This increased knowledge of the factors influencing breastfeeding will assist in identifying women at risk of early weaning and in constructing programmes capable of increasing the length of time for which women breastfeed.

AimsThe study investigated factors empowering women to continue breastfeeding despite experiencing extraordinary difficulties. The study documented the experiences and characteristics of women who continued to breastfeed (continuing cohort) and those who weaned (non-continuing cohort) despite extraordinary difficulties. DesignRetrospective case control. MethodsThe study was undertaken in south-east Queensland, Australia in 2004. Forty women (20 in each cohort) were recruited over six months. Both quantitative (breastfeeding knowledge questionnaire) and qualitative (semi-structured interviews) data were collected. This paper describes the qualitative data. Page 2 of 16 ResultsWomen from both cohorts expressed idealistic expectations about breastfeeding and experienced psychological distress due to their breastfeeding problems. Those who continued breastfeeding used coping strategies and exhibited personal qualities that assisted them to overcome the difficulties experienced. Women who continued to breastfeed were more likely to report relying on a health professional they could trust for support. This latter cohort were also more likely to report having peers with which they shared their experiences. Non-continuing women expressed feelings of guilt and inadequacy following weaning and were more likely to feel isolated. ConclusionsThis study has highlighted the methods women use to deal with breastfeeding problems. It has also revealed modificable factors that can improve breastfeeding duration. Relevance to clinical practiceThe findings indicate that clinicians should:• Provide information which accurately reflects the breastfeeding experience; • Ensure systems are in place so that effective postnatal support for breastfeeding difficulties is available;• Consider screening to ascertain levels of psychological distress, sadness and disillusionment among breastfeeding women; • Design educational interventions with elements of cognitive skills, problem-solving and self-efficacy training to equip women with the skills to overcome any experienced difficulties.

Breastfeeding duration rates in Australia are low, prompting a search for modifiable factors capable of increasing the duration of breastfeeding. In this study, participants were asked which psychological factors they believed influence breastfeeding duration. Participants included 3 groups of mothers who had breastfed for varied lengths of time (n = 17), and 1 group of breastfeeding clinicians (n = 4). The nominal group technique was employed, involving a structured group meeting progressing through several steps. Analyses included collation of individual and group responses, group comparisons, and a thematic analysis of group discussions. Forty-five psychological factors thought to influence the duration of breastfeeding were identified. Factors considered most important included the mother's priorities and mothering self-efficacy, faith in breast milk, adaptability, stress, and breastfeeding self-efficacy. In addition to informing the design of phase 2 of this study, these results add to our knowledge of this emerging research area.

The aims of this article are to outline the reasons Australian women give for initiating breastfeeding, identify unique predictors for these reasons, and use principal components factor analysis to determine factors that influence a woman's decision to breastfeed. Data were collected as part of a large longitudinal study investigating the breastfeeding behaviors and supports of women in Southern Queensland, Australia. The most common reason women (N = 562) gave for deciding to breastfeed was breast milk is better for my baby (95.5%). Reasons related to the mother such as breastfeeding is more convenient (84.3%) were also popular. Four significant components-mother-related reasons, health effects for the infant, moral and family influences, and advice from others-were determined after principal components factor analysis. As well as health benefits for the infant, convenience and other reasons related to the mother appear to be important factors in an Australian woman's decision to breastfeed.