A qualitative approach to social support and breast-feeding decisions

Objective: to explore pregnant women's perceptions and personal experiences of the influence of formal and informal social support on breast-feeding decision-making, in relation to breast-feeding initiation and duration. Design: qualitative focus groups and interviews. Setting: four primary-care centres in Valencia, Spain. Participants: 19 primiparous women in their first trimester of pregnancy participated in focus groups and 12 primiparous and multiparous women in their third trimester of pregnancy participated in interviews. Women had different socio-demographic backgrounds and socio-economic status. Findings and conclusions: women's perceptions and personal experiences of formal and informal social support of breast feeding may be linked to age and socio-cultural status. Women from higher socio-cultural backgrounds took their partner's opinion and support more into account when choosing breast feeding. They also conceded great importance to formal health support, and employed mothers wished to have more institutional support. Among women from tower socio-cultural backgrounds, friends were the closest social network and had the greatest influence on feeding decisions. They perceived some contradictions in health-promotion messages on breast feeding, and most of them preferred to leave work after birth to exclusively care for their baby. Younger women, without previous experience of breast feeding or possibility of receiving tangible support from their mothers, wanted more practical health-care support (e.g. providing skills in breast-feeding technique). Implications for practice: breast-feeding promotion strategies should take into account women's different characteristics. Health professionals should consider offering postnatal support as a follow-up to practical support (e.g. breast-feeding workshops). (c) 2007 Elsevier Ltd. All rights reserved.