Indicators of 'good' feeding, breastfeeding latch, and feeding experiences among healthy women with healthy infants: A qualitative pathway analysis using Grounded Theory

Background: Breastfeeding behaviour remains a public health priority worldwide. Despite evidencebased guidelines, healthy women who give birth to healthy, term infants continue to face barriers to breastfeeding. Understanding women's experiences of feeding in the early postnatal period is crucial to identify how support may be better tailored to improve breastfeeding outcomes, including women's experiences. Question: To understand women's experiences of infant feeding amongst healthy women who give birth to healthy, average-weight, term infants. Methods: Grounded Theory methodology was used to analyse data from a nested qualitative interview study. Twelve women between four and twelve months postpartum were recruited from a longitudinal cohort study and public advertisements. Semi-structured face-to-face interviews were audio-recorded and transcribed for analysis. Findings: Three distinct themes were found, subsuming identified super-categories: Perceived indicators of 'good' feeding (infant 'output'; infant crying; weight gain; feeding frequency and duration); Women's experiences of breastfeeding latch ('good' latch; 'bad' latch with pain and discomfort); and Overall breastfeeding experience (positive; negative; and uncertain). Data suggest women give precedence to their latch experiences over indicators of 'good' feeding, highlighting breastfeeding latch as a possible mediating factor to the overall breastfeeding experience. Feeding experience can be achieved through four distinct pathways. Discussion: The physical and psychological impacts of latch pain were pronounced. Even amongst healthy women with healthy infants, a positive breastfeeding experience overall was uncommon, highlighting the difficulties women continue to encounter. Understanding women's perceptions of 'good' feeding, and ensuring a pain-free latch, may better support women to have a positive breastfeeding experience. (c) 2020 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Automated summary

Women prioritize latch experiences over feeding indicators, with nipple pain being a key factor affecting the overall breastfeeding experience. Feeding experience can be achieved through four distinct pathways.