Existential security is a necessary condition for continued breastfeeding despite severe initial difficulties: a lifeworld hermeneutical study

Abstract

BackgroundThe majority of new mothers in Sweden initiate breastfeeding and many experience initial difficulties. This experience is an important cause of early breastfeeding cessation. To increase understanding, there is a need to explore the lived experiences of the decision to continue or cease breastfeeding. The aim of this study is therefore to explain and understand how this decision is influenced by the meaning of severe initial difficulties.MethodsA lifeworld hermeneutical approach was used for the study. The study was conducted in Sweden with eight mothers who experienced severe difficulties with initial breastfeeding. All except one were interviewed on two different occasions resulting in fifteen interviews. The interviews were conducted between 2010 and 2013.ResultsMothers who experience severe difficulties with initial breastfeeding feel both overtaken and violated not only by their own infants and their own bodies but also by their anger, expectations, loneliness and care from health professionals. These feelings of being overtaken and invaded provoke an existential crisis and place mothers at a turning point in which these feelings are compared and put in relation to one another in the negotiation of the decision to continue or cease breastfeeding. This decision thus depends on the possibility of feeling secure with the breastfeeding relationship. If insecurity dominates, this can, in severe cases, create a feeling of fear of breastfeeding that is so great that there is no alternative but to stop breastfeeding.ConclusionsExistential security in the breastfeeding relationship seems to be an underlying factor for confidence and therefore a necessary condition for continued breastfeeding when having severe initial breastfeeding difficulties. Unresolved feelings of insecurity may be a serious barrier to further breastfeeding that can result in a fear of breastfeeding. Such fear can force the mother to cease breastfeeding. This study highlights how women are situated in a complex cultural and biological context of breastfeeding that has existential consequences for them. An existential crisis forces mothers into a turning point for the breastfeeding decision. In the existential crisis, mothers’ responsibility for the mother-infant relationship guides continuing or ceasing breastfeeding.

‘Scrutinised, judged and sabotaged’: A qualitative video diary study of first-time breastfeeding mothers

“…This study added to these findings with audio-visual evidence of how the mothers ascribed their emotions to their feelings of persistent scrutiny by the healthcare team and how the feelings persisted and fluctuated in strength over hours and days. However it is interesting that Palmér et al (2015) have suggested that when mothers are able to blame others for their breastfeeding difficulties, they are more likely to continue breastfeeding.…”

Validation of Nursing Outcomes Related to Breastfeeding Establishment

“…Studies report that women's satisfaction with breastfeeding is closely related to the perception that their milk is enough to nurture the infant, and not for the pleasure of breastfeeding only (Heidari, Keshvari, & Kohan, ; Zahra, Monireh, Easa, & Susan, ). Thus, when realizing that the infant was satisfied with the amount of milk offered, a woman tends to feel satisfied, regardless of whether the breastfeeding process caused her pleasure or pain (Palmér, Carlsson, Brunt, & Nyström, ).…”

Conceptual and operational definition of nursing outcomes regarding the breastfeeding establishment

“…Operational definition: Upon inspection or palpation, observe whether the breasts contain milk before the baby is positioned to start sucking (27,(45)(46)53,55,57,59,74) . before and during breastfeeding (21,(28)(29)33,49,60,63,65) . in the oropharynx (38)(39)(44)(45)52,61,65,68,(70)(71) .…”

“…Operational definition: Observe, when talking to the mother, if she is knowledgeable about techniques that help prevent nipple sensitivity (21,36,44,46,53,55,59,63,70,(73)(74)(75).…”