"I Just Want to Do Everything Right:" Primiparous Women's Accounts of Early Breastfeeding via an App-Based Diary

Jill Demirci, Erin Caplan, Nora Murray, Susan Cohen, Jill Demirci, Erin Caplan, Nora Murray, Susan Cohen

Abstract

Introduction: Our objective was to describe the early breastfeeding experience of primiparous women.

Methods: Healthy, primiparous women intending to exclusively breastfeed downloaded a commercial infant feeding mobile application (app) during their postpartum hospitalization. Women free-texted breastfeeding thoughts and experiences through 8 weeks postpartum in the app's diary. Diary content was qualitatively coded.

Results: Thirty-five participants completed diaries and were included in analyses. The overarching theme was Seeking sustainability and validation. Mothers felt overwhelmed, anxious, and frustrated with the intensity and unpredictability of breastfeeding and inconsistent professional breastfeeding support. The ability to exclusively breastfeed was seen as a bellwether of maternal competence. Breastfeeding progress was primarily measured through external feedback (e.g., weight checks) and managed through strict adherence to provider feeding plans. As breastfeeding problems and intensity abated, women exhibited optimism and assumed greater independence in feeding decisions.

Discussion: The primiparous breastfeeding experience is fraught with internally imposed and externally reinforced pressure to produce and persevere despite inadequate breastfeeding support infrastructure.

Keywords: Breastfeeding; mobile applications; primiparity; qualitative research.

Conflict of interest statement

Ethical Statment: We declare no conflicts of interest.

Copyright © 2017 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

References

    1. Centers for Disease Control and Prevention. Breastfeeding among U.S. Children Born 2002–2013, CDC National Immunization Surveys. [Accessed 09.16.16];2016 16:16.
    1. Chantry CJ, Dewey KG, Peerson JM, Wagner EA, Nommsen-Rivers LA. In-hospital formula use increases early breastfeeding cessation among first-time mothers intending to exclusively breastfeed. J Pediatr. 2014;164(6):1339–1345.
    1. Wagner EA, Chantry CJ, Dewey KG, Nommsen-Rivers LA. Breastfeeding concerns at 3 and 7 days postpartum and feeding status at 2 months. Pediatrics. 2013;132(4):e865–875.
    1. Dewey KG, Nommsen-Rivers LA, Heinig MJ, Cohen RJ. Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss. Pediatrics. 2003;112(3 Pt 1):607–619.
    1. Neville MC, Morton J. Physiology and endocrine changes underlying human lactogenesis II. J Nutr. 2001;131(11):3005S–3008S.
    1. Wambach K, Watson Genna C. Anatomy and physiology of lactation. In: Wambach K, Riordan J, editors. Breastfeeding and Human Lactation. 5th. Burlington, MA: Jones and Bartlett Learning; 2016.
    1. Demirci JR, Bogen DL. Feasibility and acceptability of a mobile app in an ecological momentary assessment of early breastfeeding. Maternal & Child Nutrition. 2017;13(3):e12342.
    1. Demirci JR, Bogen DL. An ecological momentary assessment of primiparous women's breastfeeding behavior and problems from birth to eight weeks. 2017;33(2):285–295.
    1. Corbin J, Strauss A. Strategies for qualitative data analysis. In: Corbin J, Strauss A, editors. Basics of Qualitative Research. 3e. Thousand Oaks, CA: Sage Publications, Inc.; 2008.
    1. Kronborg H, Harder I, Hall EO. First time mothers' experiences of breastfeeding their newborn. Sex Reprod Healthc. 2015;6(2):82–87.
    1. Marshall JL, Godfrey M, Renfrew MJ. Being a ‘good mother’: managing breastfeeding and merging identities. Soc Sci Med. 2007;65(10):2147–2159.
    1. Kelleher CM. The physical challenges of early breastfeeding. Soc Sci Med. 2006;63(10):2727–2738.
    1. Hall WA, Hauck Y. Getting it right: Australian primiparas' views about breastfeeding: A quasi-experimental study. Int J Nurs Stud. 2007;44(5):786–795.
    1. Leeming D, Williamson I, Johnson S, Lyttle S. Making use of expertise: a qualitative analysis of the experience of breastfeeding support for first-time mothers. Matern Child Nutr. 2015;11(4):687–702.
    1. Dykes F. ‘Supply’ and ‘demand’: breastfeeding as labour. Soc Sci Med. 2005;60(10):2283–2293.
    1. Chaput KH, Nettel-Aguirre A, Musto R, Adair CE, Tough SC. Breastfeeding difficulties and supports and risk of postpartum depression in a cohort of womenwho have given birth in Calgary: a prospective cohort study. CMAJ Open. 2016;4(1):E103–109.
    1. Tully KP, Holditch-Davis D, Silva S, Brandon D. The relationship between infant feeding outcomes and maternal emotional well-being among mothers of late preterm and term infants: A secondary, exploratory analysis. Adv Neonatal Care. 2017;17(1):65–75.
    1. Blixt I, Martensson LB, Ekstrom AC. Process-oriented training in breastfeeding for health professionals decreases women's experiences of breastfeeding challenges. Int Breastfeed J. 2014;9:15.
    1. McFadden A, Gavine A, Renfrew MJ, et al. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev. 2017;2:CD001141.
    1. Kent JC, Mitoulas LR, Cregan MD, Ramsay DT, Doherty DA, Hartmann PE. Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics. 2006;117(3):e387–395.
    1. Chatterji P, Markowitz S. Family leave after childbirth and the mental health of new mothers. J Ment Health Policy Econ. 2012;15(2):61–76.
    1. Muzik M, Umarji R, Sexton MB, Davis MT. Family social support modifies the relationships between childhood maltreatment severity, economic adversity and postpartum depressive symptoms. Matern Child Health J. 2016 doi: 10.1007/s10995-016-2197-4. online only.
    1. Kapinos KA, Bullinger L, Gurley-Calvez T. Lactation support services and breastfeeding initiation: evidence from the affordable care act. Health Serv Res. 2016 doi: 10.1111/1475-6773.12598. e-published ahead of print.
    1. Feldman-Winter L, Barone L, Milcarek B, et al. Residency curriculum improves breastfeeding care. Pediatrics. 2010;126(2):289–297.
    1. Herold RA, Bonuck K. Medicaid IBCLC service coverage following the Affordable Care Act and the Center for Medicare and Medicaid Services Update. J Hum Lact. 2016;32(1):89–94.
    1. Munn AC, Newman SD, Mueller M, Phillips SM, Taylor SN. The impact in the United States of the Baby-Friendly Hospital Initiative on early infant health and breastfeeding outcomes. Breastfeed Med. 2016;11:222–230.
    1. Lawrence RA, Lawrence RM. Breastfeeding A Guide for the Medical Profession. 8th. Philadelphia, PA: Elsevier; 2016.
    1. Wambach K, Riordan J. Breastfeeding and Human Lactation. 5th. Burlington, MA: Jones and Bartlett Learning; 2016.

Source: PubMed

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