A Situational Analysis of the Discourse of Mothers Who Have Chosen an Alternative to Exclusive Breastfeeding: Challenges in Nursing Practice
Download PDF

Keywords

Breastfeeding
Autonomy
Decision-making process
Situational analysis
Feminism
Submitted : 2023-05-27
Accepted : 2023-06-11
Published : 2023-06-26

Abstract

The health benefits of breastfeeding for infants have been established by numerous scientific studies. However, mothers who opt for alternatives to exclusive breastfeeding may feel guilty or that they have failed. This issue raises the importance of understanding the experiences of these mothers, who live on the fringes of public policies and healthcare practices that currently favor exclusive breastfeeding. This qualitative research presents a situational analysis of the experiences of nine mothers who chose alternatives to breastfeeding and interviewed in the form of semi-structured interviews. The results describe the decision-making processes involved in choosing an alternative to breastfeeding, situate this choice within a set of care measures that are culturally congruent with breastfeeding, and position this choice in relation to the social norm of breastfeeding. The discussion presents the processes of negotiation and resistance mobilized by the mothers concerning the different norms related to breastfeeding.

References

Binns C, Lee M, Low WY, 2016, The Long-Term Public Health Benefits of Breastfeeding. Asia-Pacific Journal of Public Health, 28(1): 7–14.

Colen CG, Ramey DM, 2014, Is Best Truly Best? Estimating the Effects of Breastfeeding on Long-Term Child Health and Wellbeing in the United States Using Sibling Comparisons. Social, Science and Medicine, 109: 55–65.

World Health Organization, 2021, Exclusive Breastfeeding, viewed on April 23, 2021. http://www.who.int/elena/titles/exclusive_breastfeeding/fr/

UNICEF, 2021, Allaitement [Breastfeeding], viewed on April 23, 2021. http://www.unicef.org/french/nutrition/index_24824.html

Ministry of Health and Social Services of Quebec, 2021, Initiative des Amis des Bébés [Baby-Friendly Initiative], viewed on April 23, 2021. http://www.msss.gouv.qc.ca/professionnels/amis-des-bebes/

Ordre des infirmières et infirmiers du Québec, 2015, Standards de Pratique de l’Infirmière: Soins de Proximité en Périnatalité [Standards of Nursing Practice: Perinatal Care], viewed on November 2, 2020. http://www.oiiq.org/sites/default/files/4443-perinatalite-web.pdf

Ordre des Sages-Femmes du Québec, 2020, Philosophie et Normes de Pratique [Philosophy and Standards of Practice], viewed November 2, 2020. https://www.osfq.org/quest-ce-quune-sage-femme/philosophie-et-normes-depratiques/

Goberna-Tricas J, Banus-Gimenez R, Palacio-Tauste A, et al., 2011, Satisfaction with Pregnancy and Birth Services: The Quality of Maternity Care Service as Experienced by Women. Midwifery, 27(6): 231–237.

Murphy E, 1999, “Breast is Best”: Infant Feeding Decisions and Maternal Deviance. Sociology of Health and Illness, 21(2): 187–208.

Fallon V, Komninou S, Bennett KM, et al., 2017, The Emotional and Practical Experiences of Formula-Feeding Mothers. Maternal and Child Nutrition, 13(4): 1–14.

Hunt L, Thomson G, 2017, Pressure and Judgement Within a Dichotomous Landscape on Infant Feeding: A Grounded Theory Study to Explore Why Breastfeeding Women Do Not Access Peer Support Provision. Maternal and Child Nutrition, 13(2): 1–13.

Hvatum I, Glavin K, 2016, Mothers’ Experience of Not Breastfeeding in a Breastfeeding Culture. Journal of Clinical Nursing, 26(19–20): 3144–3155.

Wirihana LA, Barnard A, 2011, Women’s Perceptions of Their Healthcare Experience When They Choose Not to Breastfeed. Women and Birth, 25(3): 135–141.

Chabrol H, Walburg V, Teisssedre F, et al., 2004, Influence of Mother’s Perceptions on the Choice to Breastfeed or Bottle-Feed: Perceptions and Feeding Choice. Journal of Reproductive and Infant, 22(3): 189–198.

Knaak SJ, 2010, Contextualising Risk, Constructing Choice: Breastfeeding and Good Mothering in Risk Society. Health, Risk & Society, 12(4): 345–355.

Labbok M, 2008, Exploration of Guilt Among Mothers Who Do Not Breastfeed: The Physician’s Role. Journal of Human Lactation, 24(1): 80–84.

Lee E, 2008, Living with Risk in the Era of ‘Intensive Motherhood’: Maternal Identity and Infant Feeding. Health, Risk and Society, 10(5): 467–477.

Mander R, 2008, Baby Friendly-Mother Friendly? Policy Issues in Breastfeeding Promotion. MIDIRS Midwifery Digest, 18(1): 104–108.

Nihlén Fahlquist J, 2016, Experience of Non-Breastfeeding Mothers. Norms and Ethically Responsible Risk Communication. Nursing Ethics, 23(2): 231–241.

Redshaw M, Henderson J, 2012, Learning the Hard Way: Expectations and Experiences of Infant Feeding Support. Birth Issues in Perinatal Care, 39(1): 21–29.

Lakshman R, Ogilvie D, Ong KK, 2009, Mothers’ Experiences of Bottle-Feeding: A Systematic Review of Qualitative and Quantitative Studies. Arch Dis Child, 94(8): 596–601.

Chumova M, 2014, Le Guide Pratique Mieux Vivre Avec Notreenfant: Témoin des Discours et Représentations Autour del’allaitement [The Practical Guide to Living Better with Our Child: Witness to the Discourse and Representations Around Breastfeeding], in La Promotion de l’Allaitement au Québec [Promoting Breastfeeding in Quebec], Les Éditions du Remue-Ménage, Montreal, 45–65.

Gostin LO, 2008, Public Health Law: Power, Duty, Restraint (2nd Ed.), University of California Press, Los Angeles.

Leininger M, 2002, Culture Care Theory: A Major Contributionto Advance Transcultural Nursing Knowledge and Practice. Journal of Transcultural Nursing, 13(3): 189–192.

Clarke A, Friese C, Washburn R, 2018, Situational Analysis: Grounded Theory After the Interpretative Turn, Sage Publications, California.

Badinter E, 2010, Le Conflit, La Femme et La Mère [The Conflict, The Woman and The Mother], Flammarion, Paris.

McBride-Henry K, 2010, The Influence of the “They”: An Interpretation of Breastfeeding Culture in New Zealand. Qualitative Health Research, 20(6): 768–777.

Spencer RL, Greatrex-White S, Fraser DM, 2015, ‘I Thought It Would Keep Them All Quiet’. Women’s Experiences of Breastfeeding as Illusions of Compliance: An Interpretive Phenomenological Study. Journal of Advanced Nursing, 71(5): 1076–1086.

Striley KM, Field-Springer K, 2014, The Bad Mother Police: Theorizing Risk Orders in the Discourses of Infant Feeding Practices. Health Communication, 29(6): 552–562.

Thomson G, Ebisch-Burton K, Flacking R, 2015, Shame If You Do–Shame If You Don’t: Women’s Experiences of Infant Feeding. Maternal and Child Nutrition, 11(1): 33–46.

Lee E, 2007, Health, Morality, and Infant Feeding: British Mothers’ Experiences of Formula Milk Use in the Early Weeks. Sociology of Health and Illness, 29(7): 1075–1090.

Thomson G, Dykes F, 2011, Women’s Sense of Coherence Related to Their Infant Feeding Experiences. Maternal and Child Nutrition, 7(2): 160–174.

Wolf J, 2007, Is Breast Really Best? Risk and Total Motherhood in the National Breastfeeding. Awareness Campaign. Journal of Health Politics, Policy and Law, 32(4): 59.

Eden AR, 2012, New Professions and Old Practices. Lactation Consulting and the Medicalization of Breastfeeding, in Beyond Health, Beyond Choice: Breastfeeding Constraints and Realities, Rutgers University Press, New Jersey, 98–109.

Rivard A, 2014, Histoire de l’Accouchement dans un Québec Moderne [History of Childbirth in Modern Quebec], Les Éditions du Remue-Ménage, Montreal.

Sheehan A, Schmied V, Barclay l, 2009, Women’s Experiences of Infant Feeding Support in the First 6 Weeks Post-Birth. Maternal and Child Nutrition, 5(2): 138–150.

McCarter-Spaulding D, 2008, Is Breastfeeding Fair? Tensions in feminist Perspectives on Breastfeeding and the Family. Journal of Human Lactation, 24(2): 206–212.

Johns HM, Amir LH, McLachlan HL, et al., 2016, Breast Pump Use Amongst Mothers of Healthy Term Infants in Melbourne Australia: A Prospective Cohort Study. Midwifery, 33: 82–89.

Lowdermilk LD, Perry ES, Cashion K, 2018, Périnatalité [Perinatal], Chenelière Education, Montreal.

Jones SR, Stoppard M, 2011, Baby Friendly Hospital: Are We Failing Mother Who Formula Feed Their Babies? Journal of Family Health Care, 21(1): 12–14.

Battersby S, 2014, The Role of the Midwife in Breastfeeding: Dichotomies and Dissonance. British Journal of Midwifery, 22(8): 551–556.

Benoit B, Goldberg L, Campbell-Yeo M, 2016, Infant Feeding and Maternal Guilt: The Application of a Feminist Phenomenological Framework to Guide Clinician Practices in Breast Feeding Promotion. Midwifery, 34: 58–65.

Carroll M, Gallagher L, Clarke M, et al., 2015, Artificial Milk-Feeding Women’s Views of Their Feeding Choice in Ireland. Midwifery, 31(6): 640–646.

Ross L, 2003, Guide de Santé Postnatale 9 Mois Plus Tard [Postnatal Health Guide 9 Months Later], viewed on November 2, 2020. http://collections.banq.qc.ca/ark:/52327/bs57392

Massé R, 2014, Éthique et Santé Publique. Enjeux, Valeurs et Normativité (6e Ed.) [Ethics and Public Health. Issues, Values and Normativity (6th Ed.)], Presses de l'Université Laval, Quebec.

Government of Quebec, 1991, CCQ-1991: Code civil du Québec [Civil Code of Quebec], viewed on November 2, 2020. http://legisquebec.gouv.qc.ca/fr/ShowDoc/cs/CCQ-1991

Bayard C, 2014, Introduction, in La Promotion de l’Allaitement au Québec [Breastfeeding Promotion in Quebec], Les Éditions du Remue-Ménage, Montreal, 17–22.

Lee R, 2019, Queering Lactation: Contributions of Queer Theory to Lactation Support for LGBTQIA2S+ Individuals and Families. Journal of Human Lactation, 35(2): 233–238.

Pepin J, Ducharme F, Kérouac S, 2017, La Pensée Infirmière (4e Ed.) [Nursing Thought (4th Ed.)], Chenelière Éducation, Montreal.