Objective To investigate the infant feeding experiences of women and their significant others from pregnancy until 6 months after birth to establish what would make a difference.
Design Qualitative serial interview study.
Setting Two health boards in Scotland.
Participants 72 of 541 invited pregnant women volunteered. 220 interviews approximately every 4 weeks with 36 women, 26 partners, eight maternal mothers, one sister and two health professionals took place.
Results The overarching theme was a clash between overt or covert infant feeding idealism and the reality experienced. This is manifest as pivotal points where families perceive that the only solution that will restore family well-being is to stop breast feeding or introduce solids. Immediate family well-being is the overriding goal rather than theoretical longer term health benefits. Feeding education is perceived as unrealistic, overly technical and rules based which can undermine women's confidence. Unanimously families would prefer the balance to shift away from antenatal theory towards more help immediately after birth and at 3–4 months when solids are being considered. Family-orientated interactive discussions are valued above breastfeeding-centred checklist style encounters.
Conclusions Adopting idealistic global policy goals like exclusive breast feeding until 6 months as individual goals for women is unhelpful. More achievable incremental goals are recommended. Using a proactive family-centred narrative approach to feeding care might enable pivotal points to be anticipated and resolved. More attention to the diverse values, meanings and emotions around infant feeding within families could help to reconcile health ideals with reality.
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Review history and Supplementary material
To cite: Hoddinott P, Craig LCA, Britten J, et al. A serial qualitative interview study of infant feeding experiences: idealism meets realism. BMJ Open 2012;2:e000504. doi:10.1136/bmjopen-2011-000504
Contributors All authors were involved in the design of the study, the analysis of data and the writing and editing of this paper. LC and JB conducted the interviews with participants. All authors had full access to all the data in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. PH wrote the first draft of the paper, and all authors made important intellectual contributions to the content and approved the final version.
Funding This study was funded by NHS Health Scotland. The Health Service Research Unit, University of Aberdeen, is supported by the Chief Scientist Office (CSO) of the Scottish Government Health Directorates. The views expressed are those of the authors and the authors are all independent of the funding body.
Competing interests None.
Ethics approval Approval was obtained from the North of Scotland Research Ethics Committee (reference number 09/S0802/65). All participants provided written informed consent and any details that could allow identification of participants have been changed to protect confidentiality.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement A full study report is available at http://www.healthscotland.com/documents/4720.aspx and no additional data are available as consent was not obtained.
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