The breast or bottle? Women’s infant feedings choices in a subsequent birth after a previous Caesarean Section

Abstract

Objective: The objective of the study was to explore, from mothers’ perspectives, the experiences and decision‑making associated with a subsequent birth following a Caesarean Section (CS) of which feeding their newborns was a specific focus. This article presents the sub‑set of findings on infant feeding choices. Design: A qualitative methodological framework, utilizing descriptive phenomenology. Setting: A maternity hospital in Brisbane, Australia. Participants: Twenty women who had given birth at Redland Hospital after experiencing a previous CS were invited to participate. Data Collection Techniques: Tape recorded interviews were conducted six weeks postpartum. Results: The findings identify that mothers fell into three different attitudinal groups regarding their decision‑making with respect to feeding their newborn. The first perspective was based on a strong commitment to breastfeeding, which was often maintained in the face of quite significant difficulties. The second perspective was a complete refusal to breastfeed and a clear decision to bottle feed made prior to the birth and adhered to irrespective of alternative advice or persuasion. The third perspective was an initial desire to breastfeed that was easily thwarted by difficulties. The findings emphasise the importance of facilitating for CS births an environment that promotes bonding and breastfeeding by ensuring, where possible, that there is no separation of mother and baby after the birth, maximum opportunity for skin‑to‑skin contact, time for the mother to breastfeed the baby in the period immediately after the birth and no supplementation of breastfeeding with formula. Conclusions: The success of the midwife or maternity nurse in relation to supporting breastfeeding was, in part, impacted on by the mother’s pre‑determined approach to feeding the newborn. Breastfeeding support for attitudinal groups one and three were most likely to be successful, while the second group was refractory to nursing breastfeeding assistance.