed to exclusive breastfeeding (Nesbitt et al, 2012). However, intentions to breastfeed are complex and some mothers decide to feed using a combination of breast milk and breast milk substitute. This can lead to shorter breastfeeding duration and a reduced likelihood of meeting breastfeeding goals (Chezem et al, 2003), increased levels of guilt and dissatisfaction with feeding choice in mothers of babies under 26 weeks of age (Komninou et al, 2017) and an increased risk of obesity when the child reaches school age (Rossiter et al, 2015). This illustrates that mixed feeding can have important implications for both mother and child. Cabieses et al (2014) conducted a multi-methods study and found that mothers who intended to mixed feed reported that their intention was influenced by the health benefits of breastfeeding and the convenience of bottle feeding. Further research is required to more fully understand the reasons behind intentions to mixed feed.
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