Breast-feeding difficulties experienced by women taking part in a qualitative interview study of postnatal depression

Abstract

Objective: to explore how women experience breast-feeding difficulties. This theme emerged unexpectedly during a study of women's experiences of screening with the Edinburgh postnatal depression scale (EPDS) and subsequent care from primary health-care professionals. Design: qualitative in-depth interview study. Setting: postnatal women of 22 general practices within Oxford City Primary Care Group area. Participants: 39 postnatal women from a purposeful sample were interviewed at an average of 15 months postnatal. They were chosen from different general practices and with a range of emotional difficulties after birth, judged using EPDS results at eight weeks and eight months postnatal, and whether they received ‘listening visits’ from health visitors. Measurements and findings: a qualitative thematic analysis was used, including searches for anticipated and emergent themes. Fifteen women had breast-feeding difficulties. Five themes emerged which explore the difficulties. Firstly, commitment to breast feeding and high expectations of success; secondly, unexpected difficulties; thirdly, seeking professional support for difficulties; fourthly, finding a way to cope; and fifthly, guilt. Key conclusions: in this study breast-feeding difficulties were common, caused emotional distress and interactions with professionals could be difficult. Current breast-feeding policy, such as the ‘Baby Friendly Initiative’, may be a contributing factor. This needs to be explored in a further study.