Understanding maternal breastfeeding confidence: A hermeneutic analysis of women's breastfeeding stories




Grassley, Jane Shackelford

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Increasing breastfeeding rates is important because of health benefits of breastfeeding for women and children. Studies have identified maternal breastfeeding confidence as a significant predictor of breastfeeding duration. Yet none of these quantitative studies used women's own words as the foundation for understanding maternal breastfeeding confidence. The purpose of this feminist hermeneutic study was to explore maternal breastfeeding confidence through analysis of women's breastfeeding stories. Using the frameworks of Gadamerian hermeneutics and feminist epistemology, this study investigated the phenomenon of maternal breastfeeding confidence, how it develops and how it is expressed. The study also documented the social context of breastfeeding through examining the content and influence of sociocultural messages women receive about breastfeeding.

Thirteen women whose children were between 4 months and 4 years of age were asked to tell their breastfeeding stories. Data were analyzed using the Gadamerian concepts of history, language, dialogue and fusion of horizons to identify patterns and themes. Three patterns were identified: Constructing a Breastfeeding Reality, Breastfeeding My Baby, and Transforming My Experiences.

Maternal breastfeeding confidence was defined as an individual woman's interpretation of her ability to nourish her infant through breastfeeding. This phenomenon was a dynamic, embodied, and interdependent process that a woman renegotiated at several junctures throughout the time she breastfed a particular child. Maternal breastfeeding confidence developed when a woman's expectations were congruent with her actual experiences, when she experienced a synchronous relationship with her infant, and when she had at least one consistent person in her life who trusted breastfeeding and could show her how to breastfeed. Disruptions in the development of maternal confidence were related to difficulties initiating breastfeeding in the early postpartum, infant behavior, encountering problems, use of breastfeeding technology, unsupportive comments from family friends and healthcare professionals, feeling overwhelmed by too many differing opinions, and living in a culture unsupportive of breastfeeding. Nurses can use knowledge from this study in a number of ways to enhance maternal breastfeeding confidence.



Health and environmental sciences, Social sciences, Breastfeeding, Confidence, Women