[Women and breast feeding: understanding their experiences and analyzing the performance of the health system]

Abstract

Objective: To understand the conditioning factors which, whether negatively or positively, affect the success or failure of breast-feeding and to analyse the intervention of the health system to support it.

Design: A descriptive, prospective study which uses qualitative methodology in data gathering and analysis.

Setting: Health District of Santa Perpetua de la Mogoda, Barcelona.

Participants: 56 in-depth interviews of 20 women were carried out at different moments of the pregnancy and suckling.

Measurements and main results: The decision to breast-feed was taken by women before or during their pregnancy under the influence of their social and family environment. The performance of the health system had little influence on the decision. The birth, even if it was pathological, did not prevent breast-feeding except when it was experienced as a failure. The days before the milk came increased women's insecurity about their capacity to suckle. Information from hospitals was evaluated as being scant. Fear of not feeding the baby well was the major source of breast-feeding failure. Mothers who breast-fed for longer felt they received more sympathy from paediatricians than those who gave up early. These felt blamed and did not seek doctors' advice on their decision.

Conclusions: The health system has to plan an efficient intervention to support breast-feeding in the most crucial moments: after the birth and on arriving home.