Examining Supports and Barriers to Breastfeeding through a Socio-Ecological Lens: A Qualitative Study

Abstract BACKGROUND: Early breastfeeding cessation is a societal concern given the massive benefits associated with breastfeeding for mother and child. More effective interventions are needed to increase breastfeeding duration. Prior to developing such interventions more research is needed to examine breastfeeding supports and barriers from the perspective of breastfeeding stakeholders. One such framework that can be utilized is the Socio-Ecological Model which stems from Urie Broffenbrenner’s early theoretical frameworks (1973-1979). The purpose of this study was to examine supports and barriers to breastfeeding across environmental systems. METHODS: A total of 49 representatives participated in a telephonic interview. Interviewees represented various levels of the model based on their current breastfeeding experience (i.e., mother or significant other) or occupation. A direct content analysis was performed as well as a constant comparative analysis to determine differences between level representatives. RESULTS: Common supports identified by all interviewees were in-hospital breastfeeding education (organizational level) and the existence of breastfeeding protection legislation (policy level). Barriers identified by all interviewees included a lack of support (interpersonal level), lack of hospital resources (organizational level) and lack of specificity within the existing breastfeeding protection legislation (policy level). Other identified supports and barriers varied by representatives for each level of the model. CONCLUSION: Future efforts should target multiple levels of the SEM to eliminate the disparities between breastfeeding mothers’ perceptions and the stakeholders working to increase breastfeeding initiation and duration rate.