Experiences and attitudes of breastfeeding mothers related to support on their breastfeeding journeys: a reflexive thematic analysis

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While 54.3% of mothers start breastfeeding after birth, only 1% exclusively breastfeed for the first six months and barely anyone continues for up to two years as, recommended by the World Health Organization and UNICEF. Methods Eight interviews were conducted with mothers who breastfed for at least nine months of their baby’s life. The participants were between 38 and 52 years old and originated from different countries. They all had a similar level of education and partnership status while breastfeeding, and all lived in East London at the time of the study. Results Four themes were created from the interview transcripts: “Breastfeeding is hard”, “Breastfeeding is magical”, “Breastfeeding is an emotional rollercoaster”, and “Support is everything”. Conclusion There are two key findings. First, support is crucial when it comes to breastfeeding. Support may be given by the mother’s partner or by her own mother, but the support from other mothers and healthcare professionals is especially important. This support can even be provided by phone/video call to conserve the resources off the healthcare professional and the energy of the new mother. Second, education and knowledge about breastfeeding will better prepare a mother and increase her self-confidence, enabling her to make an informed choice about breastfeeding. breastfeeding journey self-efficacy peer support support from grandmothers partners and healthcare professionals Introduction This introduction discusses key terms described in this study and presents the global recommendations and current statistics around breastfeeding. Breastfeeding has been described as a journey with milestones and a clear beginning and ending (Foxworthy Scott & Bute, 2024). The benefits of breastfeeding, such as nutrition and immune support, are presented, and the characteristics and motivations of mothers who breastfeed – especially those who continue breastfeeding for longer – are explored. How breastfeeding mothers are supported by their partners, their mothers, healthcare providers (HCPs), and other mothers is evaluated. Finally, policies supporting a breastfeeding-friendly environment, as well as the alternatives to breastfeeding are discussed. In this study the terms ‘breastfeeding’ and ‘mothers’ are used for brevity. The term ‘mother’ is used to describe the birthing and breastfeeding person, because all participants identified as mothers and referred to themselves in this way during the interviews. However, it is acknowledged that some people who breastfeed might not identify as a mother and/or would prefer the term chest feeding. Recommendations and statistics While the benefits of breastfeeding, especially exclusive breastfeeding, are known by researchers, the global breastfeeding rates are decreasing and fall below the targets of the World Health Organization (WHO) and other organisations (Lehane et al., 2024). The current recommendations from the WHO and UNICEF are that mothers start breastfeeding within the first hour after birth, exclusively breastfeed for the first six months and continue to breastfeed until the infant is at least two years old (WHO, 2025). However, in 2024, 44% of babies aged 0–6 months worldwide were exclusively breastfed, meaning only receiving breastmilk either directly from the mother’s breast or expressed and administered via a bottle. The WHO aims to increase the rate of exclusively breastfeeding to at least 50% by the end of 2025 and 70% by 2030 (WHO, 2023). While babies can be breast or bottle-fed (or tube-fed for those with feeding difficulties) the WHO describes breastfeeding as ‘‘the normal way’’ to feed a baby (WHO, 2025). The research presented in this dissertation was done in London and focusses on statistics in the UK. Little research has been done about breastfeeding rates in London specifically, nor on breastfeeding rates among mothers of different ethnicities. However, the UK is ranked 67 th on the World Breastfeeding Trends Initiative (WBTI, 2025), and exclusive breastfeeding rates in England are among the lowest worldwide: 54.3% at birth, 17% at three months, 12% at four months and 1% at six months (Office for Health Improvement and Disparities, 2025). Although these are low, the rates have risen over time. For example, the rates of ever breastfeeding are 55% at six weeks (versus 48% in 2005) and 34% at six months (versus 25% in 2005), according to the Office for Health Improvement and Disparities (2025). After six months, babies in the UK tend to be weaned, and, therefore, feeding becomes a combination of breastmilk and solid foods. UNICEF launched the global Baby-Friendly Hospital Initiative (BFHI) in 1994 and rewarded health organizations with accreditation based on standards relating to maternity and child service (UNICEF, 2025). In the UK, almost 95% of maternity units have received BFHI accreditation (or are currently working towards it) (UNICEF, 2025), which could have contributed to the increasing rates over the past 20 years. Nonetheless, the number of mothers who continue to breastfeed for over one year is only 0.5%, and the number continuing until 2 years (adhering to the WHO recommendation) is negligible (Office for Health Improvement and Disparities, 2025). Benefits of breastfeeding Breastmilk is widely recognised for its adaptive, interactional and dynamic nature, contributing to improved infant survival, growth and development (Pérez-Escamilla et al., 2023). It is estimated that an annual 823,000 infant deaths worldwide could be prevented if all mothers breastfed their babies until two years of age (WHO, 2025; Victora et al., 2016). The benefits are partially due to hormones in breastmilk that regulate a baby’s appetite, digestion, and sleep (Shaji et al., 2024), although night waking is normal for all babies regardless of their feeding habits (Brown & Harries, 2015). Besides that, breastmilk also provides babies with extra immune protection and reduces the chances of sudden infant death syndrome (Hauck et al., 2011). Studies indicate that breastfeeding reduces the risk of ear infections and asthma, as well as diabetes and obesity in later life (Lehane et al., 2024; Pérez-Escamilla et al., 2023). Additionally, Di Mario et al. (2019) found that formula feeding was associated with more need for antibiotics, and Shaji et al. (2024) reported a lower rate of hospitalisation in breastfed babies. Breastfeeding has also been associated with cognitive and socioeconomic benefits. Some studies have suggested that breastfed children have higher IQs and better school attendance and engagement, potentially leading to higher income in later life (Pérez-Escamilla et al., 2023; Lehane et al., 2024). However, it remains unclear if this is due to the mother’s higher IQ, the composition of the milk or other reasons. Indeed, factors such as parental education and genetics also play significant roles (Krol & Grossmann, 2018; Bartels et al., 2009). Another advantage of breastfeeding is related to mental health. Pérez-Escamilla et al. (2023) provided evidence that the composition of breastmilk changes in response to the infant’s needs, as well as to the mother’s and infant’s physical and emotional well-being. Breastfeeding also reduces stress for both mother and child due to the release of oxytocin and other hormones (Gust et al., 2020), although these benefits can also be activated by skin-to-skin contact (UNICEF, 2016) which can be practised regardless of feeding habits. Breastfeeding mothers seem to experience fewer and shorter episodes of post-partum depression (Kim et al., 2021; Xia et al., 2022), which might be related to the optimisation of cortisol levels (Gust et al., 2020) and better regulation of stress responses in the parasympathetic nervous system (Sibolboro Mezzacappa, 2004, as cited by García et al. 2024). However, it is acknowledged that mothers can also experience stress related to breastfeeding difficulties (Fewtrell et al., 2020) or loss of independence (Brown & Arnott, 2014), impacting their anxiety levels and well-being. Besides benefits for the child, breastfeeding also has health advantages for mothers. Studies estimate that 20,000 to 98,000 maternal deaths could be prevented annually by breastfeeding (Castro-Cuervo, 2025; Victora et al., 2016), because breastfeeding positively affects the amount of postpartum blood loss and reduces the chances of breast and ovarian cancer (Victora et al., 2016) as well as Type 2 diabetes (Gunderson et al., 2015). However, challenges such as physical discomfort can impact a mother’s ability to breastfeed (Levinienė et al., 2013). One benefit that is not often mentioned is the financial savings of breastfeeding, which are estimated to be as much as 341.3 billion USD a year in total (Victora et al., 2016). Additionally, breastfeeding has an impact on sustainability, as it causes less (food) waste (Lehane, 2024). Nonetheless, it is important to consider that not all mothers have access to workplace accommodations or adequate support systems, including antenatal education, which may limit their ability to breastfeed. Characteristics of mothers Mothers who breastfeed for an extended period tended to be breastfed themselves (Crawford et al., 2023; Cole et al., 2024) and older when they became a mother (between 31 and 40 years) according to Michalopoulou et al. (2024) and Levinienė et al. (2013). They are also more likely to be better educated (with almost 80% having university degrees), to be married or living with the father of their child, and to have had a planned pregnancy (Levinienė et al., 2013), and may also have a higher socioeconomic status (SES; Kozachenko et al., 2024). All these characteristics create favourable circumstances for breastfeeding, and it is acknowledged that not every woman has these privileges. How much mothers know about the benefits of breastfeeding is a motivation to start breastfeeding, and women who decide to breastfeed while still pregnant are more likely to breastfeed than those who make this decision after birth (Xu et al., 2021). Breastfeeding mothers tend to feed their babies on demand and do not offer their babies formula milk or pacifiers (Levinienė et al., 2013; Muelbert & Giugliani, 2018). Mothers tend to breastfeed their second child longer than their first (Kozachenko et al., 2024). In contrast, besides having the opposite characteristics of mothers who breastfed for longer, mothers who breastfed for less than six weeks were also more often smokers, obese, and/or had high gestational weight gain (Levinienė et al., 2013). Some mothers choose to formula feed due to a desire for independence and routine (Brown & Arnott, 2014). Mothers who have to return to work also often breastfeed for a shorter time (Xu et al., 2021). Crawford et al. (2023) stated that both breastfeeding initiation and duration were negatively impacted by having a caesarean delivery compared to a vaginal delivery. However, the relationship between the type of birth and breastfeeding is not consistent in the literature. Some research has shown that milk supply might be delayed following a caesarean delivery (Di Mario et al., 2019), while others did not establish any correlation (Prior et al., 2012). Furthermore, pain medication such as an epidural had contradictory findings in relation to breastfeeding outcomes (Levinienė et al., 2013). Lastly, if mothers started breastfeeding immediately after birth, this influenced their adaptation to breastfeeding (Kozachenko et al., 2024). While some studies suggested that a positive birth experience resulted in higher breastfeeding rates and negative experiences led to less breastfeeding (Di Mario et al., 2019; Brown & Arnott, 2014), Çark & Çankaya (2024) did not find any significant relationship between birth satisfaction and breastfeeding. For this reason, the topic of delivery type was not further explored in this research. Self-efficacy The greater the sense of self-efficacy, the more effort mothers tend to make to continue to breastfeed (Castro-Cuervo et al., 2025). Originating from Bandura’s (1986) social-cognitive theory, self-efficacy indicates an individual's belief in their capability to achieve a specific goal. Dennis (2003) applied this theory to breastfeeding, proposing that a mother’s breastfeeding self-efficacy influenced her efforts, thoughts, and overall responses to breastfeeding, which in turn impact the initiation and continuation of breastfeeding. Dennis and Faux (1999) created the Breastfeeding Self-Efficacy Scale (BSES), which measures a mother’s confidence in her ability to breastfeed successfully. Later, Dennis simplified the scale from 33 to 14 items, creating the BSES-Short Form (Dennis, 2003). Castro-Cuervo et al. (2025) explored the scale’s structure and proposed a three-dimensional structure, incorporating competence, motivation, and confidence, with the latter increasing as the mother had more breastfeeding experience. The current study does not include the use of the BSES-SF because all participants had stopped breastfeeding at the time of the study. However, the study does refer to self-efficacy as an important factor in breastfeeding, especially the competence component. García et al. (2024) used the BSES-SF scale and reported that mothers who exclusively breastfed reported a significantly higher level of self-efficacy (t(94) = 2.4, p = .044). Huang et al. (2024) also found that lower self-efficacy in first-time mothers was related to a lack of knowledge and unrealistic expectations. However, besides higher self-efficacy levels, mothers who exclusively breastfed at five months post-partum did not report better mental health due to breastfeeding. This finding was consistent with earlier studies that suggested that there was no correlation between exclusive breastfeeding and maternal mental health a few months postpartum (García et al., 2024). First-time mothers were at higher risk of feeling confused or anxious about breastfeeding and low support was found to lead to low self-efficacy (Kozachenko et al., 2024). Kim et al. (2021) found a negative relationship between antepartum depression and exclusive breastfeeding for up to eight weeks and that depressive symptoms strongly influenced exclusive breastfeeding cessation, meaning that post-partum depression led to shorter breastfeeding duration. Another complication was that new mothers received varied – and sometimes even conflicting – advice from HCPs which can also lead to earlier cessation (Lehane, 2024). Self-efficacy and support Knold Rossau et al. (2024) concluded that three out of five women discontinued breastfeeding due to the challenges they experienced in the first weeks and that ensuring consistent support from HCPs may improve breastfeeding rates, but that there was a lack of knowledge and counselling skills. Chambers et al. (2023) also found that the self-efficacy of breastfeeding mothers was related to empathy and emotional support of HCPs, but that many HCPs were overloaded, under pressure and did not have the time or capacity to be emotionally supportive; they advised that HCPs should give non-conflicting, non-judgemental and relevant information about breastfeeding. Jackson and Hallam (2020) and Kronborg et al. (2007) found similar results; they also concluded that mothers needed a positive attitude from HCPs but that HCPs were influenced by their own breastfeeding experience. Therefore, Chambers et al. (2023) argued that a more holistic approach was needed in order to support mothers in their breastfeeding journey. In support of this, it has been shown that maternal mental health is positively impacted by breastfeeding counselling (Chrzan-Detkos et al., 2021, as cited by García et al., 2024). Warm chain To achieve the recommended two years of breastfeeding, mothers need support beyond that provided by their HCPs. Sources of support can be divided into healthcare, workplace, and community, including family life. The ‘warm chain’ describes the support across all three settings (Lancet, 1994, as cited by Tan et al., 2023), emphasising that no single organisation or individual can be solely responsible for supporting breastfeeding; instead, it requires a collective effort. However, the chain is often not coordinated or aligned (Tan et al., 2023). Support of a partner Mothers tend to breastfeed for longer when they have a partner. For example, at six to twelve months, married mothers are twice as likely to still be breastfeeding compared with unmarried mothers (Levinienė et al., 2013). The support of a partner has a positive influence on mothers to start and continue to breastfeed, and it also positively contributes to the self-efficacy of women trying to breastfeed (Yuan et al., 2024). In addition, Emmott and Mace (2015) found that a father’s support was not necessarily only financial, as his emotional support was crucial. However, when a partner offers practical support (for example, bottle-feeding the baby), this could become a reason to stop breastfeeding (Emmott & Mace, 2015). Wang et al. (2020) found that partners with a higher educational background tend to be more positive towards their spouse’s breastfeeding, and they were more likely to familiarise themselves with its benefits. In particular, when a partner received breastfeeding education (for example, by HCPs), their attitudes improved, leading to more support and, therefore, prolonged breastfeeding by their spouses (Yuan et al., 2024). Support of a grandmother If a grandmother had breastfed her child(ren) or had a positive attitude towards breastfeeding, the mother was also more likely to breastfeed her own children (De Brito Angelo et al., 2015; Emmott & Mace, 2015). A grandmother’s positive opinion resulted in a 12% higher chance that a new mother breastfed, while a negative attitude was related to 70% of new mothers being less likely to breastfeed (Negin et al., 2016). Therefore, the education of grandmothers and partners will have beneficial effects on breastfeeding rates (Negin et al., 2016; Brown & Arnott, 2014). Peer support Mothers expressed that breastfeeding is a ‘‘rugged and difficult’’ journey and new mothers benefit from a calm attitude from supporting mothers (Lehane et al., 2024). The influence of peers was an indicator of a continued breastfeeding journey (Jeon et al., 2024; Jackson & Hallam, 2020). Tawia (2024) also found that peer support encouraged mothers to continue to breastfeed, as it reduced their isolation and improved their self-esteem. An example of this was Community Mothers, a project developed in Ireland during the 1980’s; this successful project consisted of mothers visiting new mothers at home to provide peer support (Lehane et al., 2024). Another study showed that peer support was a predictor for breastfeeding at 12 months; in particular, if that support came from mothers who had breastfed for longer, then this motivated new mothers to also continue (Xu et al., 2021). Education and information There are several challenges facing the provision of support for new mothers to start and continue breastfeeding. These challenges include misinformation about breastfeeding physiology, a lack of evidence-based knowledge and skills among HCPs, and insufficient sustained support for exclusive breastfeeding among the wider society (Lehane et al., 2024; Chambers et al., 2023). Research suggests that when information is contradictory, this increases mothers’ frustrations and, therefore, the likelihood that they will stop breastfeeding (Chambers et al., 2023; Marino et al., 2023). Tawia (2024) also found that an authoritative style of advice-giving was seen as judgemental and bossy, and consequently ineffective. It has been argued that support from well-trained HCPs is crucial in order to improve breastfeeding rates (Lehane et al., 2024; Thomson et al., 2015). For example, attending antenatal classes tripled the likelihood of breastfeeding, according to Levinienė et al. (2013), but it is unclear how many people attend antenatal classes and what kind of guidance is given (Kozachenko et al., 2024). Hoddinott et al. (2012) found that antenatal courses made breastfeeding sound easy and did not address the expectation-reality gap. Fewtrell et al. (2020) suggested that breastfeeding education should be provided in schools in order to raise awareness among the entire population. A breastfeeding-friendly environment Besides the warm chain, a new mother’s environment impacts her breastfeeding journey. Therefore, Tan et al. (2023) advocated for breastfeeding-friendly cities where breastfeeding is encouraged, and policies exist to support the whole chain. They found such cities to be better for health and nutrition, as well as more sustainable due to less waste, less use of resources, and a lower carbon footprint (Tan et al., 2023). Breastfeeding-friendly cities also adopt the BFHI; mothers benefit from the support in the hospital due to this initiative but also need support from a qualified person when they return home because breastfeeding extends beyond the length of the hospital stay (Levinienė et al., 2013; McNaughton et al., 2024). Alternatives to breastfeeding In a study with almost 2,000 participants, Michalopoulou et al. (2024) found that 65% of mothers had issues with latching and experienced pain in the first two weeks of breastfeeding. They also found that mothers who mixed-fed using commercial milk formula (CMF) were less committed to breastfeeding and three times more likely to stop (Michalopoulou et al., 2024). However, mixed feeding may be necessary for some mothers due to medical conditions or personal circumstances. The use of CMF increased during the Industrial Revolution, coinciding with a decline in breastfeeding rates (Rollins et al., 2023). However, in the 1970s, the feminist movement had a positive effect on breastfeeding rates due to its emphasis on women’s bodily autonomy and challenging medical authority (Pemberton, 2014). At the same time, other feminist perspectives supported CMF feeding to enable women’s independence and return to the workplace (Johnson et al., 2009). This era also introduced skin-to-skin contact, rooming-in, and greater use of pain medication during labour (Foxworthy Scott & Bute, 2024). It is acknowledged that CMF is necessary for many families; when a child cannot be breastfed, CMF serves as an appropriate alternative (Meek et al., 2022, as cited by Marino et al., 2023). However, concerns have been raised about misleading marketing (Tan et al., 2023), particularly about the promotion of CMF as equal to breastmilk, contrary to most evidence (Shaji et al., 2024; Pérez-Escamilla et al., 2023). Marketing of CMF has been linked to lower breastfeeding rates (Topothai et al., 2023; McNaughton et al., 2024). In response, the WHO introduced a code in 1981 to restrict the marketing of CMF, prohibiting promotion direct-to-consumer and within healthcare settings, but CMF is still provided on some UK maternity wards according to recent research (McNaughton et al., 2024). Currently, CMF packaging must state that ‘breastfeeding is best for babies’ and cannot include pictures of infants (Foxworthy Scott & Bute, 2024; McNaughton et al., 2024). Research question While research demonstrates multiple benefits of breastfeeding, the majority of women do not achieve the recommendation for exclusively breastfeeding for the first six months of their child’s life, and far fewer maintain at least some breastfeeding for at least two years. In light of this, this study aimed to understand – on a local and small scale – what encourages mothers to breastfeed and how society may be able to help women feel comfortable to breastfeed and continue to breastfeed despite the obstacles they face. The research investigated what support is needed for women to thrive in their breastfeeding journey. While there is extensive research about breastfeeding, most research is quantitative, and there are not many reflexive thematic analyses (RTA). Most research is also done on a larger scale, which may not address the topic in sufficient depth. There is also a lack of data on the factors that lead mothers to continue breastfeeding after six months (Kozachenko et al., 2024); such mothers are relatively uncommon, and this research aimed to contribute to closing that gap. Thus, the research questions addressed here were: What do women need in order to pursue and persist in breastfeeding? How do (internal) motivation and (external) attitudes towards breastfeeding influence a breastfeeding journey? Methods Participants Eight women were recruited to participate in this study and take part in semi-structured interviews. The requirement was that they had breastfed for at least nine months of their baby’s life. All participants were mothers and held university degrees. Except for two participants, everyone was married or in a long-term relationship with the father of their children at the time of the interview. They were aged between 34 and 52, with a median of 40. Except for one participant, all participants were above 30 when they had their first child. The participants were all residents of the UK and living in London at the time of the interview. However, they had varied ethnic backgrounds. Participants were purposely invited to explore any differences between their cultures and that in the UK, as well as differences with the researcher’s Dutch culture. Some researchers believe that when a participant and interviewer have similar social characteristics, the interviewee will be more likely to be open and reveal sensitive information (Braun & Clarke, 2013). For the interviews to be effective, it was important that the participants knew that I had breastfed for a substantial amount of time myself. Our friendships meant that participants could be even more honest and open, which was one of the reasons why I chose to interview friends. As I already had background knowledge of each participant, we could skip over introductions and have in-depth conversations. Although recording the sessions might have made the participants more self-conscious, participants were willing to share personal experiences and details, talking about topics from sore nipples to their relationships with their spouses and their mothers. The biographical information of the participants is shown in Table 1; the participants’ names have been changed. Table 1 Description of participants Pseudonym Age Background Duration of breastfeeding (for each child) Begonia 41 Brazilian 1. 16 months (girl) Carnation 52 British 1. 12 months (boy) 2. 7.5 months (boy) 3. 8 weeks (girl) Clematis 38 British 1. 20 months (boy) 2. 34 months (boy) Chrysanthemum 44 British 1. 12 months (boy) 2. 15 months (girl) 3. 14 months (girl) Edelweiss 34 Italian 1. 10 months (girl) 2. 9 months (boy) Gladiolus 43 Korean 1. 15-16 months (boy) 2. 14-15 months (girl) Peony 39 Turkish 1. 3 months plus 3 months expressing (boy) 2. 17 months (boy) Sunflower 39 Turkish 1. 24 months (boy) Procedure Recruitment Recruitment was done via the friend and family approach, meaning that all the participants were known to the researcher. When the research was explained to the participants a few weeks before the interviews, they all agreed to be part of the study. When the first six participants had been interviewed, it became clear that they were all in the same age group and had a similar SES (middle class, double income) because they were all mothers that I had met through the nursery or the private school attended by my children. All of them were able to take maternity leave for at least six to nine months, most even a year, and some of them did not return to work at all. After a few weeks, I reconsidered this decision and added two more interviewees to balance the SES of the sample more evenly. They were single mothers at the time of the interview but had been in a relationship with the father of their child(ren) when they breastfed their babies. Both participants were known to the researcher due to being part of the same cohort at university. The benefit of their inclusion was that the data became richer and more diverse. There were no notable differences between the mothers in the two subsamples, as they all seemed to discuss similar topics and experiences in their interviews. Interviews All interviews were completed via video conference (using Microsoft Teams); the interviews were also recorded via Teams, which has the benefit of automatic transcription. The transcriptions had to be checked and edited afterwards as the different accents made some of the words unclear or captured incorrectly. All participants were given a pseudonym to ensure their anonymity. The names of children and husbands/spouses that were mentioned during the interviews and could identify the participant were also removed from the transcripts. The interviews took place between September 2024 and January 2025 and were about 30–45 minutes each. The interviews were semi-structured: each had the same questions and general structure, but follow-up or clarification questions were asked to ensure that the answers were understood in the way they were intended. Semi-structured interviews also give a chance for participants to raise any matters they think are of importance to the research topic (Braun & Clarke, 2013). The interview questions explored the intrinsic motivation to breastfeed (e.g. Why did you want to breastfeed? ) and revealed what was happening in the participants’ inner world while they were breastfeeding (e.g. How did it make you feel to be able to breastfeed? ). They also explored how mothers experienced the support of their spouse, own mother, HCPs, and other mothers. Due to the small sample size, the interview questions were not focused on cultural differences, although participants did refer to their original cultures. RTA is not ideal for generalisations and one person cannot represent a whole culture, especially with each woman living in London for a substantial amount of time and having adapted to the UK culture. Interview questions can be found in Appendix 1. Only mothers who had breasted were interviewed in order to explore the reasons for breastfeeding, the relationship with being breastfed, and other motivations. If non-breastfeeding mothers had been included, the research would have been notably different. Since the aim was to explore the participants’ lived experiences, their partners were also excluded from the study. Data analysis RTA is an adaptable theoretical approach, which means that data can be interpreted on psychological and social aspects and themes. RTA offers the potential for unexpected insights (Braun & Clarke, 2022). Not being an experienced researcher, I felt most comfortable with a flexible, research-centric approach where I was allowed to be creative with the interpretation. RTA consists of six phases: familiarisation with the data, generating codes, combining codes into themes, refining themes, naming themes, and describing the findings (Braun & Clarke, 2022). An advantage of RTA is that one can go back and forth between analysing the data, doing research, and recording findings, then repeating this process until it is finished. After each interview was conducted, it was transcribed immediately afterwards so as not to lose any impressions and to ensure everything was captured correctly. After all the interviews were transcribed, I listened to the recordings several times to familiarise myself with the emotions and intonations of the speaker. Following the six phases of RTA, I also read and reread the transcripts to immerse myself in the data. Following this, I created my initial coding ideas of topics and sentences that stood out for me. I used a top-down approach using my research question to define codes, as well as a bottom-up approach in which I worked with the data to discover more codes. Next, I used Delve, an online data analysis tool, to create codes using descriptive, in vivo, and process coding. In this tool, I was able to highlight and tag paragraphs that belonged to specific codes to create evidence. This process was followed for each of the eight transcripts, resulting in over 70 codes (Appendix 2). These codes were narrowed down by merging and joining those that had similarities, as well as deleting those which only had one paragraph as evidence or were mentioned by only one participant. RTA requires researchers to engage and re-engage with the data rather than draw conclusions after the first analysis, as this might lead to superficial results (Braun & Clarke, 2022). After working on different aspects of the dissertation, I immersed myself in the data for a third time to assess whether new and different topics would emerge. Lastly, I compared the themes produced by all three data analyses described above, as these seemed to be the strongest; these themes became the ones discussed in this report. Ethical considerations The study adhered to the ‘Code of Conduct of the British Psychology Society’ (British Psychology Society, 2021). The project proposal was reviewed and approved by the ethical committee of the University of East London’s School for Psychology prior to the research taking place. The ethical approval can be found in Appendix 3. Each participant received a Participant Information Sheet (Appendix 4), which provided relevant information about the research. They received these in advance so that they had a chance to read them before the interview, ensuring that each participant had an opportunity to ask questions before the interview and provided their informed consent to participate. Each participant consented to their interview being recorded and their data being analysed by signing the Consent Form (Appendix 5). Due to the online nature of the interviews and because they were being recorded, participants were asked to be in a quiet and private space while being interviewed. At the start of the interview, the purpose of the research was specified, and participants were given the option to ask any questions. Participants had the right to stop the interview and/or withdraw from the research (within a three-week period), but none of them did. All participants expressed that they experienced positive emotions when looking back at certain moments with their newborn babies, which was also apparent due to their smiles while recalling this period. Several participants became emotional during the interview when remembering a challenging time, when they had experienced difficulties (for example, feeding a pre-mature baby in an incubator with a syringe, feeling isolated, or having mastitis). One participant revealed that she stopped breastfeeding because she and her husband wanted to try for another baby but then did not become pregnant. To keep the interview on track, I did not probe this further and focused on the following questions instead. Participants were encouraged to express their perspectives, and they had the chance to pause or stop the interview at any time. They could also refuse to answer a question without an explanation if they wanted, but this did not happen. In the debrief form (Appendix 6) several organisations were mentioned that could be helpful should participants be experiencing negative emotions after the interview, because the breastfeeding journey can be an emotional and intense phase of a mother’s life and was relived through the interviews. In order to ensure confidentiality, the data were scanned for identifying information, such as the names of the participant’s child(ren) and partners, and these were removed. Data were securely stored and protected by passwords. The raw data were only accessible to the researcher, while her supervisor had access to the data once they had been anonymised. Results and Discussion Four themes were developed from the data: “Breastfeeding is hard”, “Breastfeeding is magical”, “Breastfeeding is an emotional rollercoaster”, and “Support is everything”. These themes and their subthemes are described in more detail below. Quotes from the interviews are used to illustrate how these themes were created. Breastfeeding is hard Despite breastfeeding for at least a year, each participant stated several times during their interviews that breastfeeding was hard; this could be for different reasons, which are outlined. Peony summarised it as follows: “It's the hardest thing that nobody talks about. […] Nobody talks about your sore nipples the first few weeks or mastitis or how difficult it is at 3–4 months and to stop…, how sad you are to stop.” Because in the beginning, it hurts Establishing breastfeeding was physically challenging. According to Begonia, “The first night was a nightmare”. The early days of breastfeeding are tricky, with engorged breasts and sore nipples, while the body is recovering from birth and sleep-deprived, combined with the many emotions of the postpartum stage, getting to know their baby, learning a new skill, and settling into new routines (Hoddinott et al., 2012 ). Some mothers think that because breastfeeding is a natural phenomenon, it should be an easy and intuitive thing to do (Yuen et al., 2022, as cited by García et al., 2024 ). However, in one study, 76% of women experienced difficulties with breastfeeding, including pain and cracked nipples (García et al., 2024 ). Pain during breastfeeding is a common reason to stop, and several researchers have found significant relationships between pain and shorter breastfeeding journeys (Li et al., 2008 ; Levinienė et al., 2013 ; Min et al., 2022 ). Chrysanthemum was shocked by how much breastfeeding could hurt, reflecting a feeling of being unaware of the initial pain of breastfeeding. “I had no concept that it would really hurt, really hurt. I remember the drawdown…, like…, being really painful and being quite shocked by that.” Clematis experienced a similar physical strain, describing her first week: I guess in those early hours, when it’s really painful in the middle of the night, and you’re sharing that your nipples are sore and raw, and you cannot get your sleep, and your back is broken, and this child just won’t go to sleep. Gladiolus also reflected on how exhausted she was in trying to establish breastfeeding, especially in a hospital setting, where she had to pump, syringe-feed, and combi-feed. She reflected on how breastfeeding was challenging at first, stating that it took a “couple of months” before she and her baby finally found a rhythm. She said: I was determined to do it. So, from the colostrum, you know, get, get, getting the colostrum and putting it into these tiny syringes, to pumping as much as I could and then feeding it, feeding it to him. […] So, in the beginning, I also had to combi-feed, you know…, to make sure that he was getting his nutrients, so it was a journey, umm. But after…, I think I would say, you know…, a good couple of months, I feel like we were in the zone. But the first couple of months were hard. Because of the three months’ fussiness After establishing a breastfeeding routine, some mothers experienced ‘the three months’ breastfeeding crisis’, a growth spurt where babies experience increased milk demand, leading to fussiness and frequent feeding requests (Taut et al., 2015 ; Hoddinott et al., 2012 ). Babies also become more curious and distracted by the world around them as their sight and coordination improve (Hunnius, 2007 ). Keeping them focused on feeding was a challenge, as Peony described: I tried everything. […] With [my second child], I was like, ‘’No, I’m going to power through this. It's the three months fussiness.’’ […] There’s things going on. They can see things. They’re looking around. You know. And that’s when I started to do all the other positions like the rugby hold and like, like the rock climber, the rock climber. [laughing] And that is to be in a cafe and be like, you know, I want him to breastfeed. I, this is really weird. Nobody else has to do this. But I was too scared to not do that because that, it will be like [my first child], and I wouldn’t be able to breastfeed. Peony described her determination to persevere. She tried multiple positions, including the “rugby hold” and even jokingly named one the “rock climber”. This trial-and-error process reflected the physical challenges of breastfeeding. She also highlighted that she felt self-conscious and isolated, similar to Lehane et al.’s ( 2024 ) findings that mothers experienced a fear of the unknown and (especially new mothers) felt lonely and alone. Lastly, her fear of failing again – even though she breastfed her first child for six months – pushed her to keep going. This latter point relates to Menekse et al.’s ( 2021 ) findings that mothers with more self-control and who are open to development tend to breastfeed for longer. Because it is always you Another aspect that contributed to this theme was that the journey could be relentless, especially due to the infant’s dependence on the mother and a lack of breaks from looking after one’s child. Over time, sharing their body and time with their infant became daunting to some participants. Always having to be the one to feed and do bedtime took its toll, and some participants even stated that their “sense of self” was impaired. For example, Chrysanthemum described how she had to be present for nearly all feeds while her baby was in the ICU, with few opportunities to express milk: He’s in ICU, and he had to feed every two hours. So either I had to be there, I was allowed to, I was allowed to express 2 times every 24 hours, so I had to be there for the other ones. And they were quite stressy about– […] So I was having to go in at 2:00 AM, 4:00 AM, 6:00 AM. I wasn’t…, I didn’t have a bed. So we weren’t at the hospital, we were in a hotel. I remember that fairly bleak point and feeling stressed, because if we didn’t feed, he wouldn’t, like, get better. He wouldn’t be able to be discharged, as ‘‘If you can’t prove that you’re feeding, we won’t discharge you.’’ […] And sometimes I could find it a bit much because, because they, like [my first child] never really bottle-fed. None of them really ever bought it, so I could never really escape like an hour in the early days, which can be quite intense. This quote shows how breastfeeding can be relentless, emphasising the constant demands placed on breastfeeding mothers. The hospital staff’s insistence on breastfeeding added to the pressure, making the experience even more difficult. Chrysanthemum had to wake up repeatedly during the night to feed, all the while staying in a hotel, separated from her baby. The frequency of feeding, combined with the stress of her baby’s health and the expectation to ‘‘prove that you’re feeding’’, made the experience overwhelming. The request from the hospital staff was not aligned with the UK recommendation of expressing eight times in a 24 period (NHS, 2025), and research has even shown that expressing eight times does not yield more milk than doing it less frequently (Levene et al., 2024 ). Even later, at home, Chrysanthemum described how her children never took a bottle, meaning she could never get a break from breastfeeding; it consumed every hour of her early postpartum experience. She captured how mothers can feel trapped by this constant demand. Expressing milk was another aspect of breastfeeding that was difficult, partly due to the lack of the baby’s physical presence, as described by Begonia: Pumping is super difficult. I, I did not really manage to pump much. It’s just because you’re lacking that physical presence that gets your body to, to do it. So, I think that’s what’s lacking. If the if the baby is not there, it becomes really, really difficult. Almost 60% of mothers stop breastfeeding due to not being able to express (Theurich et al., 2019 ). Hoddinott et al. ( 2012 ) described how some mothers expressed to enable their partner to bond with the baby and used CMF when expressing was not successful. However, none of the participants mentioned that in this study. In this study, most participants stopped breastfeeding due to other circumstances or to have time back. For example, Chrysanthemum stated: I wanted to have that break because I think at bedtime it always had to be me. I had to do every bedtime, and we were thinking about having another baby. I was going back to work, and I felt I needed a bit of separation from him. Additionally, stopping breastfeeding was a challenging experience. The body went through hormonal changes, and emotions varied from relief to sadness and guilt. Seeing their baby grow, the participants understood that this time would never return. Some participants felt sadness, and this has been described as post-breastfeeding depression (Vincent, 2024). For example, when asked why she stopped breastfeeding, Begonia said: It was due to family planning. We decided we wanted to try for a second, a second child and my doctor mentioned the hormones could, you know, start to influence my ability to get pregnant again. And it was super hard because from the perspective of [my child], I wanted to carry on. […] I was having a really hard time stopping. […] I would have definitely done it for longer if it wasn’t for that. The above experiences aligned with research stating that motherhood and work were considered to be ‘‘two greedy institutions expecting full devotion’’ (Blair-Loy, 2003; Coser, 1974, as cited by Johnson & McCarthy, 2024 ) and that breastfeeding added extra demands on a mother (Brown & Arnott, 2014 ). Starting breastfeeding was self-consuming (Johnson & McCarthy, 2024 ) and time-consuming (Brown & Arnott, 2014 ); this also relates to ‘parent-offspring conflict theory’ which proposes that each child seeks more maternal resources than is ideal for the mother (Trivers, 1974, as cited by Fewtrell et al., 2020 ). Because it takes up all your time Breastfeeding was also hard because it takes a lot of time. Smith & Ellwood (2010) found that exclusively breastfeeding mothers spend 75 hours a month breastfeeding and another 50 hours a month on emotional care. Furthermore, Emmott and Mace ( 2015 ) stated that exclusively breastfeeding mothers burn an extra 400–750 kcal per day. Because breastmilk is easier to digest than CMF, babies drink more frequently and irregularly (Shaji et al., 2024 ; Brown & Arnott, 2014 ); they also receive more night feeds, even though CMF-fed babies wake-up as many times and take longer to settle (Brown & Harries, 2015 ). Begonia summarised this: ‘‘They’re always feeding, especially in the beginning’’. She also realised that babies sometimes want closeness even if not necessarily to be fed (Smith & Ellwood, 2010; Brown & Harries, 2015 ). Once Begonia knew this, she offered her baby more skin-to-skin contact, which also improved her milk supply, reflecting the biological process: The person doing the NCT or the, the birth prep class had mentioned. ‘‘You can do skin-to-skin’’. And I didn’t think of it as a tool relating to breastfeeding, but what happened was… […] I had just pumped and she wanted to feed. And I was like, ‘‘What am I going to do? I’m not gonna have any milk.’’ And then I just decided to do the skin-to-skin, and the milk came. And I was like: ‘‘Oh, what is that?’’ And then I was like, ‘‘Yeah, I'm really an animal’’. Clematis also referred to the time costs of breastfeeding, describing how it took a toll on a mother and how consuming it was: That time to breastfeed, it costs money. It plays, plays a physical toll on every woman’s body. […] You need to spend your time, and you give your body up to do it. […] When you add on the pregnancies, it’s quite a lot of, like, time giving your body over to, to others. […] [My first child] just didn’t stop feeding. He was feeding all the time. Clematis did not only experience this herself but also mentioned her mother, who breastfed her and her three siblings: My mum was not working when we were little. So, she, yeah, that was her job, really, to look after the kids, and her time was, was that, was spent on that. […] And I guess I was fortunate that I had a year off on maternity leave, which I know is not available to everybody for lots of reasons. Clematis also acknowledged the privilege of being able to take a year of maternity leave and recognised that not many women have this option. She contrasted her own experience with that of her mother, whose ‘‘job’’ was to care for the children, emphasising how breastfeeding was often unpaid labour and acknowledging how women across generations have given up time to nurture their babies. Research suggests that mothers need better maternity leave, as 649 million women of childbearing age worldwide live in countries with no statutory maternity leave (Pérez-Escamilla et al., 2023 ). More facilities are also needed for mothers who express milk after returning to work: it has been argued that when workplaces support mothers, they feel more self-efficacy and breastfeed for longer (Pérez-Escamilla et al., 2023 ; Xu et al., 2021 ). However, studies have found that workplace accommodations are uncommon; for example, Jackson and Hallam ( 2021 ) found that mothers were sometimes expected to express in the toilet. Several participants gave ‘‘wanting my body back’’ as a reason to stop breastfeeding (as also found by Hauck & Irurita, 2002 ), but interestingly, none of the participants spoke about the restrictions in their diets, as a breastfeeding mother is not allowed to drink or eat certain foods (Shaji et al., 2024 ). Perhaps they did not experience these restrictions as limiting, were already used to them due to the pregnancy, or forgot that part of the journey. Because it sometimes causes mastitis Participants spoke about the sacrifices they made in offering their time and bodies to their babies. Some mothers even experienced mastitis. On average, one in five breastfeeding women experiences an episode of mastitis, a breast infection, most often in the first month of breastfeeding (Amir et al., 2020, as cited by Amir et al., 2024 ). However, as mastitis can resolve itself on its own and does not necessarily need medical intervention, this estimate is likely an underestimate, as it is based on reports from GP surgeries. If a visit to the GP is made, this is likely because the symptoms – like fever and inflammation – are more severe, and antibiotics may be required. In their study of more than 3,000 participants, Amir et al. ( 2024 ) found that over 90% of women with mastitis received antibiotics. Although mastitis is very painful, the general recommendation (stated by the WHO) is to continue to breastfeed and even express breastmilk if possible (WHO, 2025). One of the reasons for this is that stopping breastfeeding can lead to (more) clogged milk ducts and, eventually, the formation of abscesses (Amir et al., 2024 ). Peony remembered her episode of mastitis: And the mastitis was just like, ‘‘Oh, my God, there is nothing worse than this’’. I mean, my boobs were like rocks. It was like rocks you couldn’t like [pokes her breast with her finger]. Anything, it didn’t go in, it was like, like this [balls hands to fists]. And then you’re like, still have to breastfeed and like, ‘‘Oh, my God, my God’’. Yeah, the pain. Sunflower was feeling unwell, describing her state as not being able to get up from the couch. However, she did not go to the hospital because she was afraid of being separated from her baby. Instead, she continued to breastfeed, highlighting a huge sacrifice for her baby: Sunflower – Just early when I started newly, like, and then I was feeling really sick probably with this mastitis, I’m sure it was mastitis, because my, you know, that [points at breasts]. Yeah, and then my ex-husband had to call the ambulance. On the call while they were talking, I said […] ‘‘OK, can you hang up the phone?’’ because I was thinking if I go, you know what it might be… Interviewer: What are they gonna do with the baby? Sunflower: Yeah, because I didn’t know it was about breastfeeding as well. Maybe, I was thinking, it might be about my diabetes, and I might stay, because in pregnancy, I had to stay maybe three days, or something, because of my insulin pump. Because it is a taboo Participants also experienced breastfeeding as hard because, at times, it felt like a taboo and something that should be hidden, in accordance with research from Boyer ( 2010 ). This perception was especially strong concerning breastfeeding after infancy; indeed Jackson and Hallam ( 2021 ) found that this had a stigma attached to it, even from partners and family members, highlighting that the WHO recommendations were not widely known. Gladiolus challenged the idea that breastfeeding should be kept ‘‘a secret’’. She emphasised the importance of fostering pride around it, suggesting that societal attitudes often make women feel like they must be discreet rather than celebrating breastfeeding as a natural achievement. And I would say understanding that however your birth experience was, that what you’ve done is such an achievement, and trying to like foster this sense of pride about it and not make breastfeeding like a ssssh secret that we didn’t talk about, right? She also shared an experience which highlighted an issue with breastfeeding in public. She linked this judgement to broader attitudes about women’s bodies: how they were hypersexualized, and breastfeeding was seen as something that should be hidden. These attitudes relate to research suggesting that sexualisation and objectification can be obstacles to breastfeeding (Newman & Williamson, 2018 ; Thomson et al., 2015 ; Bresnahan et al., 2019 ). Jackson and Hallam ( 2021 ) reported similar results, particularly calling out the male gaze. Gladiolus said: I think that there’s this sort of weirdly repressed ideas about women’s bodies and you know, we are in a very hypersexualized world and at the same time, breastfeeding a child is like, ‘‘Oh, we have to cover up with a with a muslin.’’ You know, I was breastfeeding a child, [my first child], when I was at this thing, this event. And the husband […] he tried to sort of embarrass me about it. Establishment of breastfeeding can be a source of pride (Jackson & Hallam, 2021 ), but many women stop before reaching this stage. Bresnahan et al. ( 2019 ) concluded that some people found breastfeeding in public ‘‘inappropriate and indecent’’. Thomson et al. ( 2015 ) emphasised that real or imagined reactions of others were a key issue for breastfeeding mothers. Edelweiss described her initial uncertainty about breastfeeding in public, reflecting how it was not always normalized, as also found by Boyer ( 2010 ). She had been unsure if it was even allowed until she did it, showing how a lack of open discussion contributed to this hesitation. Her husband’s reaction to physically shield her reinforced the idea that breastfeeding should be hidden: And then I thought, ‘‘Oh, my gosh, I am on the bus and she’s crying. She’s hungry. What do I do? Do I just drop off the bus and go back home and I breastfeed her?’’ And I breastfed her and I was like, ‘‘Oh, I'm allowed to do it’’, like no one ever told me that. But then [my husband] was very protective, like when I was breastfeeding in public, he was like standing in front of me with the coat open and not wanting anyone to see me. These quotes illustrated how breastfeeding was seen as something private or even inappropriate in public spaces, contributing to the taboo status, as also discussed by Thomson et al. ( 2015 ). All participants spoke about having to cover up and about how other mothers were not helpful when covering up, as it made them feel like they should too. As Chrysanthemum described: ‘‘I found people with these elaborate cover-ups unhelpful. Because I felt like I should be. […] I found these things made me feel a bit uncomfortable.’’ How other mothers can be helpful will be discussed in ‘‘ Support is everything’’ . Because of judgement from others In addition to a perceived taboo around breastfeeding, some participants felt judged for doing it, aligning with research by Bresnahan et al. ( 2019 ) and Thomson et al. ( 2015 ). However, Dillard ( 2015 ) found that older mothers, those in secure relationships and those who are established in their careers tend to feel more confident in challenging negative comments and views of others. The following quotes illustrated how participants experienced judgement from different sources, including nurseries and HCPs, as also reported by others (Dillard, 2015 ; Kronborg et al., 2007 ; Thomson et al., 2015 ). Sunflower described how nursery staff viewed breastfed babies as ‘‘spoiled’’ because they sought more affection and reassurance. This view reflected a judgemental attitude that breastfeeding makes children more dependent, reinforcing negative stereotypes. She said: My nursery say little bit around like, ‘’Ah that, that baby's breastfed, that baby is little […] more spoiled.’’ […] Because they want the babies not crying. They want the babies not like, seeking for affection, or like, you know, like reassurance. A potential reason for this view comes from Krol and Grossmann ( 2018 ), who showed that when mothers breastfed on demand, they reacted directly to requests from their children, which might lead to infants expecting immediate reactions. Levinienė et al. ( 2013 ) reported that breastfeeding on demand was becoming the norm among breastfeeding mothers. Brown and Arnott ( 2014 ) also described this infant-led approach as nurturing and common among breastfeeding mothers, ultimately leading to healthier weight gain and cognitive development. Carnation was shocked by nurses also expressing frustration toward breastfed babies, wishing they were bottle-fed so they would ‘‘go to sleep’’. This judgement from HCPs, who should be supportive, was upsetting. Notwithstanding this, some studies report that breastfed babies sleep better than CMF-fed babies (Shaji et al., 2024 ; Pérez-Escamilla et al., 2023 ); although Brown and Harries ( 2015 ) did not, as mentioned above. Carnation said: But then also I heard the nurses at the hospital say ‘‘Bloody breastfed babies. They should give them all bottles and they should just shut up and go to sleep’’. And that was the nurses in the hospital. And I was horrified by that. Because of all the emotions and the lack of support All participants described experiencing many different emotions during the time they breastfed; in view of this, these comments are gathered under the theme ‘‘ Breastfeeding is an emotional rollercoaster’’ . Breastfeeding was also experienced as hard because everybody seemed to have a different opinion or expectation about it; these will be discussed under the theme ‘‘ Support is everything’’ . Breastfeeding is magical In response to the question, ‘‘How did it make you feel that you were able to breastfeed?’’ all participants answered similarly: ‘‘Really happy.’’, ‘‘So amazing.’’, ‘‘Most beautiful thing in the world.’’, and ‘‘Something special.’’ The tennis player Serena Williams also described breastfeeding as ‘‘a magical superpower’’ (Gregory, 2018). Such feelings align with Davis et al. (2025), who stated that mothers experienced breastfeeding as a magical and transformative part of a mother and child’s life. Jackson and Hallam ( 2020 ) noted that ‘‘amazing’’ also referred to something to be proud of and not standard practice. The quotes below underline different components of the theme ‘‘ Breastfeeding is magical’’ , from connection to transformation and the power of the female body. Sunflower described breastfeeding as a wonderful experience. The ‘‘magic’’ came from how her baby brought love into her life, easing feelings of isolation and homesickness: It was magical. […] I was socially quite isolated as well, before baby comes as well. And then this baby came like a, you know, everybody’s baby is sunshine, but even more, you know, like because, that you were already not, maybe socially isolated. You are missing your previous life in Turkey. […] But, all of a sudden, it is great. Big love come to your life. Gladiolus emphasised the awe of creating, birthing, and then nourishing a baby with her own body. She reflected that no ‘‘other human talent’’ compared to this process: You realise that you have taken a little tiny cell, and you have grown it. […] You’ve birthed them. Then you feed them. There’s, like just an indescribable magic when you realise that’s all coming from your body. I think that’s…, honestly, why we’re not shouting about this? But you know, it’s magic. Yeah, no other human talent can do anything close to that. Chrysanthemum framed breastfeeding as an extension of pregnancy, continuing the intimate connection between mother and baby. She saw it as a privilege, underscoring the unique, almost sacred role of a mother in sustaining her child’s life: ‘‘It's a bit of having a baby, isn’t it? That’s one of those magical things. But you’re lucky. As a woman, you. It is a privilege that you can do it – feed your child.’’ Because it is everything a baby needs Every participant gave a version of ‘breast is best’ – meaning that breastmilk is the optimal way to feed a baby – as the most important reason to breastfeed. Foxworthy Scott and Bute ( 2024 ) found that ‘breast is best’ is a master narrative, and their research showed that breastfeeding mothers feel that they are good mothers. Being a good mother was also associated with minimal medical interventions and aligned with what the body is naturally expected to do (Cripe, 2018; Miller, 2005, as cited by Foxworthy Scott & Bute, 2024 ). Others have also found that some women interpret breastfeeding as a choice and a sign of being a good mother rather than a biological process (Davis et al., 2025; Thomson et al., 2015 ; Hauck & Irurita, 2002 ). However, in this study no participants seemed to espouse this interpretation; rather, they emphasised being concerned about their baby and wanting what was best for them. To at least some extent, all participants were aware of the benefits of breastfeeding, as emphasised in the following quotes. Gladiolus implied that breastfeeding provided the ultimate in terms of nutrients and benefits: ‘‘Oh, yeah, that it was the best start you could give to a child’’. Peony reflected on the natural aspect of breastfeeding, suggesting that it felt like the way things are meant to be. She also acknowledged the evidence supporting breastmilk as a source of nutrition, particularly for the immune system. Her commitment to pumping, even after she stopped direct breastfeeding, showed her belief in the benefits: It’s natural, right? It feels. It felt like it was. It’s the way it should be. […] But then I pumped for another three months because I wanted to give my, my breastmilk and, you know, research has shown that for the immune system, the, the breastmilk is the best. Edelweiss went even further by stating that breastfeeding is the ‘‘only real way’’ to give a baby what it needs, both in terms of nutrients and emotional bonding. She said: ‘‘I think it’s the only really way to, um, I think it’s very important for the children, like to bond to, give them what they need, the right nutrients like, yeah and everything.’’ Lastly, Chrysanthemum stated that she knew breastfeeding provided benefits for children and highlighted the fact that the mother can provide everything a baby requires: I knew it, it provides a lot of benefits to the kids. […] I like that feeling that I can provide everything they needed. I guess it’s an extension of them being in your tummy. You’re still everything they need. Because you do not need anything else There was another, more practical reason for breastfeeding being experienced as magical: unlike bottle feeding (because bottles must be sterilised and clean water is needed), breastmilk is always available and accessible (Davis et al., 2025). Clematis noted that breastfeeding allowed her to feed her baby instantly, reinforcing the idea that breastmilk was always on hand, eliminating delays or extra effort. She said: ‘‘Because it’s the most practical. I think when you have a baby, you just want to be able to feed them quickly and just don’t have to rely on preparing bottles.’’ Carnation agreed, stating that breastmilk was always available and highlighting its convenience: ‘‘It was so convenient. I think, you know: the milk is warm, it’s the right temperature, it’s always available. The baby’s there. You’re there.’’ None of the participants mentioned the cost difference between breastfeeding and bottle feeding, probably because they felt that their time spent is also valuable, as described by Clematis in the section ‘‘ All of your time’’ . Carnation also mentioned the connection, which leads to another reason why breastfeeding is magical. Because the connection is amazing All participants felt lucky that they were able to experience this magical journey, as it felt amazing to them. Sunflower stated: ‘‘I feel I’m so lucky. […] I will say: ‘You are a lucky girl, without knowing. You’re going to have some good experience in that life’’. Participants also realised that breastfeeding was not only about nutrition but also a deep bonding connection. According to Jackson and Hallam ( 2021 ), breastfeeding can be a tool to settle a baby to sleep and reconnect after a mother has returned to work. Peony described the way her body physically responded to her baby, highlighting the biological bond. She expressed awe at the experience, repeatedly calling it ‘‘amazing’’. The act of hearing her baby suck and feeling the closeness created an emotional attachment. Peony said: I think the connection you have […] with your baby, like how linked you are. […] You get the flow or you get this thing and you like he’s hungry or you hear him cry and your boobs react, like you react physically to your baby. You are so connected. And then having that like…, Hearing him suck, like, I don’t know, like, hearing him suck and like, holding my boob. My huge, humongous boob that was like bigger than his head when he’s a baby. Oh, my God. I don’t know. It’s amazing. Similarly, Begonia described the intimate and peaceful moments shared with her baby, even in the quiet hours of the night, making breastfeeding a cherished experience: Just that having that one-on-one closeness. That’s just gonna be stuck in my memory as the, the best probably of all of it. It’s just that quiet time, even if it’s four in the morning, it’s just you and the baby, you know, it’s, it was amazing. Gladiolus focused on the unbreakable bond formed through breastfeeding, emphasising how it created a connection with her child that continued even years later: Then it was so amazing, like it was such a bond. I loved how he looked up at me. I loved holding him. I think our bond, you know, still to this day, he’s nearly seven now, there’s something about what we went through. Edelweiss also reinforced the emotional closeness and the process of growing: ‘‘It was more about like, yeah, the connection as well. Not only like he needs to grow. You know what I mean? Like, I need to feed him. It was that whole process.’’ Chrysanthemum reflected on another aspect when she spoke about trust and the safe place her baby was in when ‘‘milk drunk’’ and that this was part of the motherhood experience: When they’re little and they fall asleep drunk on your boob and they look so happy and just like, so safe, they just trust you completely. […] I loved it. Like them gazing up at you. I thought it was a nice bonding experience. […] It’s part of the whole motherhood experience. Breastfeeding is an emotional rollercoaster While all participants expressed how happy they felt to breastfeed and that they experienced a sense of pride and magic, they also felt many negative emotions. They felt overwhelmed by the huge responsibility of solely feeding this tiny human being. At times, they felt trapped. They felt like ‘‘it’s us against the world’’, while being isolated at the same time. They felt shame as well as doing a natural thing like ‘‘a real mum’’. They felt judged as well as being all their baby needs. These contradictory emotions were also found by Davis et al. (2025), who described the breastfeeding period as a journey with ‘‘mixed and intense emotions’’. The most often mentioned emotions are discussed below. Insecurity and anxiety Most participants felt uncertain and worried about whether they were breastfeeding optimally, if they had enough milk, and whether their baby was drinking enough. There is no manual or clear evidence to indicate whether a baby is getting enough milk when being breastfed, other than wet nappies and contentment (NHS, 2025). When a baby is fussy or discontented, some mothers interpreted this as having insufficient milk (Brown & Arnott, 2014 ). Approximately 45% of breastfeeding mothers self-reported insufficient milk supply (SRIM, also known as perceived insufficient milk supply (PIMS)), as the most important reason to stop breastfeeding (Pérez-Escamilla et al., 2023 ; Huang et al., 2024), despite SRIM being generally an incorrect interpretation of an unsettled baby (Pérez-Escamilla et al., 2023 ; Fewtrell et al., 2020 ) and there being no evidence that the mother does not have enough milk (Huang et al., 2024). If mothers received more education about infants and their development, a mother may be less worried about sleep patterns, crying, and posseting (Pérez-Escamilla et al., 2023 ; García et al., 2024 ). These behaviours cause stress and negatively influence the self-efficacy of the mother, ultimately leading her to stop breastfeeding (Pérez-Escamilla et al., 2023 ; Menekse et al., 2021 ; Brown & Arnott, 2014 ). Huang et al. (2024) also found that crying was mentioned as the most important symptom of PIMS and the reason to discontinue breastfeeding, while only 5% of mothers actually have insufficient supply. Begonia described insecurity as the worst part of breastfeeding, including self-doubt over whether her baby was feeding enough and whether she should supplement with CMF. Uncertainty over whether she was producing enough milk created stress. She said: And you go like: ‘‘Are they really feeding? Do I have enough? Should I offer formula?’’ Because they are just, just off the breast, an hour later and they want to go back in and it’s just normal for them. But for us, it makes us feel like, ‘‘do I have milk?’’. It’s just, you start to question itself. So that’s the worst, the worst part. Edelweiss also shared a personal internal struggle. Despite receiving positive reassurance from others, she worried that her baby’s short latch times meant that she was not producing enough milk. This insecurity seemed to stem from her own fears and lack of experience rather than comments from others. They said it was very good that I was trying to. It was, it was, she was growing very well. I was doing a great job. Like everyone was very positive about that. I was just only concerned that because she was not latching for a long time. Like, I know maybe some babies latch for like an hour or 40 minutes. This one is like 5 minutes. ‘‘What am I doing something wrong?’’ My only concern that I wasn’t going to produce enough milk, for enough, for a long period of time. Chrysanthemum also reflected on how experience helped reduce her insecurity. In the early days, breastfeeding felt overwhelming and uncertain, and she wanted reassurance. She contrasted the uncertainty of breastfeeding with bottle-feeding, where intake was measurable: Also, there’s that deep down thing; mother’s instinct. Do you know? Like, I knew [my first child] was a fat little baby. He was happy. He was fine. But you just want that reassurance. […] And I think the further long you go and the more kids you have, the less insecure you are. […] Because I remember being a bit concerned with how much they’re eating like because with the bottles, with the bottle, you know exactly how often they’re being fed. Most women, especially primiparas, experience breastfeeding issues at the onset, which can lead to insecurity (Lindblad et al., 2022 ). García et al. ( 2024 ) found that mothers who experienced issues, were more likely to supplement with CMF, which could interfere with the baby’s capacity to suckle. Poor suckling capacity could then be interpreted by the mother as ‘‘the baby does not want the breast’’ or ‘‘I do not have enough milk’’, leading to further supplementation with CMF and ultimately leading to breastfeeding cessation. This vicious circle could be broken if a mother receives adequate support early on (García et al., 2024 ). Confidence Each participant expressed concerns about whether they were breastfeeding correctly and whether their babies were getting enough nourishment. In contrast, confidence in their ability would have made all the difference in the participants’ eyes. To the question, ‘‘What would you tell yourself if you could go back to the start of your breastfeeding journey?’’ participants all answered similarly: ‘‘to relax and enjoy the experience’’, rather than being worried about the process. For example, Edelweiss said: To relax with [my first child]. Because it makes a difference, it makes a difference for a baby, it makes a difference for like, for the quality of milk that you’re producing, you know it, is not a stressful milk but it’s a relaxed milk. Baby will latch at some point. And you will have enough milk, because we are biological like made to do this, right? It’s a natural thing. Clematis, Carnation and Gladiolus all expressed similar thoughts: ‘‘I guess just to enjoy it’’ (Clematis), ‘‘You just need to relax and enjoy the moment’’ (Carnation), and ‘‘Just to say to myself, ‘‘You're doing great, and you're enough’’ (Gladiolus). This feeling of ‘‘I am enough’’ and ‘‘What I am doing is enough’’ was also shown by the different experiences mothers had the second time around. Complementing the theme of ‘‘Breastfeeding is hard’’, participants who had a second baby all found that experience easier. They had the assurance, knew how to do things, had been here before, expected it to be hard but fulfilling, trusted their bodies, were not worried about milk supply and had different expectations; these feelings align with research by Fewtrell et al. ( 2020 ). The confidence was evident, for example, by being more comfortable with delaying breastfeeding until a more convenient time, compared with the first baby with which they sat ‘‘on dirty steps next to cigarette butts’’ and ‘‘on the floor of the mall, with my husband keeping me out of sight with their coat’’. As Edelweiss reflected on her second experience: ‘‘I enjoyed the whole thing more because I was more relaxed.’’ Clematis also described how confidence helped her, stating that she was much more relaxed. She described how, with her first child, she was more rigid and careful, ensuring she followed the ‘‘right’’ way to breastfeed (e.g. posture). With her second child, she felt more at ease, indicating self-assurance. Initially, she experienced physical discomfort, but over time, she became ‘‘desensitised’’ to the pain and learned to adjust to her baby’s needs. Clematis said: [My second child] was a bigger baby, so it physically was a bit less comfortable to begin with, but then I was much more relaxed about it in general. So I would, with [my first child], I would, I would sit upright and definitely feed in the right way and I wouldn’t let myself fall asleep. With [my second child] it wasn’t like that. ‘‘Just lie down next to me and I’ll feed you again.’’ I just need to get as much sleep as I can. Yes. Yeah, I think you’ve become much more confident in yourself. The above aligns with findings that multiparity is positively related to exclusive and continued breastfeeding, due to previous experience, intention and self-efficacy (Gusmão et al. 2013, as cited by Muelbert & Giugliani, 2018 ; Kronborg et al., 2018 ). In contrast, primiparous mothers experienced more doubts, and twice as many felt anxious at six weeks postpartum (Lindblad, 2022). Self-consciousness and embarrassment Other emotions mentioned by several participants were self-consciousness, shame and embarrassment. The following quote highlights the initial self-consciousness that was experienced while breastfeeding, especially in public. Chrysanthemum described feeling uncomfortable about exposing her body while breastfeeding and mentioned how her mother’s and partner’s reactions reinforced that self-consciousness and how she pushed past the embarrassment: You feel a bit subconscious and a bit embarrassed about doing it. […] I remember her being quite sensitive to, because I remember with my first child being a bit embarrassed about getting my boobs out. […] But I remember him sort of trying to cover me up and I said: ‘No, don’t do that. Don’t do that. Like, if I don’t feel, feel self-conscious, don’t make me feel self-conscious.’ I think it’s just a new experience and I just decided not to worry about it. And he definitely, it took him a while to get used to that. Participants also described that if it was time to feed their baby but they could not feed immediately for any reason, this was uncomfortable and sometimes caused leaking, which heightened their embarrassment. This feeling also relates to judgement and taboo, as described in earlier sections. More on this topic is provided in the section ‘‘Expectations from yourself and others’’ . Isolation Several participants mentioned that they felt isolated at times. Peony expressed feelings of being alone and on her own in the current Western world, which is very individualised and without the support that once existed. She contrasted modern motherhood with the past, when women lived in close-knit communities with their families available to share knowledge and offer guidance. Without this, she felt ‘‘completely alone’’ in navigating breastfeeding challenges. Her husband was at work, but she perceived him as unhelpful in any case due to his lack of experience. While she had an antenatal group, everyone had different approaches, making it difficult to find consistent advice. She also described how clinic visits did not capture the struggles she faced at home, leading to frustration and a sense that no one truly understood her difficulties, which led to even more feelings of loneliness. She connected feelings of isolation and struggling with the risk of postpartum depression, emphasizing how a lack of community affected her, just as García et al. ( 2024 ) found that low levels of support led to low self-efficacy, which could lead to depression and anxiety symptoms. Peony said: You are completely by yourself. I’m on my own in my house. My husband is at work. And completely useless anyway: he’s never gone through this. […] I only have my NCT. And everyone does it differently. […] The clinic. Yes, but again, every time I went there, he fed. […] And I feel like that is, I feel, so isolated. […] You’re alone in the hospital. […] Then you miss out on all the women’s experiences that are so crucial for like bringing like knowledge down generations and generations. […] We don’t have our parents, we don’t have our sisters, we don’t have anyone. We are completely on our own. And then postpartum depression becomes a real risk. Gladiolus also spoke about her feelings of isolation and of not feeling supported. She described experiencing not feeling like she was enough, which showed a lack of confidence at the start of her journey: ‘‘I felt very alone, and I felt very, very sad at times.’’ In contrast, Sunflower mentioned that the baby helped her feel less isolated and alone, as described in the section ‘‘Breastfeeding is magical’’ . Support is everything As previously mentioned, the warm chain of support for breastfeeding mothers consists of their partner, family (e.g. their own mother or mother-in-law), HCPs, and other mothers. Support is sometimes helpful and at other times counterproductive. In this section, the positive and negative experiences are presented. Expectations from yourself and others Emmott and Mace ( 2015 ) suggested that social pressure to breastfeed can be seen as a way of social support. The following quotes illustrate how expectations from others shaped the participants’ experiences with breastfeeding; they highlight the assumptions and perceptions surrounding breastfeeding. Chrysanthemum reflected on how she ‘‘expected herself’’ to breastfeed because it was the norm in her family. Even though no one pressured her, she assumed her mother and husband would expect it, showing how family norms influence decisions: It’s not that she expects me. It is a societal... I expected myself to do it. I expected her to expect me to do it like. I knew [my husband] was breastfed. Yeah, I just kind of… It’s just assumed that I would do it, not that I felt pressure to do it, but just it’s sort of the norm in our family. Begonia reinforced this idea, explaining that she thought breastfeeding was widely practiced in Brazil, which may be partly due to her SES and that of her friends. It felt like the obvious choice even though she had not lived in Brazil for over a decade, which shows how cultural norms create expectations. She said: ‘‘I think culturally as well in Brazil, a lot of people breastfeed, at least for some time, so that also you know, it’s just something obvious that, that’s what you would do.’’ Peony also highlighted how society played a role. Seeing other mothers breastfeed for a long time made it feel more normal to her as has been described previously (Lehane et al., 2024 ). However, she also pointed out that societal attitudes shift over time. In her view, reactions became more awkward the longer she breastfed. Jackson and Hallam ( 2021 ) also found that society did not accept breastfeeding beyond infancy, and their participants received judgement, especially from strangers. Peony said: Like, it impacts me to know what other people have done. I think. It makes, like, what is normal, it impacts what is normal for me. […] When at 12 months, everyone was like, ‘‘Wow, amazing’’. And then that kind of stops and then people are like, ‘‘Are you still breastfeeding?’’ […] And I used to joke, I was like: ‘‘I’m breast–, still breastfeeding and it’s reached a point that it’s become awkward to say’’. Like, people’s reactions change. Gladiolus contrasted different cultural expectations around postpartum recovery and breastfeeding. She explained how, in her Korean culture, new mothers are treated like ‘‘warriors’’ and given time to heal. In contrast, the UK’s fast-paced postpartum expectations – such as getting back to exercise – created intense pressure. She noted that many women ‘‘drop breastfeeding’’ because they are overwhelmed by the need to ‘‘make everything else work’’: I think that – and I can only speak from my experience here – but different cultures that I’ve encountered, the way that they absolutely, you know, make the women feel like a superhero warrior for having done what they do, like in my culture, you don’t move for the first month, you stay inside, you just nourish yourself because of what you’ve gone through. In the UK, you’re expected to go into a spinning class after five days or something and do the shopping and be, be this and be that. It is so much pressure. I’m not surprised women drop breastfeeding as the first thing because they’re just like, ‘‘I’ve got to make everything else work’’. I’m not surprised at all. In the UK, there seems to be a focus on mental health; for example, people are urged to leave the house to get exercise and fresh air when they experience depressive symptoms (NHS, 2025). Mothers are also expected to visit their HCPs rather than vice versa because HCPs have many cases and are under time pressure (Chambers et al., 2023 ; Kronborg et al., 2007 ). Indeed, Jackson and Hallam ( 2019 ) report that contact with HCPs becomes more limited as the child gets older. Support from partner Another part of the warm chain is the partner. Despite mothers in a long-term relationship being more likely to breastfeed for longer (Levinienė et al., 2013 ), the support of a partner was not seen as crucial by participants in this study. This finding could be due to different reasons; for example, it could be due to sample selection, or that having a partner allows a mother to be on maternity leave longer. In the interviews most participants described a partner who had a passive role. Their partners accepted their breastfeeding, not actively supporting it but also not being against it, and not putting them under pressure. Ultimately. it was the mothers’ decision. For example, Clematis described a sort of silent approval from her husband. She felt that he was taking her lead on all matters related to the pregnancy: I think he, with the pregnancy and the birth, he became clearer in his own mind that it’s my body and I get to choose what I do with that. […] I think, I led the way, and I sort of said ‘‘I’m going to breastfeed’’, and that was it. Gladiolus emphasised how overwhelming and isolating the first weeks were, and described how her husband’s support was beneficial: He saw the struggle of latching, you know, combi-feeding. […] He also saw how exhausted I was because I just never got any sleep. And so, I think that side and the toll it takes on women. […] So, I feel like the first month when we were in the hospital, we were actually really like allies. Carnation had a more negative experience and reflected on the lack of involvement from her partner in the decision-making process. She felt that it was her responsibility as a mother. Instead of turning to her partner, she sought advice from ‘‘female friends’’, which could imply that she either did not feel supported by her partner or did not see him as supportive: No, I wouldn’t have been taken his view because it, it’s not about him. As a mother it’s about you and the baby. And you know, I really did think it was the best, the best thing for them. So, I didn’t really discuss it with him, I discussed it with my female friends more. While most participants described silent approval from their partners, Peony experienced pressure from her partner to stop breastfeeding because he felt that it was stopping the baby ‘‘from eating properly at mealtimes’’. Not relying on partners can also be due to new mothers tending to rely more on HCPs and/or people who have been through the same experiences, such as their mothers. As Peony stated under the section ‘‘Isolation’’ , ‘‘partners are useless in that way’’ because they do not have the same lived experience. Kozachenko et al. ( 2024 ) also found that the support of a partner is not critical for breastfeeding, as there were no differences in breastfeeding duration between mothers with or without a partner in their study. However, Levinienė et al. ( 2013 ) report that partners who are more aware of breastfeeding benefits are more supportive; however, if they are not, it can result in new mothers having feelings of isolation, anxiety and helplessness. Another study found that when a mother breastfed beyond infancy, fathers became less supportive and found this weird or limiting their social lives (Jackson & Hallam, 2021 ). Support from own mother The second important component of the warm chain is the mother’s mother. In this study, all participants were breastfed by their mother, aligning with Cole et al.’s ( 2024 ) research that being breastfed leads to breastfeeding. Peony’s mother breastfed her but stopped because she had twins and found it too demanding. Peony also did not ask her mother for much support. She reasoned that she was older when she had children and that there was some resentment towards her mother. Begonia was also not breastfed for long, because her mother wanted to use bottle to be ‘‘more in control’’ and see how much her baby was drinking. In her interview, Begonia also did not expand on any particular support she received from her mother. In contrast, she did mention how her father – as a paediatrician – gave her some practical tips; this contributes to the idea of new mothers taking advice from HCPs, as discussed in the following section. Most participants asked their mother for support, although that support varied from living with her for a few months just after birth (in Sunflower’s case) to not asking anything specific but knowing that her mother would support her if she needed anything (Clematis) to active support as ‘‘supporting her in everything’’ (Carnation). Three participants (Peony, Edelweiss and Gladiolus) wanted to be more independent, figuring things out on their own or doing it their way. This was probably also because their mothers had them in different countries and a different era, so their experiences relating to babies were perceived as no longer relevant. While grandmothers’ attitudes can positively influence a mother’s breastfeeding journey (Negin et al., 2016 ; Scelza & Hinde, 2019 ), mothers who lived with their mother breastfed less frequently and stopped earlier (Emmott & Mace, 2015 ; Muelbert & Giugliani, 2018 ). Such findings may relate to the practical support (e.g. babysitting) that grandmothers can offer (Emmott & Mace, 2015 ). Support from HCPs Most participants gave birth in a BFHI hospital, as described in the Introduction. Hospital staff promoted breastfeeding by telling them that breastfeeding was important and encouraged them to continue even when it became hard. Some received practical support and attended drop-in sessions while still in hospital. For example, Begonia said: ‘‘Some of them were breastfeeding consultants, so they looked at the latch and that was reassuring.’’ Begonia also mentioned the different levels of support from HCPs: There is some misinformation. […] I think more training and more people available to, to speak to the, to the mums, and the dads for that matter, informing the dads, I think, is very helpful because in these moments of crisis, the two parents are there. However, Carnation experienced the opposite with HCPs speaking badly about breastfed babies (as discussed in the section ‘‘Judgement from others’’ ). The reason for this might be that she had babies about 15 years earlier than the other participants. Carnation also had a bad experience with HCPs not taking her seriously when she expressed concerns about her breasts: But what they did not ask or did not discuss was when I said I had a dimple on my breast. […] They dismissed it, and I was really annoyed because I waited 7½ months, and then the cancer had spread. […] It wasn’t until I did La Leche course, and I was looking at this, the breast and everything else, I started wondering, and I went to my GP. And that’s when the whole thing happened. The above quotes align with the literature. For example, Hoddinott et al. ( 2012 ) described how mothers prefer support immediately after birth rather than before. However, physical support (touch) from HCPs was experienced as negative (Thomson et al., 2015 ). Jackson and Hallam ( 2020 ) described how mothers experienced HCPs sometimes lacking knowledge and support, which became manifest in their advice and language. McNaughton et al. ( 2024 ) found that some HCPs promoted CMF. Chrysanthemum suggested that continuity of care by HCPs would be helpful. Seeing the same HCP would create a bond, and the HCP would be able to follow the progress of mother and baby, especially because growth is not always linear and one-off visits do not paint the full picture (as described by Peony under ‘‘Isolation’’) . Hoddinott et al. ( 2012 ) also found that mothers prefer continuity of care. Chrysanthemum mentioned the healthcare system in the Netherlands, where new mothers receive free care from a maternity care assistant in their home during the first eight days. Despite a shorter maternity leave (16 weeks paid leave), their exclusive breastfeeding rate at six months is 39% (Theurich et al., 2019 ). However, Van Minde et al. ( 2019 ) found that, afterwards, there was a lack of handover care from the maternity care assistant to the GP. Chrysanthemum said: A bit more support would be helpful. […] Like in the Netherlands, where you get someone who maybe is there for a week. It’s the same person who sees what you’re doing, sees how you’re struggling, sees what’s working. Different opinions As described by Chrysanthemum, the lack of continuity of care creates that mothers meet different HCPs, each with their own opinion, which has also been found in earlier studies (Hoddinott et al., 2012 ; Lehane et al., 2024 ). Gladiolus highlighted the sometimes contradictory support that HCPs provided and described feeling overwhelmed by their conflicting advice, which contributed to frustration and emotional exhaustion in an already stressful situation. Instead of feeling supported, she felt criticised which impacted her mental state. Her experience also underlined the importance of how HCPs communicate. While their intentions may be to help, the way information was delivered impacted her well-being, especially in her sleep-deprived and stressed state. Gladiolus showed frustration when she said: Every time a nurse came in, they would correct my position. […] That was hard. Where people always had different opinions. And sometimes they expressed it nicely. Sometimes they didn’t, and then it was just a bit like it was tiring, you know? […] It’s not really what they’re saying, it is how they say it that is so detrimental to your mental state. Different opinions can also be found on social media, although Jackson and Hallam ( 2020 , 2021 ) concluded that social media offered support to women, especially those who breastfeed beyond infancy. However, social media is known to contain a lot of judgement (Thomson et al., 2015 ). The following quotes illustrate different perspectives on online support: one related to seeking validation and connection through social media and the other reflecting concerns about the reliability of ‘‘the internet’’. First, Clematis found support in social media by looking for information and connecting with others. For her, even if the information was not necessarily helpful, the act of viewing others’ experiences made her feel less isolated, emphasising how emotional support can come from connecting with others who share similar challenges. The sense of shared experience helped reduce feelings of loneliness: I did sort of use Instagram a bit and social media to look for information and I don’t know if that was necessarily helpful at the time, but it felt like there were other people out there. Therefore, they can maybe make me feel less alone when you are dealing with the difficulties. On the other hand, Carnation expressed scepticism about online advice, particularly for new mothers: ‘‘People say stupid things, and I just, I just wish mothers would not take as much advice off the Internet because I think it just makes people more stressful.’’ Her perspective underscored that support should not just be about the availability of information but also its quality. One reason for the difference in these perspectives was likely the age difference between the participants. Support from other mothers The last element of the warm chain is the support of other mothers, several studies have found to be essential (Jackson & Hallam, 2019 , 2021 ; Chang et al., 2022 ; Jeon et al., 2024 ). Peer support can be helpful because mothers are going through the same thing, at the same time, in the same place. Because their experience is also recent, it is also more relevant (in contrast to, for example, a new mother’s own mother), which became clear from the following quotes. Peony felt encouraged by knowing that other mothers were breastfeeding for a longer time: ‘‘Everyone else is doing it. So, it's possible.’’ This quote showed that she most likely socialised with mothers with the same characteristics as her (as mentioned in the Introduction). Peony highlighted the importance of sharing experiences with other mothers and expressed frustration that this topic was not discussed openly, which led to insecurity. When she found others who were experiencing similar challenges, such as the change in the milk’s colour when the baby was unwell, it reassured her and reduced her feelings of isolation: I want to spread that knowledge. I want people women to know that, that journey is special but hard. […] That it can be beautiful, and it can be really long. […] Maybe more knowledge about that. Like I stopped with [my first child] at seven months because I was like, ‘‘Oh my God, the, the, the colour is changing’’. More knowledge of it. Why did it change? Clematis also described how the support from other mothers in her antenatal group provided a sense of community which she needed especially during challenging moments like the first nights. Her group met once a week for a year which complements the continuity of care described above. Clematis said: ‘‘When you're up in those night feeds, the NCT group was such a lifeline.’’ Similarly, Edelweiss pointed out that her experience was shaped by being in a non-judgemental community where breastfeeding was normalised. The fact that she was surrounded by other mothers who breastfed made her feel less isolated and more confident. She also shared the influence of her friend’s experience with twins, reinforcing the importance of supportive advice from peers: I never felt judged by anyone, especially because I was always around other mums, and everyone was breastfeeding and it was kind of normal. […] So, at the beginning [my first child] did not latch very well. And because of my friend’s experience. […] She told me: ‘‘Just keep doing it if you want to breastfeed, because otherwise the milk won’t come’’ and so I was like, ‘‘OK, I need to breastfeed there’’. Lastly, Carnation reflected on the importance of peer support in a hospital setting, where other mothers helped her through the early stages of breastfeeding. She contrasted the peer support with the busyness of the hospital staff, suggesting that sometimes other mothers were more relatable and available. This observation relates to the Community Mothers project, as described in the Introduction, as well as to research that showed that support is most helpful immediately after birth (Hoddinott et al., 2012 ; Hauck & Irurita, 2002 ). Carnation said: Having sort of a peer support in hospital when mums are first trying to latch on because the nurses are too busy and, and again, those night staff were, you know, very against it. Different people were really encouraging. […] So, my friend [friend's name] had older children. So, there were some things that I talked to about with her. […] And it was, it was very accepted amongst my friends that we were all breastfeeding. So, there’s times when I remember sitting in a room with my friend, and we both fed our babies. Alternative ways of support Phone support is another option that may be cheaper and easier to provide than the current system of HCPs. Karimi et al.’s ( 2024 ) study of new mothers with COVID–19 in Iran suggested that telephone support as an early intervention might positively encourage mothers to exclusively breastfeed. However, there were no significant differences in the fourth and sixth months after birth, suggesting that the effects decrease, or that a different intervention is needed for those mothers to continue exclusive breastfeeding if they wish to do so. Karimi et al. concluded that new mothers experience more self-efficacy in breastfeeding when their mental health is addressed. This point is critical because self-efficacy is related to stress levels; when a mother experiences more stress, her self-efficacy diminishes. When her stress is expressed and dealt with through counselling, her self-efficacy improves, resulting in longer breastfeeding journeys (Karimi et al., 2024 ). A telephone support intervention called CHAT was also used in Australia (Xu, 2024), and similar results were found. Thomson et al. ( 2024 ) also found that telephone support provided beneficial support for breastfeeding; sometimes, this support boosts the confidence of new mothers and helps them to continue breastfeeding. Reassurance from the helpline meant that mothers reported that they felt calmer and/or relieved after talking to someone (Thomson et al., 2024 ). Other themes and codes Surprisingly, cultural differences were not often mentioned during the interviews. Once established, breastfeeding seemed to be a universal experience of bonding and magic. Mothers’ experiences crossed boundaries, so while cultural differences were mentioned, this was not often enough to become a theme. Other codes and themes that were developed from the data include: 1) knowledge and education, 2) policies like maternity leave, 3) financial aspects and 4) the promotion of CMF. However, these topics were mentioned less during the interviews, and they did not align as much with the other themes as the four discussed previously. These external aspects are also more difficult to be directly influenced by one study. For all these reasons, these topics were not further developed into themes. Conclusion The focus of this research was how to support women in breastfeeding more and longer. The findings indicate that the initiation of breastfeeding is driven mainly by internal motivation as well as socioeconomic circumstances and that the continuation is also impacted by education and the support of others (Xu et al., 2021 ). First key finding A key finding is that support is crucial in breastfeeding. When a mother’s confidence is enhanced, she feels more empowered to breastfeed and cope with the challenges. Community-based interventions that educate fathers and grandmothers are also beneficial (Pérez-Escamilla et al., 2023 ; De Brito Angelo et al., 2015 ). More promotion through the partner and grandmother will mean that they will give proper support, which leads to enhanced self-efficacy among mothers and longer breastfeeding journeys. Fathers can give practical support, such as changing diapers, practising skin-to-skin and providing snacks and water for the mother. Most of all, they can encourage her. Furthermore, a grandmother’s positive attitude towards breastfeeding also increases a mother’s willingness to breastfeed. While the support of spouses and family members is important, the most critical support comes from peers and healthcare staff. Peer support is crucial for new mothers, as it offers a space where they can share their challenges and feel reassured by others who are going through similar experiences at the same time, who live in the same neighbourhood and are of similar age. Sharing relevant and recent experiences is helpful. When mothers feel understood and listened to, they are more willing to take advice. Participants also expressed that they want to spread their knowledge in order to help others avoid the same difficulties. There is also a need for more consistent and compassionate support from healthcare professionals. Ensuring that guidance is clear is fundamental, but emotional support is even more important than sharing information. Support via phone/video call can be as valuable as face-to-face, as this provides cost-effective support and reassurance for the new mother without her having to leave the house with her newborn. In this way, the HCPs can also attend to more people. Second key finding A second key finding concerns breastfeeding education and knowledge, which are provided in, for example, antenatal classes. Knowledge influences attitudes and behaviours (Di Mario et al., 2019 ) as mothers can make more informed choices. New mothers must understand that breastfeeding can be hard and emotionally fulfilling at the same time. They will be better equipped at the start of the journey if they are aware that people will give different opinions and that it can be challenging to know what is correct, and if they are resilient and so less impacted by others while sleep-deprived and going through all the emotions of the newborn stage. When mothers-to-be know what to expect, it will be easier to have this resilience, and they will have higher levels of self-efficacy. Another topic that should be addressed with better knowledge sharing is SRIM or PIMS, as almost 50% of mothers give this as a reason to discontinue breastfeeding, despite only 5% of mothers actually having an insufficient milk supply (Huang et al., 2021 ). Currently, however, the amount of breastfeeding education given in antenatal classes is not tracked. Proper governance is needed, especially because the newer generation of mothers will most likely get more information online. Education should emphasise three key aspects of breastfeeding: health benefits, convenience, and bonding (Cole et al., 2024 ). Other recommendations Policies supporting breastfeeding (e.g. longer maternity leave) are also needed, as well as fewer misconceptions about CMF. CMF is promoted by the companies that market it, making the promotion biased and highlighting the advantages while neglecting the risks (Di Mario et al., 2019 ). Strengths and limitations The current study offers unique perspectives on how mothers can be supported to breastfeed for longer. However, it also has a few limitations. First, the sample size is small, as is common with RTAs, especially since it consists of long-term breastfeeding mothers who are an uncommon group. Second, the participants were relatively homogeneous, having a similar SES and partnership status and living in the same area. Due to their higher education, they were also aware of the benefits of breastfeeding. Third, the participants might have had recall bias as their breastfeeding journeys were made several years ago; therefore, emotions and feelings might be romanticised. In general, much research on this topic is done by female researchers, which leads to a certain bias. In addition, the researcher’s attitude influenced how the data were collected and analysed, and her knowledge and experience of the topic may also have resulted in bias. Besides this, the researcher was biased due to her friendships with most of the participants. However, due to the awareness of these biases and continually asking for feedback from others while writing the report, bias effects were reduced. Nonetheless, while this study represents a small group of breastfeeding women, findings can still contribute to the understanding of breastfeeding mothers and the difficulties they experience. The study demonstrates that small-scale research can be useful to support new mothers due to the suggested solutions. It also highlights how breastfeeding can impact a mother’s mental health and well-being. Future research Low breastfeeding rates emphasise that more funding is needed to continue research into breastfeeding and support around this topic. Ultimately it would save the economy money if more women breastfed. Future research could focus on younger and/or lower-educated mothers as they are less likely to breastfeed, and if they do, it is often for a shorter time. This comment also relates to most of the research being done in high-income countries, but birth rates are higher in low-income countries (Pérez-Escamilla et al., 2023 ). Therefore, more research in low-income countries will be helpful in gaining insights and raising awareness. Declarations The research was conducted in accordance with the Helsinki Declaration and the Code of Conduct of the British Psychology Society. Ethics approval - ethics approval was received by the School of Psychology Ethics Committee of the University of East London. Consent to participate - Participants’ informed consent to participate was received in participant’s signed consent forms (available). Consent for publication – Participant’s informed consent to publicise was received in participant’s signed consent forms (available). All participants gave written informed consent for their personal or clinical details along with any identifying images to be published in this study. Identifying images – not applicable Availability of data – interview transcripts uploaded in section Related Files. Competing interests – not applicable Funding – not applicable Authors' contributions – not applicable Acknowledgement – The authors are very grateful to all the participants who were willing to be open and share their personal stories. The interview was developed for this study, the questions have been uploaded. References Amir, L.H., Crawford, S.B., Cullinane, M. et al. (2024). General practitioners’ management of mastitis in breastfeeding women: a mixed method study in Australia. BMC Primary Care, 25 , 161. https://doi.org/10.1186/s12875-024-02414-4 Bandura A. (1986). Self-efficacy. Cognitive regulators. Social foundation of thought and action. A social cognitive theory . 2 nd ed. Prentice-Hall Inc. 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Supplementary Files 20250806InterviewSchedule.docx AppendicesforarticleExperiencesandattitudesofbreastfeedingmothersrelatedtosupportontheirbreastfeedingjourneys.docx Cite Share Download PDF Status: Published Journal Publication published 27 Mar, 2026 Read the published version in BMC Pregnancy and Childbirth → Version 1 posted Editorial decision: Revision requested 20 Oct, 2025 Reviews received at journal 28 Sep, 2025 Reviews received at journal 16 Sep, 2025 Reviews received at journal 14 Sep, 2025 Reviews received at journal 12 Sep, 2025 Reviewers agreed at journal 12 Sep, 2025 Reviewers agreed at journal 12 Sep, 2025 Reviewers agreed at journal 10 Sep, 2025 Reviewers agreed at journal 05 Sep, 2025 Reviewers invited by journal 04 Sep, 2025 Editor assigned by journal 02 Sep, 2025 Editor invited by journal 12 Aug, 2025 Submission checks completed at journal 12 Aug, 2025 First submitted to journal 12 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7243754","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":511134381,"identity":"e77e0127-f5d2-4aaf-a43a-5f302da962a6","order_by":0,"name":"Renate Uijtewaal","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABAElEQVRIiWNgGAWjYAgACzkQeeABIXUHQAQbmClhDBZIIEVLYgOIwqfFvL334OcPFQyJG+43H5P4USORPj/s8EOgLXZyug3YtcicOZcsceAMUMsxtjTJnmMSuRtvpxkAtSQbmx3ArkVCIsdA4mAbSAuP2Q0eNqCW2QkgLQcSt+HSIv/G+MfBfyAt/N9u/vknkW44O/0Dfi0SPGYSBxvAtrDd5m2TSJCXziFgC0+OmcWZYxLGM4+lmf+W7ZMw3CCdU3AgwQCPX9jPGN+oqLGR7Tt8+LHhm2828vKz0zd/+FBhJ4dLC0wngwJMgQGYYYBXOQTIN6AzRsEoGAWjYBRAAQDag2O5u5FK4gAAAABJRU5ErkJggg==","orcid":"","institution":"University of East London","correspondingAuthor":true,"prefix":"","firstName":"Renate","middleName":"","lastName":"Uijtewaal","suffix":""},{"id":511134382,"identity":"057fa1f9-8c16-476d-ad4d-bd82f1e6e23d","order_by":1,"name":"Caroline Edmonds","email":"","orcid":"","institution":"University of East London","correspondingAuthor":false,"prefix":"","firstName":"Caroline","middleName":"","lastName":"Edmonds","suffix":""}],"badges":[],"createdAt":"2025-07-29 13:23:31","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7243754/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7243754/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12884-026-08800-3","type":"published","date":"2026-03-27T16:08:52+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":105754934,"identity":"0bd51fbf-dfe8-43f1-ba1e-be2ca9f0e5dc","added_by":"auto","created_at":"2026-03-30 16:23:12","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1342260,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7243754/v1/5669b375-c0f4-4413-8717-ecd3a979d519.pdf"},{"id":91056190,"identity":"eb200f99-2ac6-4360-aeed-ef765be7f195","added_by":"auto","created_at":"2025-09-11 07:54:07","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":15427,"visible":true,"origin":"","legend":"","description":"","filename":"20250806InterviewSchedule.docx","url":"https://assets-eu.researchsquare.com/files/rs-7243754/v1/00c8333be2bd6cd21aa60259.docx"},{"id":91056464,"identity":"2f828111-e39a-4e97-9dd7-6a4f32ab45fc","added_by":"auto","created_at":"2025-09-11 08:02:06","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":67565,"visible":true,"origin":"","legend":"","description":"","filename":"AppendicesforarticleExperiencesandattitudesofbreastfeedingmothersrelatedtosupportontheirbreastfeedingjourneys.docx","url":"https://assets-eu.researchsquare.com/files/rs-7243754/v1/45b4e48f0ebc3994433e55cb.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Experiences and attitudes of breastfeeding mothers related to support on their breastfeeding journeys: a reflexive thematic analysis","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThis introduction discusses key terms described in this study and presents the global recommendations and current statistics around breastfeeding. Breastfeeding has been described as a journey with milestones and a clear beginning and ending (Foxworthy Scott \u0026amp; Bute, 2024). The benefits of breastfeeding, such as nutrition and immune support, are presented, and the characteristics and motivations of mothers who breastfeed \u0026ndash; especially those who continue breastfeeding for longer \u0026ndash; are explored. How breastfeeding mothers are supported by their partners, their mothers, healthcare providers (HCPs), and other mothers is evaluated. Finally, policies supporting a breastfeeding-friendly environment, as well as the alternatives to breastfeeding are discussed.\u003c/p\u003e\n\u003cp\u003eIn this study the terms \u0026lsquo;breastfeeding\u0026rsquo; and \u0026lsquo;mothers\u0026rsquo; are used for brevity. The term \u0026lsquo;mother\u0026rsquo; is used to describe the birthing and breastfeeding person, because all participants identified as mothers and referred to themselves in this way during the interviews. However, it is acknowledged that some people who breastfeed might not identify as a mother and/or would prefer the term chest feeding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRecommendations and statistics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWhile the benefits of breastfeeding, especially exclusive breastfeeding, are known by researchers, the global breastfeeding rates are decreasing and fall below the targets of the World Health Organization (WHO) and other organisations (Lehane et al., 2024). The current recommendations from the WHO and UNICEF are that mothers start breastfeeding within the first hour after birth, exclusively breastfeed for the first six months and continue to breastfeed until the infant is at least two years old (WHO, 2025). However, in 2024, 44% of babies aged 0\u0026ndash;6 months worldwide were exclusively breastfed, meaning only receiving breastmilk either directly from the mother\u0026rsquo;s breast or expressed and administered via a bottle. The WHO aims to increase the rate of exclusively breastfeeding to at least 50% by the end of 2025 and 70% by 2030 (WHO, 2023). While babies can be breast or bottle-fed (or tube-fed for those with feeding difficulties) the WHO describes breastfeeding as \u0026lsquo;\u0026lsquo;the normal way\u0026rsquo;\u0026rsquo; to feed a baby (WHO, 2025).\u003c/p\u003e\n\u003cp\u003eThe research presented in this dissertation was done in London and focusses on statistics in the UK. Little research has been done about breastfeeding rates in London specifically, nor on breastfeeding rates among mothers of different ethnicities. However, the UK is ranked 67\u003csup\u003eth\u003c/sup\u003e on the World Breastfeeding Trends Initiative (WBTI, 2025), and exclusive breastfeeding rates in England are among the lowest worldwide: 54.3% at birth, 17% at three months, 12% at four months and 1% at six months (Office for Health Improvement and Disparities, 2025). Although these are low, the rates have risen over time. For example, the rates of ever breastfeeding are 55% at six weeks (versus 48% in 2005) and 34% at six months (versus 25% in 2005), according to the Office for Health Improvement and Disparities (2025). After six months, babies in the UK tend to be weaned, and, therefore, feeding becomes a combination of breastmilk and solid foods.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eUNICEF launched the global Baby-Friendly Hospital Initiative (BFHI) in 1994 and rewarded health organizations with accreditation based on standards relating to maternity and child service (UNICEF, 2025). In the UK, almost 95% of maternity units have received BFHI accreditation (or are currently working towards it) (UNICEF, 2025), which could have contributed to the increasing rates over the past 20 years. Nonetheless, the number of mothers who continue to breastfeed for over one year is only 0.5%, and the number continuing until 2 years (adhering to the WHO recommendation) is negligible (Office for Health Improvement and Disparities, 2025).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBenefits of breastfeeding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBreastmilk is widely recognised for its adaptive, interactional and dynamic nature, contributing to improved infant survival, growth and development (P\u0026eacute;rez-Escamilla et al., 2023). It is estimated that an annual 823,000 infant deaths worldwide could be prevented if all mothers breastfed their babies until two years of age (WHO, 2025; Victora et al., 2016). The benefits are partially due to hormones in breastmilk that regulate a baby\u0026rsquo;s appetite, digestion, and sleep (Shaji et al., 2024), although night waking is normal for all babies regardless of their feeding habits (Brown \u0026amp; Harries, 2015). Besides that, breastmilk also provides babies with extra immune protection and reduces the chances of sudden infant death syndrome (Hauck et al., 2011). Studies indicate that breastfeeding reduces the risk of ear infections and asthma, as well as diabetes and obesity in later life (Lehane et al., 2024; P\u0026eacute;rez-Escamilla et al., 2023). Additionally, Di Mario et al. (2019) found that formula feeding was associated with more need for antibiotics, and Shaji et al. (2024) reported a lower rate of hospitalisation in breastfed babies.\u003c/p\u003e\n\u003cp\u003eBreastfeeding has also been associated with cognitive and socioeconomic benefits. Some studies have suggested that breastfed children have higher IQs and better school attendance and engagement, potentially leading to higher income in later life (P\u0026eacute;rez-Escamilla et al., 2023; Lehane et al., 2024). However, it remains unclear if this is due to the mother\u0026rsquo;s higher IQ, the composition of the milk or other reasons. Indeed, factors such as parental education and genetics also play significant roles (Krol \u0026amp; Grossmann, 2018; Bartels et al., 2009).\u003c/p\u003e\n\u003cp\u003eAnother advantage of breastfeeding is related to mental health. P\u0026eacute;rez-Escamilla et al. (2023) provided evidence that the composition of breastmilk changes in response to the infant\u0026rsquo;s needs, as well as to the mother\u0026rsquo;s and infant\u0026rsquo;s physical and emotional well-being. Breastfeeding also reduces stress for both mother and child due to the release of oxytocin and other hormones (Gust et al., 2020), although these benefits can also be activated by skin-to-skin contact (UNICEF, 2016) which can be practised regardless of feeding habits.\u003c/p\u003e\n\u003cp\u003eBreastfeeding mothers seem to experience fewer and shorter episodes of post-partum depression (Kim et al., 2021; Xia et al., 2022), which might be related to the optimisation of cortisol levels (Gust et al., 2020) and better regulation of stress responses in the parasympathetic nervous system (Sibolboro Mezzacappa, 2004, as cited by Garc\u0026iacute;a et al. 2024). However, it is acknowledged that mothers can also experience stress related to breastfeeding difficulties (Fewtrell et al., 2020) or loss of independence (Brown \u0026amp; Arnott, 2014), impacting their anxiety levels and well-being.\u003c/p\u003e\n\u003cp\u003eBesides benefits for the child, breastfeeding also has health advantages for mothers. Studies estimate that 20,000 to 98,000 maternal deaths could be prevented annually by breastfeeding (Castro-Cuervo, 2025; Victora et al., 2016), because breastfeeding positively affects the amount of postpartum blood loss and reduces the chances of breast and ovarian cancer (Victora et al., 2016) as well as Type 2 diabetes (Gunderson et al., 2015). However, challenges such as physical discomfort can impact a mother\u0026rsquo;s ability to breastfeed (Levinienė et al., 2013).\u003c/p\u003e\n\u003cp\u003eOne benefit that is not often mentioned is the financial savings of breastfeeding, which are estimated to be as much as 341.3 billion USD a year in total (Victora et al., 2016). Additionally, breastfeeding has an impact on sustainability, as it causes less (food) waste (Lehane, 2024). Nonetheless, it is important to consider that not all mothers have access to workplace accommodations or adequate support systems, including antenatal education, which may limit their ability to breastfeed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCharacteristics of mothers\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMothers who breastfeed for an extended period tended to be breastfed themselves (Crawford et al., 2023; Cole et al., 2024) and older when they became a mother (between 31 and 40 years) according to Michalopoulou et al. (2024) and Levinienė et al. (2013). They are also more likely to be better educated (with almost 80% having university degrees), to be married or living with the father of their child, and to have had a planned pregnancy (Levinienė et al., 2013), and may also have a higher socioeconomic status (SES; Kozachenko et al., 2024). All these characteristics create favourable circumstances for breastfeeding, and it is acknowledged that not every woman has these privileges.\u003c/p\u003e\n\u003cp\u003eHow much mothers know about the benefits of breastfeeding is a motivation to start breastfeeding, and women who decide to breastfeed while still pregnant are more likely to breastfeed than those who make this decision after birth (Xu et al., 2021). Breastfeeding mothers tend to feed their babies on demand and do not offer their babies formula milk or pacifiers (Levinienė et al., 2013; Muelbert \u0026amp; Giugliani, 2018). Mothers tend to breastfeed their second child longer than their first (Kozachenko et al., 2024).\u003c/p\u003e\n\u003cp\u003eIn contrast, besides having the opposite characteristics of mothers who breastfed for longer, mothers who breastfed for less than six weeks were also more often smokers, obese, and/or had high gestational weight gain (Levinienė et al., 2013). Some mothers choose to formula feed due to a desire for independence and routine (Brown \u0026amp; Arnott, 2014). Mothers who have to return to work also often breastfeed for a shorter time (Xu et al., 2021).\u003c/p\u003e\n\u003cp\u003eCrawford et al. (2023) stated that both breastfeeding initiation and duration were negatively impacted by having a caesarean delivery compared to a vaginal delivery. However, the relationship between the type of birth and breastfeeding is not consistent in the literature. Some research has shown that milk supply might be delayed following a caesarean delivery (Di Mario et al., 2019), while others did not establish any correlation (Prior et al., 2012). Furthermore, pain medication such as an epidural had contradictory findings in relation to breastfeeding outcomes (Levinienė et al., 2013). Lastly, if mothers started breastfeeding immediately after birth, this influenced their adaptation to breastfeeding (Kozachenko et al., 2024). While some studies suggested that a positive birth experience resulted in higher breastfeeding rates and negative experiences led to less breastfeeding (Di Mario et al., 2019; Brown \u0026amp; Arnott, 2014), \u0026Ccedil;ark \u0026amp; \u0026Ccedil;ankaya (2024) did not find any significant relationship between birth satisfaction and breastfeeding. For this reason, the topic of delivery type was not further explored in this research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSelf-efficacy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe greater the sense of self-efficacy, the more effort mothers tend to make to continue to breastfeed (Castro-Cuervo et al., 2025). Originating from Bandura\u0026rsquo;s (1986) social-cognitive theory, self-efficacy indicates an individual\u0026apos;s belief in their capability to achieve a specific goal.\u003c/p\u003e\n\u003cp\u003eDennis (2003) applied this theory to breastfeeding, proposing that a mother\u0026rsquo;s breastfeeding self-efficacy influenced her efforts, thoughts, and overall responses to breastfeeding, which in turn impact the initiation and continuation of breastfeeding. Dennis and Faux (1999) created the Breastfeeding Self-Efficacy Scale (BSES), which measures a mother\u0026rsquo;s confidence in her ability to breastfeed successfully. Later, Dennis simplified the scale from 33 to 14 items, creating the BSES-Short Form (Dennis, 2003). Castro-Cuervo et al. (2025) explored the scale\u0026rsquo;s structure and proposed a three-dimensional structure, incorporating competence, motivation, and confidence, with the latter increasing as the mother had more breastfeeding experience.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe current study does not include the use of the BSES-SF because all participants had stopped breastfeeding at the time of the study. However, the study does refer to self-efficacy as an important factor in breastfeeding, especially the competence component. Garc\u0026iacute;a et al. (2024) used the BSES-SF scale and reported that mothers who exclusively breastfed reported a significantly higher level of self-efficacy (t(94) = 2.4, p = .044). Huang et al. (2024) also found that lower self-efficacy in first-time mothers was related to a lack of knowledge and unrealistic expectations. However, besides higher self-efficacy levels, mothers who exclusively breastfed at five months post-partum did not report better mental health due to breastfeeding. This finding was consistent with earlier studies that suggested that there was no correlation between exclusive breastfeeding and maternal mental health a few months postpartum (Garc\u0026iacute;a et al., 2024).\u003c/p\u003e\n\u003cp\u003eFirst-time mothers were at higher risk of feeling confused or anxious about breastfeeding and low support was found to lead to low self-efficacy (Kozachenko et al., 2024). Kim et al. (2021) found a negative relationship between antepartum depression and exclusive breastfeeding for up to eight weeks and that depressive symptoms strongly influenced exclusive breastfeeding cessation, meaning that post-partum depression led to shorter breastfeeding duration. Another complication was that new mothers received varied \u0026ndash; and sometimes even conflicting \u0026ndash; advice from HCPs which can also lead to earlier cessation (Lehane, 2024).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSelf-efficacy and support\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eKnold Rossau et al. (2024) concluded that three out of five women discontinued breastfeeding due to the challenges they experienced in the first weeks and that ensuring consistent support from HCPs may improve breastfeeding rates, but that there was a lack of knowledge and counselling skills. Chambers et al. (2023) also found that the self-efficacy of breastfeeding mothers was related to empathy and emotional support of HCPs, but that many HCPs were overloaded, under pressure and did not have the time or capacity to be emotionally supportive; they advised that HCPs should give non-conflicting, non-judgemental and relevant information about breastfeeding. Jackson and Hallam (2020) and Kronborg et al. (2007) found similar results; they also concluded that mothers needed a positive attitude from HCPs but that HCPs were influenced by their own breastfeeding experience. Therefore, Chambers et al. (2023) argued that a more holistic approach was needed in order to support mothers in their breastfeeding journey. In support of this, it has been shown that maternal mental health is positively impacted by breastfeeding counselling (Chrzan-Detkos et al., 2021, as cited by Garc\u0026iacute;a et al., 2024).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWarm chain\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo achieve the recommended two years of breastfeeding, mothers need support beyond that provided by their HCPs. Sources of support can be divided into healthcare, workplace, and community, including family life. The \u0026lsquo;warm chain\u0026rsquo; describes the support across all three settings (Lancet, 1994, as cited by Tan et al., 2023), emphasising that no single organisation or individual can be solely responsible for supporting breastfeeding; instead, it requires a collective effort. However, the chain is often not coordinated or aligned (Tan et al., 2023).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSupport of a partner\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMothers tend to breastfeed for longer when they have a partner. For example, at six to twelve months, married mothers are twice as likely to still be breastfeeding compared with unmarried mothers (Levinienė et al., 2013). The support of a partner has a positive influence on mothers to start and continue to breastfeed, and it also positively contributes to the self-efficacy of women trying to breastfeed (Yuan et al., 2024). In addition, Emmott and Mace (2015) found that a father\u0026rsquo;s support was not necessarily only financial, as his emotional support was crucial. However, when a partner offers practical support (for example, bottle-feeding the baby), this could become a reason to stop breastfeeding (Emmott \u0026amp; Mace, 2015).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWang et al. (2020) found that partners with a higher educational background tend to be more positive towards their spouse\u0026rsquo;s breastfeeding, and they were more likely to familiarise themselves with its benefits. In particular, when a partner received breastfeeding education (for example, by HCPs), their attitudes improved, leading to more support and, therefore, prolonged breastfeeding by their spouses (Yuan et al., 2024).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSupport of a grandmother\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIf a grandmother had breastfed her child(ren) or had a positive attitude towards breastfeeding, the mother was also more likely to breastfeed her own children (De Brito Angelo et al., 2015; Emmott \u0026amp; Mace, 2015). A grandmother\u0026rsquo;s positive opinion resulted in a 12% higher chance that a new mother breastfed, while a negative attitude was related to 70% of new mothers being less likely to breastfeed (Negin et al., 2016). Therefore, the education of grandmothers and partners will have beneficial effects on breastfeeding rates (Negin et al., 2016; Brown \u0026amp; Arnott, 2014).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePeer support\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMothers expressed that breastfeeding is a \u0026lsquo;\u0026lsquo;rugged and difficult\u0026rsquo;\u0026rsquo; journey and new mothers benefit from a calm attitude from supporting mothers (Lehane et al., 2024). The influence of peers was an indicator of a continued breastfeeding journey (Jeon et al., 2024; Jackson \u0026amp; Hallam, 2020). Tawia (2024) also found that peer support encouraged mothers to continue to breastfeed, as it reduced their isolation and improved their self-esteem. An example of this was \u003cem\u003eCommunity Mothers,\u003c/em\u003e a project developed in Ireland during the 1980\u0026rsquo;s; this successful project consisted of mothers visiting new mothers at home to provide peer support (Lehane et al., 2024). Another study showed that peer support was a predictor for breastfeeding at 12 months; in particular, if that support came from mothers who had breastfed for longer, then this motivated new mothers to also continue (Xu et al., 2021).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEducation and information\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere are several challenges facing the provision of support for new mothers to start and continue breastfeeding. These challenges include misinformation about breastfeeding physiology, a lack of evidence-based knowledge and skills among HCPs, and insufficient sustained support for exclusive breastfeeding among the wider society (Lehane et al., 2024; Chambers et al., 2023). Research suggests that when information is contradictory, this increases mothers\u0026rsquo; frustrations and, therefore, the likelihood that they will stop breastfeeding (Chambers et al., 2023; Marino et al., 2023). Tawia (2024) also found that an authoritative style of advice-giving was seen as judgemental and bossy, and consequently ineffective.\u003c/p\u003e\n\u003cp\u003eIt has been argued that support from well-trained HCPs is crucial in order to improve breastfeeding rates (Lehane et al., 2024; Thomson et al., 2015). For example, attending antenatal classes tripled the likelihood of breastfeeding, according to Levinienė et al. (2013), but it is unclear how many people attend antenatal classes and what kind of guidance is given (Kozachenko et al., 2024). Hoddinott et al. (2012) found that antenatal courses made breastfeeding sound easy and did not address the expectation-reality gap. Fewtrell et al. (2020) suggested that breastfeeding education should be provided in schools in order to raise awareness among the entire population.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eA breastfeeding-friendly environment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBesides the warm chain, a new mother\u0026rsquo;s environment impacts her breastfeeding journey. Therefore, Tan et al. (2023) advocated for breastfeeding-friendly cities where breastfeeding is encouraged, and policies exist to support the whole chain. They found such cities to be better for health and nutrition, as well as more sustainable due to less waste, less use of resources, and a lower carbon footprint (Tan et al., 2023). Breastfeeding-friendly cities also adopt the BFHI; mothers benefit from the support in the hospital due to this initiative but also need support from a qualified person when they return home because breastfeeding extends beyond the length of the hospital stay (Levinienė et al., 2013; McNaughton et al., 2024).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAlternatives to breastfeeding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn a study with almost 2,000 participants, Michalopoulou et al. (2024) found that 65% of mothers had issues with latching and experienced pain in the first two weeks of breastfeeding. They also found that mothers who mixed-fed using commercial milk formula (CMF) were less committed to breastfeeding and three times more likely to stop (Michalopoulou et al., 2024). However, mixed feeding may be necessary for some mothers due to medical conditions or personal circumstances.\u003c/p\u003e\n\u003cp\u003eThe use of CMF increased during the Industrial Revolution, coinciding with a decline in breastfeeding rates (Rollins et al., 2023). However, in the 1970s, the feminist movement had a positive effect on breastfeeding rates due to its emphasis on women\u0026rsquo;s bodily autonomy and challenging medical authority (Pemberton, 2014). At the same time, other feminist perspectives supported CMF feeding to enable women\u0026rsquo;s independence and return to the workplace (Johnson et al., 2009). This era also introduced skin-to-skin contact, rooming-in, and greater use of pain medication during labour (Foxworthy Scott \u0026amp; Bute, 2024).\u003c/p\u003e\n\u003cp\u003eIt is acknowledged that CMF is necessary for many families; when a child cannot be breastfed, CMF serves as an appropriate alternative (Meek et al., 2022, as cited by Marino et al., 2023). However, concerns have been raised about misleading marketing (Tan et al., 2023), particularly about the promotion of CMF as equal to breastmilk, contrary to most evidence (Shaji et al., 2024; P\u0026eacute;rez-Escamilla et al., 2023). Marketing of CMF has been linked to lower breastfeeding rates (Topothai et al., 2023; McNaughton et al., 2024). In response, the WHO introduced a code in 1981 to restrict the marketing of CMF, prohibiting promotion direct-to-consumer and within healthcare settings, but CMF is still provided on some UK maternity wards according to recent research (McNaughton et al., 2024). Currently, CMF packaging must state that \u0026lsquo;breastfeeding is best for babies\u0026rsquo; and cannot include pictures of infants (Foxworthy Scott \u0026amp; Bute, 2024; McNaughton et al., 2024).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResearch question\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWhile research demonstrates multiple benefits of breastfeeding, the majority of women do not achieve the recommendation for exclusively breastfeeding for the first six months of their child\u0026rsquo;s life, and far fewer maintain at least some breastfeeding for at least two years. In light of this, this study aimed to understand \u0026ndash; on a local and small scale \u0026ndash; what encourages mothers to breastfeed and how society may be able to help women feel comfortable to breastfeed and continue to breastfeed despite the obstacles they face. The research investigated what support is needed for women to thrive in their breastfeeding journey.\u003c/p\u003e\n\u003cp\u003eWhile there is extensive research about breastfeeding, most research is quantitative, and there are not many reflexive thematic analyses (RTA). Most research is also done on a larger scale, which may not address the topic in sufficient depth. There is also a lack of data on the factors that lead mothers to continue breastfeeding after six months (Kozachenko et al., 2024); such mothers are relatively uncommon, and this research aimed to contribute to closing that gap.\u003c/p\u003e\n\u003cp\u003eThus, the research questions addressed here were: What do women need in order to pursue and persist in breastfeeding? How do (internal) motivation and (external) attitudes towards breastfeeding influence a breastfeeding journey?\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eParticipants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEight women were recruited to participate in this study and take part in semi-structured interviews. The requirement was that they had breastfed for at least nine months of their baby\u0026rsquo;s life.\u003c/p\u003e\n\u003cp\u003eAll participants were mothers and held university degrees. Except for two participants, everyone was married or in a long-term relationship with the father of their children at the time of the interview. They were aged between 34 and 52, with a median of 40. Except for one participant, all participants were above 30 when they had their first child.\u003c/p\u003e\n\u003cp\u003eThe participants were all residents of the UK and living in London at the time of the interview. However, they had varied ethnic backgrounds. Participants were purposely invited to explore any differences between their cultures and that in the UK, as well as differences with the researcher\u0026rsquo;s Dutch culture.\u003c/p\u003e\n\u003cp\u003eSome researchers believe that when a participant and interviewer have similar social characteristics, the interviewee will be more likely to be open and reveal sensitive information (Braun \u0026amp; Clarke, 2013). For the interviews to be effective, it was important that the participants knew that I had breastfed for a substantial amount of time myself. Our friendships meant that participants could be even more honest and open, which was one of the reasons why I chose to interview friends. As I already had background knowledge of each participant, we could skip over introductions and have in-depth conversations.\u003c/p\u003e\n\u003cp\u003eAlthough recording the sessions might have made the participants more self-conscious, participants were willing to share personal experiences and details, talking about topics from sore nipples to their relationships with their spouses and their mothers.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe biographical information of the participants is shown in Table 1; the participants\u0026rsquo; names have been changed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u0026nbsp;\u003c/strong\u003e\u003cem\u003eDescription of participants\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"576\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePseudonym\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.8543%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.229%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of breastfeeding (for each child)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eBegonia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.8543%;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.229%;\"\u003e\n \u003cp\u003eBrazilian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003e1. 16 months (girl)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eCarnation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.8543%;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.229%;\"\u003e\n \u003cp\u003eBritish\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003e1. 12 months (boy)\u003c/p\u003e\n \u003cp\u003e2. 7.5 months (boy)\u003c/p\u003e\n \u003cp\u003e3. 8 weeks (girl)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eClematis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.8543%;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.229%;\"\u003e\n \u003cp\u003eBritish\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003e1. 20 months (boy)\u003c/p\u003e\n \u003cp\u003e2. 34 months (boy)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eChrysanthemum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.8543%;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.229%;\"\u003e\n \u003cp\u003eBritish\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003e1. 12 months (boy)\u003c/p\u003e\n \u003cp\u003e2. 15 months (girl)\u003c/p\u003e\n \u003cp\u003e3. 14 months (girl)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eEdelweiss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.8543%;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.229%;\"\u003e\n \u003cp\u003eItalian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003e1. 10 months (girl)\u003c/p\u003e\n \u003cp\u003e2. 9 months (boy)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eGladiolus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.8543%;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.229%;\"\u003e\n \u003cp\u003eKorean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003e1. 15-16 months (boy)\u003c/p\u003e\n \u003cp\u003e2. 14-15 months (girl)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003ePeony\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.8543%;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.229%;\"\u003e\n \u003cp\u003eTurkish\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003e1. 3 months plus 3 months expressing (boy)\u003c/p\u003e\n \u003cp\u003e2. 17 months (boy)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eSunflower\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.8543%;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.229%;\"\u003e\n \u003cp\u003eTurkish\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 300px;\"\u003e\n \u003cp\u003e1. 24 months (boy)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProcedure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eRecruitment\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRecruitment was done via the friend and family approach, meaning that all the participants were known to the researcher. When the research was explained to the participants a few weeks before the interviews, they all agreed to be part of the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWhen the first six participants had been interviewed, it became clear that they were all in the same age group and had a similar SES (middle class, double income) because they were all mothers that I had met through the nursery or the private school attended by my children. All of them were able to take maternity leave for at least six to nine months, most even a year, and some of them did not return to work at all.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAfter a few weeks, I reconsidered this decision and added two more interviewees to balance the SES of the sample more evenly. They were single mothers at the time of the interview but had been in a relationship with the father of their child(ren) when they breastfed their babies. Both participants were known to the researcher due to being part of the same cohort at university. The benefit of their inclusion was that the data became richer and more diverse. There were no notable differences between the mothers in the two subsamples, as they all seemed to discuss similar topics and experiences in their interviews.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eInterviews\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll interviews were completed via video conference (using Microsoft Teams); the interviews were also recorded via Teams, which has the benefit of automatic transcription. The transcriptions had to be checked and edited afterwards as the different accents made some of the words unclear or captured incorrectly. All participants were given a pseudonym to ensure their anonymity. The names of children and husbands/spouses that were mentioned during the interviews and could identify the participant were also removed from the transcripts.\u003c/p\u003e\n\u003cp\u003eThe interviews took place between September 2024 and January 2025 and were about 30\u0026ndash;45 minutes each. The interviews were semi-structured: each had the same questions and general structure, but follow-up or clarification questions were asked to ensure that the answers were understood in the way they were intended. Semi-structured interviews also give a chance for participants to raise any matters they think are of importance to the research topic (Braun \u0026amp; Clarke, 2013).\u003c/p\u003e\n\u003cp\u003eThe interview questions explored the intrinsic motivation to breastfeed (e.g. \u003cem\u003eWhy did you want to breastfeed?\u003c/em\u003e) and revealed what was happening in the participants\u0026rsquo; inner world while they were breastfeeding (e.g. \u003cem\u003eHow did it make you feel to be able to breastfeed?\u003c/em\u003e). They also explored how mothers experienced the support of their spouse, own mother, HCPs, and other mothers.\u003c/p\u003e\n\u003cp\u003eDue to the small sample size, the interview questions were not focused on cultural differences, although participants did refer to their original cultures. RTA is not ideal for generalisations and one person cannot represent a whole culture, especially with each woman living in London for a substantial amount of time and having adapted to the UK culture. Interview questions can be found in Appendix 1.\u003c/p\u003e\n\u003cp\u003eOnly mothers who had breasted were interviewed in order to explore the reasons for breastfeeding, the relationship with being breastfed, and other motivations. If non-breastfeeding mothers had been included, the research would have been notably different. Since the aim was to explore the participants\u0026rsquo; lived experiences, their partners were also excluded from the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eData analysis\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRTA is an adaptable theoretical approach, which means that data can be interpreted on psychological and social aspects and themes. RTA offers the potential for unexpected insights (Braun \u0026amp; Clarke, 2022). Not being an experienced researcher, I felt most comfortable with a flexible, research-centric approach where I was allowed to be creative with the interpretation. RTA consists of six phases: familiarisation with the data, generating codes, combining codes into themes, refining themes, naming themes, and describing the findings (Braun \u0026amp; Clarke, 2022). An advantage of RTA is that one can go back and forth between analysing the data, doing research, and recording findings, then repeating this process until it is finished.\u003c/p\u003e\n\u003cp\u003eAfter each interview was conducted, it was transcribed immediately afterwards so as not to lose any impressions and to ensure everything was captured correctly. After all the interviews were transcribed, I listened to the recordings several times to familiarise myself with the emotions and intonations of the speaker.\u003c/p\u003e\n\u003cp\u003eFollowing the six phases of RTA, I also read and reread the transcripts to immerse myself in the data. Following this, I created my initial coding ideas of topics and sentences that stood out for me. I used a top-down approach using my research question to define codes, as well as a bottom-up approach in which I worked with the data to discover more codes.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNext, I used Delve, an online data analysis tool, to create codes using descriptive, in vivo, and process coding. In this tool, I was able to highlight and tag paragraphs that belonged to specific codes to create evidence.\u003c/p\u003e\n\u003cp\u003eThis process was followed for each of the eight transcripts, resulting in over 70 codes (Appendix 2). These codes were narrowed down by merging and joining those that had similarities, as well as deleting those which only had one paragraph as evidence or were mentioned by only one participant.\u003c/p\u003e\n\u003cp\u003eRTA requires researchers to engage and re-engage with the data rather than draw conclusions after the first analysis, as this might lead to superficial results (Braun \u0026amp; Clarke, 2022). After working on different aspects of the dissertation, I immersed myself in the data for a third time to assess whether new and different topics would emerge. Lastly, I compared the themes produced by all three data analyses described above, as these seemed to be the strongest; these themes became the ones discussed in this report.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical considerations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study adhered to the \u0026lsquo;Code of Conduct of the British Psychology Society\u0026rsquo; (British Psychology Society, 2021). The project proposal was reviewed and approved by the ethical committee of the University of East London\u0026rsquo;s School for Psychology prior to the research taking place. The ethical approval can be found in Appendix 3.\u003c/p\u003e\n\u003cp\u003eEach participant received a Participant Information Sheet (Appendix 4), which provided relevant information about the research. They received these in advance so that they had a chance to read them before the interview, ensuring that each participant had an opportunity to ask questions before the interview and provided their informed consent to participate. Each participant consented to their interview being recorded and their data being analysed by signing the Consent Form (Appendix 5).\u003c/p\u003e\n\u003cp\u003eDue to the online nature of the interviews and because they were being recorded, participants were asked to be in a quiet and private space while being interviewed. At the start of the interview, the purpose of the research was specified, and participants were given the option to ask any questions. Participants had the right to stop the interview and/or withdraw from the research (within a three-week period), but none of them did.\u003c/p\u003e\n\u003cp\u003eAll participants expressed that they experienced positive emotions when looking back at certain moments with their newborn babies, which was also apparent due to their smiles while recalling this period. Several participants became emotional during the interview when remembering a challenging time, when they had experienced difficulties (for example, feeding a pre-mature baby in an incubator with a syringe, feeling isolated, or having mastitis). One participant revealed that she stopped breastfeeding because she and her husband wanted to try for another baby but then did not become pregnant. To keep the interview on track, I did not probe this further and focused on the following questions instead.\u003c/p\u003e\n\u003cp\u003eParticipants were encouraged to express their perspectives, and they had the chance to pause or stop the interview at any time. They could also refuse to answer a question without an explanation if they wanted, but this did not happen. In the debrief form (Appendix 6) several organisations were mentioned that could be helpful should participants be experiencing negative emotions after the interview, because the breastfeeding journey can be an emotional and intense phase of a mother\u0026rsquo;s life and was relived through the interviews.\u003c/p\u003e\n\u003cp\u003eIn order to ensure confidentiality, the data were scanned for identifying information, such as the names of the participant\u0026rsquo;s child(ren) and partners, and these were removed. Data were securely stored and protected by passwords. The raw data were only accessible to the researcher, while her supervisor had access to the data once they had been anonymised.\u003c/p\u003e"},{"header":"Results and Discussion","content":"\u003cp\u003eFour themes were developed from the data: \u0026ldquo;Breastfeeding is hard\u0026rdquo;, \u0026ldquo;Breastfeeding is magical\u0026rdquo;, \u0026ldquo;Breastfeeding is an emotional rollercoaster\u0026rdquo;, and \u0026ldquo;Support is everything\u0026rdquo;. These themes and their subthemes are described in more detail below. Quotes from the interviews are used to illustrate how these themes were created.\u003c/p\u003e\u003cdiv id=\"Sec23\" class=\"Section2\"\u003e\u003ch2\u003eBreastfeeding is hard\u003c/h2\u003e\u003cp\u003eDespite breastfeeding for at least a year, each participant stated several times during their interviews that breastfeeding was hard; this could be for different reasons, which are outlined. Peony summarised it as follows: \u0026ldquo;It's the hardest thing that nobody talks about. [\u0026hellip;] Nobody talks about your sore nipples the first few weeks or mastitis or how difficult it is at 3\u0026ndash;4 months and to stop\u0026hellip;, how sad you are to stop.\u0026rdquo;\u003c/p\u003e\u003cdiv id=\"Sec24\" class=\"Section3\"\u003e\u003ch2\u003eBecause in the beginning, it hurts\u003c/h2\u003e\u003cp\u003eEstablishing breastfeeding was physically challenging. According to Begonia, \u0026ldquo;The first night was a nightmare\u0026rdquo;. The early days of breastfeeding are tricky, with engorged breasts and sore nipples, while the body is recovering from birth and sleep-deprived, combined with the many emotions of the postpartum stage, getting to know their baby, learning a new skill, and settling into new routines (Hoddinott et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2012\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eSome mothers think that because breastfeeding is a natural phenomenon, it should be an easy and intuitive thing to do (Yuen et al., 2022, as cited by Garc\u0026iacute;a et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). However, in one study, 76% of women experienced difficulties with breastfeeding, including pain and cracked nipples (Garc\u0026iacute;a et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Pain during breastfeeding is a common reason to stop, and several researchers have found significant relationships between pain and shorter breastfeeding journeys (Li et al., \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2008\u003c/span\u003e; Levinienė et al., \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2013\u003c/span\u003e; Min et al., \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eChrysanthemum was shocked by how much breastfeeding could hurt, reflecting a feeling of being unaware of the initial pain of breastfeeding. \u0026ldquo;I had no concept that it would really hurt, really hurt. I remember the drawdown\u0026hellip;, like\u0026hellip;, being really painful and being quite shocked by that.\u0026rdquo;\u003c/p\u003e\u003cp\u003eClematis experienced a similar physical strain, describing her first week:\u003c/p\u003e\u003cp\u003eI guess in those early hours, when it\u0026rsquo;s really painful in the middle of the night, and you\u0026rsquo;re sharing that your nipples are sore and raw, and you cannot get your sleep, and your back is broken, and this child just won\u0026rsquo;t go to sleep.\u003c/p\u003e\u003cp\u003eGladiolus also reflected on how exhausted she was in trying to establish breastfeeding, especially in a hospital setting, where she had to pump, syringe-feed, and combi-feed. She reflected on how breastfeeding was challenging at first, stating that it took a \u0026ldquo;couple of months\u0026rdquo; before she and her baby finally found a rhythm. She said:\u003c/p\u003e\u003cp\u003eI was determined to do it. So, from the colostrum, you know, get, get, getting the colostrum and putting it into these tiny syringes, to pumping as much as I could and then feeding it, feeding it to him. [\u0026hellip;] So, in the beginning, I also had to combi-feed, you know\u0026hellip;, to make sure that he was getting his nutrients, so it was a journey, umm. But after\u0026hellip;, I think I would say, you know\u0026hellip;, a good couple of months, I feel like we were in the zone. But the first couple of months were hard.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec25\" class=\"Section3\"\u003e\u003ch2\u003eBecause of the three months\u0026rsquo; fussiness\u003c/h2\u003e\u003cp\u003eAfter establishing a breastfeeding routine, some mothers experienced \u0026lsquo;the three months\u0026rsquo; breastfeeding crisis\u0026rsquo;, a growth spurt where babies experience increased milk demand, leading to fussiness and frequent feeding requests (Taut et al., \u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Hoddinott et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Babies also become more curious and distracted by the world around them as their sight and coordination improve (Hunnius, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). Keeping them focused on feeding was a challenge, as Peony described:\u003c/p\u003e\u003cp\u003eI tried everything. [\u0026hellip;] With [my second child], I was like, \u0026lsquo;\u0026rsquo;No, I\u0026rsquo;m going to power through this. It's the three months fussiness.\u0026rsquo;\u0026rsquo; [\u0026hellip;] There\u0026rsquo;s things going on. They can see things. They\u0026rsquo;re looking around. You know. And that\u0026rsquo;s when I started to do all the other positions like the rugby hold and like, like the rock climber, the rock climber. [laughing] And that is to be in a cafe and be like, you know, I want him to breastfeed. I, this is really weird. Nobody else has to do this. But I was too scared to not do that because that, it will be like [my first child], and I wouldn\u0026rsquo;t be able to breastfeed.\u003c/p\u003e\u003cp\u003ePeony described her determination to persevere. She tried multiple positions, including the \u0026ldquo;rugby hold\u0026rdquo; and even jokingly named one the \u0026ldquo;rock climber\u0026rdquo;. This trial-and-error process reflected the physical challenges of breastfeeding. She also highlighted that she felt self-conscious and isolated, similar to Lehane et al.\u0026rsquo;s (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) findings that mothers experienced a fear of the unknown and (especially new mothers) felt lonely and alone. Lastly, her fear of failing again \u0026ndash; even though she breastfed her first child for six months \u0026ndash; pushed her to keep going. This latter point relates to Menekse et al.\u0026rsquo;s (\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) findings that mothers with more self-control and who are open to development tend to breastfeed for longer.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec26\" class=\"Section3\"\u003e\u003ch2\u003eBecause it is always you\u003c/h2\u003e\u003cp\u003eAnother aspect that contributed to this theme was that the journey could be relentless, especially due to the infant\u0026rsquo;s dependence on the mother and a lack of breaks from looking after one\u0026rsquo;s child. Over time, sharing their body and time with their infant became daunting to some participants. Always having to be the one to feed and do bedtime took its toll, and some participants even stated that their \u0026ldquo;sense of self\u0026rdquo; was impaired.\u003c/p\u003e\u003cp\u003eFor example, Chrysanthemum described how she had to be present for nearly all feeds while her baby was in the ICU, with few opportunities to express milk:\u003c/p\u003e\u003cp\u003eHe\u0026rsquo;s in ICU, and he had to feed every two hours. So either I had to be there, I was allowed to, I was allowed to express 2 times every 24 hours, so I had to be there for the other ones. And they were quite stressy about\u0026ndash; [\u0026hellip;] So I was having to go in at 2:00 AM, 4:00 AM, 6:00 AM. I wasn\u0026rsquo;t\u0026hellip;, I didn\u0026rsquo;t have a bed. So we weren\u0026rsquo;t at the hospital, we were in a hotel. I remember that fairly bleak point and feeling stressed, because if we didn\u0026rsquo;t feed, he wouldn\u0026rsquo;t, like, get better. He wouldn\u0026rsquo;t be able to be discharged, as \u0026lsquo;\u0026lsquo;If you can\u0026rsquo;t prove that you\u0026rsquo;re feeding, we won\u0026rsquo;t discharge you.\u0026rsquo;\u0026rsquo; [\u0026hellip;] And sometimes I could find it a bit much because, because they, like [my first child] never really bottle-fed. None of them really ever bought it, so I could never really escape like an hour in the early days, which can be quite intense.\u003c/p\u003e\u003cp\u003eThis quote shows how breastfeeding can be relentless, emphasising the constant demands placed on breastfeeding mothers. The hospital staff\u0026rsquo;s insistence on breastfeeding added to the pressure, making the experience even more difficult. Chrysanthemum had to wake up repeatedly during the night to feed, all the while staying in a hotel, separated from her baby. The frequency of feeding, combined with the stress of her baby\u0026rsquo;s health and the expectation to \u0026lsquo;\u0026lsquo;prove that you\u0026rsquo;re feeding\u0026rsquo;\u0026rsquo;, made the experience overwhelming. The request from the hospital staff was not aligned with the UK recommendation of expressing eight times in a 24 period (NHS, 2025), and research has even shown that expressing eight times does not yield more milk than doing it less frequently (Levene et al., \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Even later, at home, Chrysanthemum described how her children never took a bottle, meaning she could never get a break from breastfeeding; it consumed every hour of her early postpartum experience. She captured how mothers can feel trapped by this constant demand.\u003c/p\u003e\u003cp\u003eExpressing milk was another aspect of breastfeeding that was difficult, partly due to the lack of the baby\u0026rsquo;s physical presence, as described by Begonia:\u003c/p\u003e\u003cp\u003ePumping is super difficult. I, I did not really manage to pump much. It\u0026rsquo;s just because you\u0026rsquo;re lacking that physical presence that gets your body to, to do it. So, I think that\u0026rsquo;s what\u0026rsquo;s lacking. If the if the baby is not there, it becomes really, really difficult.\u003c/p\u003e\u003cp\u003eAlmost 60% of mothers stop breastfeeding due to not being able to express (Theurich et al., \u003cspan citationid=\"CR78\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Hoddinott et al. (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2012\u003c/span\u003e) described how some mothers expressed to enable their partner to bond with the baby and used CMF when expressing was not successful. However, none of the participants mentioned that in this study.\u003c/p\u003e\u003cp\u003eIn this study, most participants stopped breastfeeding due to other circumstances or to have time back. For example, Chrysanthemum stated:\u003c/p\u003e\u003cp\u003eI wanted to have that break because I think at bedtime it always had to be me. I had to do every bedtime, and we were thinking about having another baby. I was going back to work, and I felt I needed a bit of separation from him.\u003c/p\u003e\u003cp\u003eAdditionally, stopping breastfeeding was a challenging experience. The body went through hormonal changes, and emotions varied from relief to sadness and guilt. Seeing their baby grow, the participants understood that this time would never return. Some participants felt sadness, and this has been described as post-breastfeeding depression (Vincent, 2024). For example, when asked why she stopped breastfeeding, Begonia said:\u003c/p\u003e\u003cp\u003eIt was due to family planning. We decided we wanted to try for a second, a second child and my doctor mentioned the hormones could, you know, start to influence my ability to get pregnant again. And it was super hard because from the perspective of [my child], I wanted to carry on. [\u0026hellip;] I was having a really hard time stopping. [\u0026hellip;] I would have definitely done it for longer if it wasn\u0026rsquo;t for that.\u003c/p\u003e\u003cp\u003eThe above experiences aligned with research stating that motherhood and work were considered to be \u0026lsquo;\u0026lsquo;two greedy institutions expecting full devotion\u0026rsquo;\u0026rsquo; (Blair-Loy, 2003; Coser, 1974, as cited by Johnson \u0026amp; McCarthy, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) and that breastfeeding added extra demands on a mother (Brown \u0026amp; Arnott, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Starting breastfeeding was self-consuming (Johnson \u0026amp; McCarthy, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) and time-consuming (Brown \u0026amp; Arnott, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2014\u003c/span\u003e); this also relates to \u0026lsquo;parent-offspring conflict theory\u0026rsquo; which proposes that each child seeks more maternal resources than is ideal for the mother (Trivers, 1974, as cited by Fewtrell et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec27\" class=\"Section2\"\u003e\u003ch2\u003eBecause it takes up all your time\u003c/h2\u003e\u003cp\u003eBreastfeeding was also hard because it takes a lot of time. Smith \u0026amp; Ellwood (2010) found that exclusively breastfeeding mothers spend 75 hours a month breastfeeding and another 50 hours a month on emotional care. Furthermore, Emmott and Mace (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2015\u003c/span\u003e) stated that exclusively breastfeeding mothers burn an extra 400\u0026ndash;750 kcal per day. Because breastmilk is easier to digest than CMF, babies drink more frequently and irregularly (Shaji et al., \u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Brown \u0026amp; Arnott, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2014\u003c/span\u003e); they also receive more night feeds, even though CMF-fed babies wake-up as many times and take longer to settle (Brown \u0026amp; Harries, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Begonia summarised this: \u0026lsquo;\u0026lsquo;They\u0026rsquo;re always feeding, especially in the beginning\u0026rsquo;\u0026rsquo;. She also realised that babies sometimes want closeness even if not necessarily to be fed (Smith \u0026amp; Ellwood, 2010; Brown \u0026amp; Harries, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Once Begonia knew this, she offered her baby more skin-to-skin contact, which also improved her milk supply, reflecting the biological process:\u003c/p\u003e\u003cp\u003eThe person doing the NCT or the, the birth prep class had mentioned. \u0026lsquo;\u0026lsquo;You can do skin-to-skin\u0026rsquo;\u0026rsquo;. And I didn\u0026rsquo;t think of it as a tool relating to breastfeeding, but what happened was\u0026hellip; [\u0026hellip;] I had just pumped and she wanted to feed. And I was like, \u0026lsquo;\u0026lsquo;What am I going to do? I\u0026rsquo;m not gonna have any milk.\u0026rsquo;\u0026rsquo; And then I just decided to do the skin-to-skin, and the milk came. And I was like: \u0026lsquo;\u0026lsquo;Oh, what is that?\u0026rsquo;\u0026rsquo; And then I was like, \u0026lsquo;\u0026lsquo;Yeah, I'm really an animal\u0026rsquo;\u0026rsquo;.\u003c/p\u003e\u003cp\u003eClematis also referred to the time costs of breastfeeding, describing how it took a toll on a mother and how consuming it was:\u003c/p\u003e\u003cp\u003eThat time to breastfeed, it costs money. It plays, plays a physical toll on every woman\u0026rsquo;s body. [\u0026hellip;] You need to spend your time, and you give your body up to do it. [\u0026hellip;] When you add on the pregnancies, it\u0026rsquo;s quite a lot of, like, time giving your body over to, to others. [\u0026hellip;] [My first child] just didn\u0026rsquo;t stop feeding. He was feeding all the time.\u003c/p\u003e\u003cp\u003eClematis did not only experience this herself but also mentioned her mother, who breastfed her and her three siblings:\u003c/p\u003e\u003cp\u003eMy mum was not working when we were little. So, she, yeah, that was her job, really, to look after the kids, and her time was, was that, was spent on that. [\u0026hellip;] And I guess I was fortunate that I had a year off on maternity leave, which I know is not available to everybody for lots of reasons.\u003c/p\u003e\u003cp\u003eClematis also acknowledged the privilege of being able to take a year of maternity leave and recognised that not many women have this option. She contrasted her own experience with that of her mother, whose \u0026lsquo;\u0026lsquo;job\u0026rsquo;\u0026rsquo; was to care for the children, emphasising how breastfeeding was often unpaid labour and acknowledging how women across generations have given up time to nurture their babies.\u003c/p\u003e\u003cp\u003eResearch suggests that mothers need better maternity leave, as 649\u0026nbsp;million women of childbearing age worldwide live in countries with no statutory maternity leave (P\u0026eacute;rez-Escamilla et al., \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). More facilities are also needed for mothers who express milk after returning to work: it has been argued that when workplaces support mothers, they feel more self-efficacy and breastfeed for longer (P\u0026eacute;rez-Escamilla et al., \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Xu et al., \u003cspan citationid=\"CR91\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). However, studies have found that workplace accommodations are uncommon; for example, Jackson and Hallam (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) found that mothers were sometimes expected to express in the toilet.\u003c/p\u003e\u003cp\u003eSeveral participants gave \u0026lsquo;\u0026lsquo;wanting my body back\u0026rsquo;\u0026rsquo; as a reason to stop breastfeeding (as also found by Hauck \u0026amp; Irurita, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2002\u003c/span\u003e), but interestingly, none of the participants spoke about the restrictions in their diets, as a breastfeeding mother is not allowed to drink or eat certain foods (Shaji et al., \u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Perhaps they did not experience these restrictions as limiting, were already used to them due to the pregnancy, or forgot that part of the journey.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec28\" class=\"Section2\"\u003e\u003ch2\u003eBecause it sometimes causes mastitis\u003c/h2\u003e\u003cp\u003eParticipants spoke about the sacrifices they made in offering their time and bodies to their babies. Some mothers even experienced mastitis. On average, one in five breastfeeding women experiences an episode of mastitis, a breast infection, most often in the first month of breastfeeding (Amir et al., 2020, as cited by Amir et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). However, as mastitis can resolve itself on its own and does not necessarily need medical intervention, this estimate is likely an underestimate, as it is based on reports from GP surgeries. If a visit to the GP is made, this is likely because the symptoms \u0026ndash; like fever and inflammation \u0026ndash; are more severe, and antibiotics may be required. In their study of more than 3,000 participants, Amir et al. (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) found that over 90% of women with mastitis received antibiotics. Although mastitis is very painful, the general recommendation (stated by the WHO) is to continue to breastfeed and even express breastmilk if possible (WHO, 2025). One of the reasons for this is that stopping breastfeeding can lead to (more) clogged milk ducts and, eventually, the formation of abscesses (Amir et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\u003cp\u003ePeony remembered her episode of mastitis:\u003c/p\u003e\u003cp\u003eAnd the mastitis was just like, \u0026lsquo;\u0026lsquo;Oh, my God, there is nothing worse than this\u0026rsquo;\u0026rsquo;. I mean, my boobs were like rocks. It was like rocks you couldn\u0026rsquo;t like [pokes her breast with her finger]. Anything, it didn\u0026rsquo;t go in, it was like, like this [balls hands to fists]. And then you\u0026rsquo;re like, still have to breastfeed and like, \u0026lsquo;\u0026lsquo;Oh, my God, my God\u0026rsquo;\u0026rsquo;. Yeah, the pain.\u003c/p\u003e\u003cp\u003eSunflower was feeling unwell, describing her state as not being able to get up from the couch. However, she did not go to the hospital because she was afraid of being separated from her baby. Instead, she continued to breastfeed, highlighting a huge sacrifice for her baby:\u003c/p\u003e\u003cp\u003eSunflower \u0026ndash; Just early when I started newly, like, and then I was feeling really sick probably with this mastitis, I\u0026rsquo;m sure it was mastitis, because my, you know, that [points at breasts]. Yeah, and then my ex-husband had to call the ambulance. On the call while they were talking, I said [\u0026hellip;] \u0026lsquo;\u0026lsquo;OK, can you hang up the phone?\u0026rsquo;\u0026rsquo; because I was thinking if I go, you know what it might be\u0026hellip;\u003c/p\u003e\u003cp\u003eInterviewer: What are they gonna do with the baby?\u003c/p\u003e\u003cp\u003eSunflower: Yeah, because I didn\u0026rsquo;t know it was about breastfeeding as well. Maybe, I was thinking, it might be about my diabetes, and I might stay, because in pregnancy, I had to stay maybe three days, or something, because of my insulin pump.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eBecause it is a taboo\u003c/h3\u003e\n\u003cp\u003eParticipants also experienced breastfeeding as hard because, at times, it felt like a taboo and something that should be hidden, in accordance with research from Boyer (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). This perception was especially strong concerning breastfeeding after infancy; indeed Jackson and Hallam (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) found that this had a stigma attached to it, even from partners and family members, highlighting that the WHO recommendations were not widely known.\u003c/p\u003e\u003cp\u003eGladiolus challenged the idea that breastfeeding should be kept \u0026lsquo;\u0026lsquo;a secret\u0026rsquo;\u0026rsquo;. She emphasised the importance of fostering pride around it, suggesting that societal attitudes often make women feel like they must be discreet rather than celebrating breastfeeding as a natural achievement.\u003c/p\u003e\u003cp\u003eAnd I would say understanding that however your birth experience was, that what you\u0026rsquo;ve done is such an achievement, and trying to like foster this sense of pride about it and not make breastfeeding like a ssssh secret that we didn\u0026rsquo;t talk about, right?\u003c/p\u003e\u003cp\u003eShe also shared an experience which highlighted an issue with breastfeeding in public. She linked this judgement to broader attitudes about women\u0026rsquo;s bodies: how they were hypersexualized, and breastfeeding was seen as something that should be hidden. These attitudes relate to research suggesting that sexualisation and objectification can be obstacles to breastfeeding (Newman \u0026amp; Williamson, \u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Thomson et al., \u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Bresnahan et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Jackson and Hallam (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) reported similar results, particularly calling out the male gaze. Gladiolus said:\u003c/p\u003e\u003cp\u003eI think that there\u0026rsquo;s this sort of weirdly repressed ideas about women\u0026rsquo;s bodies and you know, we are in a very hypersexualized world and at the same time, breastfeeding a child is like, \u0026lsquo;\u0026lsquo;Oh, we have to cover up with a with a muslin.\u0026rsquo;\u0026rsquo; You know, I was breastfeeding a child, [my first child], when I was at this thing, this event. And the husband [\u0026hellip;] he tried to sort of embarrass me about it.\u003c/p\u003e\u003cp\u003eEstablishment of breastfeeding can be a source of pride (Jackson \u0026amp; Hallam, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), but many women stop before reaching this stage. Bresnahan et al. (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) concluded that some people found breastfeeding in public \u0026lsquo;\u0026lsquo;inappropriate and indecent\u0026rsquo;\u0026rsquo;. Thomson et al. (\u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e2015\u003c/span\u003e) emphasised that real or imagined reactions of others were a key issue for breastfeeding mothers.\u003c/p\u003e\u003cp\u003eEdelweiss described her initial uncertainty about breastfeeding in public, reflecting how it was not always normalized, as also found by Boyer (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). She had been unsure if it was even allowed until she did it, showing how a lack of open discussion contributed to this hesitation. Her husband\u0026rsquo;s reaction to physically shield her reinforced the idea that breastfeeding should be hidden:\u003c/p\u003e\u003cp\u003eAnd then I thought, \u0026lsquo;\u0026lsquo;Oh, my gosh, I am on the bus and she\u0026rsquo;s crying. She\u0026rsquo;s hungry. What do I do? Do I just drop off the bus and go back home and I breastfeed her?\u0026rsquo;\u0026rsquo; And I breastfed her and I was like, \u0026lsquo;\u0026lsquo;Oh, I'm allowed to do it\u0026rsquo;\u0026rsquo;, like no one ever told me that. But then [my husband] was very protective, like when I was breastfeeding in public, he was like standing in front of me with the coat open and not wanting anyone to see me.\u003c/p\u003e\u003cp\u003eThese quotes illustrated how breastfeeding was seen as something private or even inappropriate in public spaces, contributing to the taboo status, as also discussed by Thomson et al. (\u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). All participants spoke about having to cover up and about how other mothers were not helpful when covering up, as it made them feel like they should too. As Chrysanthemum described: \u0026lsquo;\u0026lsquo;I found people with these elaborate cover-ups unhelpful. Because I felt like I should be. [\u0026hellip;] I found these things made me feel a bit uncomfortable.\u0026rsquo;\u0026rsquo; How other mothers can be helpful will be discussed in \u0026lsquo;\u0026lsquo;\u003cem\u003eSupport is everything\u0026rsquo;\u0026rsquo;\u003c/em\u003e.\u003c/p\u003e\u003cdiv id=\"Sec30\" class=\"Section2\"\u003e\u003ch2\u003eBecause of judgement from others\u003c/h2\u003e\u003cp\u003eIn addition to a perceived taboo around breastfeeding, some participants felt judged for doing it, aligning with research by Bresnahan et al. (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) and Thomson et al. (\u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). However, Dillard (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2015\u003c/span\u003e) found that older mothers, those in secure relationships and those who are established in their careers tend to feel more confident in challenging negative comments and views of others. The following quotes illustrated how participants experienced judgement from different sources, including nurseries and HCPs, as also reported by others (Dillard, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Kronborg et al., \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2007\u003c/span\u003e; Thomson et al., \u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e2015\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eSunflower described how nursery staff viewed breastfed babies as \u0026lsquo;\u0026lsquo;spoiled\u0026rsquo;\u0026rsquo; because they sought more affection and reassurance. This view reflected a judgemental attitude that breastfeeding makes children more dependent, reinforcing negative stereotypes. She said:\u003c/p\u003e\u003cp\u003eMy nursery say little bit around like, \u0026lsquo;\u0026rsquo;Ah that, that baby's breastfed, that baby is little [\u0026hellip;] more spoiled.\u0026rsquo;\u0026rsquo; [\u0026hellip;] Because they want the babies not crying. They want the babies not like, seeking for affection, or like, you know, like reassurance.\u003c/p\u003e\u003cp\u003eA potential reason for this view comes from Krol and Grossmann (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), who showed that when mothers breastfed on demand, they reacted directly to requests from their children, which might lead to infants expecting immediate reactions. Levinienė et al. (\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2013\u003c/span\u003e) reported that breastfeeding on demand was becoming the norm among breastfeeding mothers. Brown and Arnott (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2014\u003c/span\u003e) also described this infant-led approach as nurturing and common among breastfeeding mothers, ultimately leading to healthier weight gain and cognitive development.\u003c/p\u003e\u003cp\u003eCarnation was shocked by nurses also expressing frustration toward breastfed babies, wishing they were bottle-fed so they would \u0026lsquo;\u0026lsquo;go to sleep\u0026rsquo;\u0026rsquo;. This judgement from HCPs, who should be supportive, was upsetting. Notwithstanding this, some studies report that breastfed babies sleep better than CMF-fed babies (Shaji et al., \u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; P\u0026eacute;rez-Escamilla et al., \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2023\u003c/span\u003e); although Brown and Harries (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2015\u003c/span\u003e) did not, as mentioned above. Carnation said:\u003c/p\u003e\u003cp\u003eBut then also I heard the nurses at the hospital say \u0026lsquo;\u0026lsquo;Bloody breastfed babies. They should give them all bottles and they should just shut up and go to sleep\u0026rsquo;\u0026rsquo;. And that was the nurses in the hospital. And I was horrified by that.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec31\" class=\"Section2\"\u003e\u003ch2\u003eBecause of all the emotions and the lack of support\u003c/h2\u003e\u003cp\u003eAll participants described experiencing many different emotions during the time they breastfed; in view of this, these comments are gathered under the theme \u0026lsquo;\u0026lsquo;\u003cem\u003eBreastfeeding is an emotional rollercoaster\u0026rsquo;\u0026rsquo;\u003c/em\u003e. Breastfeeding was also experienced as hard because everybody seemed to have a different opinion or expectation about it; these will be discussed under the theme \u0026lsquo;\u0026lsquo;\u003cem\u003eSupport is everything\u0026rsquo;\u0026rsquo;\u003c/em\u003e.\u003c/p\u003e\u003cdiv id=\"Sec32\" class=\"Section3\"\u003e\u003ch2\u003eBreastfeeding is magical\u003c/h2\u003e\u003cp\u003eIn response to the question, \u0026lsquo;\u0026lsquo;How did it make you feel that you were able to breastfeed?\u0026rsquo;\u0026rsquo; all participants answered similarly: \u0026lsquo;\u0026lsquo;Really happy.\u0026rsquo;\u0026rsquo;, \u0026lsquo;\u0026lsquo;So amazing.\u0026rsquo;\u0026rsquo;, \u0026lsquo;\u0026lsquo;Most beautiful thing in the world.\u0026rsquo;\u0026rsquo;, and \u0026lsquo;\u0026lsquo;Something special.\u0026rsquo;\u0026rsquo; The tennis player Serena Williams also described breastfeeding as \u0026lsquo;\u0026lsquo;a magical superpower\u0026rsquo;\u0026rsquo; (Gregory, 2018). Such feelings align with Davis et al. (2025), who stated that mothers experienced breastfeeding as a magical and transformative part of a mother and child\u0026rsquo;s life. Jackson and Hallam (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) noted that \u0026lsquo;\u0026lsquo;amazing\u0026rsquo;\u0026rsquo; also referred to something to be proud of and not standard practice. The quotes below underline different components of the theme \u0026lsquo;\u0026lsquo;\u003cem\u003eBreastfeeding is magical\u0026rsquo;\u0026rsquo;\u003c/em\u003e, from connection to transformation and the power of the female body.\u003c/p\u003e\u003cp\u003eSunflower described breastfeeding as a wonderful experience. The \u0026lsquo;\u0026lsquo;magic\u0026rsquo;\u0026rsquo; came from how her baby brought love into her life, easing feelings of isolation and homesickness:\u003c/p\u003e\u003cp\u003eIt was magical. [\u0026hellip;] I was socially quite isolated as well, before baby comes as well. And then this baby came like a, you know, everybody\u0026rsquo;s baby is sunshine, but even more, you know, like because, that you were already not, maybe socially isolated. You are missing your previous life in Turkey. [\u0026hellip;] But, all of a sudden, it is great. Big love come to your life.\u003c/p\u003e\u003cp\u003eGladiolus emphasised the awe of creating, birthing, and then nourishing a baby with her own body. She reflected that no \u0026lsquo;\u0026lsquo;other human talent\u0026rsquo;\u0026rsquo; compared to this process:\u003c/p\u003e\u003cp\u003eYou realise that you have taken a little tiny cell, and you have grown it. [\u0026hellip;] You\u0026rsquo;ve birthed them. Then you feed them. There\u0026rsquo;s, like just an indescribable magic when you realise that\u0026rsquo;s all coming from your body. I think that\u0026rsquo;s\u0026hellip;, honestly, why we\u0026rsquo;re not shouting about this? But you know, it\u0026rsquo;s magic. Yeah, no other human talent can do anything close to that.\u003c/p\u003e\u003cp\u003eChrysanthemum framed breastfeeding as an extension of pregnancy, continuing the intimate connection between mother and baby. She saw it as a privilege, underscoring the unique, almost sacred role of a mother in sustaining her child\u0026rsquo;s life: \u0026lsquo;\u0026lsquo;It's a bit of having a baby, isn\u0026rsquo;t it? That\u0026rsquo;s one of those magical things. But you\u0026rsquo;re lucky. As a woman, you. It is a privilege that you can do it \u0026ndash; feed your child.\u0026rsquo;\u0026rsquo;\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec33\" class=\"Section3\"\u003e\u003ch2\u003eBecause it is everything a baby needs\u003c/h2\u003e\u003cp\u003eEvery participant gave a version of \u0026lsquo;breast is best\u0026rsquo; \u003cem\u003e\u0026ndash;\u003c/em\u003e meaning that breastmilk is the optimal way to feed a baby \u0026ndash; as the most important reason to breastfeed. Foxworthy Scott and Bute (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) found that \u0026lsquo;breast is best\u0026rsquo; is a master narrative, and their research showed that breastfeeding mothers feel that they are good mothers. Being a good mother was also associated with minimal medical interventions and aligned with what the body is naturally expected to do (Cripe, 2018; Miller, 2005, as cited by Foxworthy Scott \u0026amp; Bute, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Others have also found that some women interpret breastfeeding as a choice and a sign of being a good mother rather than a biological process (Davis et al., 2025; Thomson et al., \u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Hauck \u0026amp; Irurita, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2002\u003c/span\u003e). However, in this study no participants seemed to espouse this interpretation; rather, they emphasised being concerned about their baby and wanting what was best for them. To at least some extent, all participants were aware of the benefits of breastfeeding, as emphasised in the following quotes.\u003c/p\u003e\u003cp\u003eGladiolus implied that breastfeeding provided the ultimate in terms of nutrients and benefits: \u0026lsquo;\u0026lsquo;Oh, yeah, that it was the best start you could give to a child\u0026rsquo;\u0026rsquo;. Peony reflected on the natural aspect of breastfeeding, suggesting that it felt like the way things are meant to be. She also acknowledged the evidence supporting breastmilk as a source of nutrition, particularly for the immune system. Her commitment to pumping, even after she stopped direct breastfeeding, showed her belief in the benefits:\u003c/p\u003e\u003cp\u003eIt\u0026rsquo;s natural, right? It feels. It felt like it was. It\u0026rsquo;s the way it should be. [\u0026hellip;] But then I pumped for another three months because I wanted to give my, my breastmilk and, you know, research has shown that for the immune system, the, the breastmilk is the best.\u003c/p\u003e\u003cp\u003eEdelweiss went even further by stating that breastfeeding is the \u0026lsquo;\u0026lsquo;only real way\u0026rsquo;\u0026rsquo; to give a baby what it needs, both in terms of nutrients and emotional bonding. She said: \u0026lsquo;\u0026lsquo;I think it\u0026rsquo;s the only really way to, um, I think it\u0026rsquo;s very important for the children, like to bond to, give them what they need, the right nutrients like, yeah and everything.\u0026rsquo;\u0026rsquo; Lastly, Chrysanthemum stated that she knew breastfeeding provided benefits for children and highlighted the fact that the mother can provide everything a baby requires:\u003c/p\u003e\u003cp\u003eI knew it, it provides a lot of benefits to the kids. [\u0026hellip;] I like that feeling that I can provide everything they needed. I guess it\u0026rsquo;s an extension of them being in your tummy. You\u0026rsquo;re still everything they need.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\n\u003ch3\u003eBecause you do not need anything else\u003c/h3\u003e\n\u003cp\u003eThere was another, more practical reason for breastfeeding being experienced as magical: unlike bottle feeding (because bottles must be sterilised and clean water is needed), breastmilk is always available and accessible (Davis et al., 2025). Clematis noted that breastfeeding allowed her to feed her baby instantly, reinforcing the idea that breastmilk was always on hand, eliminating delays or extra effort. She said: \u0026lsquo;\u0026lsquo;Because it\u0026rsquo;s the most practical. I think when you have a baby, you just want to be able to feed them quickly and just don\u0026rsquo;t have to rely on preparing bottles.\u0026rsquo;\u0026rsquo; Carnation agreed, stating that breastmilk was always available and highlighting its convenience: \u0026lsquo;\u0026lsquo;It was so convenient. I think, you know: the milk is warm, it\u0026rsquo;s the right temperature, it\u0026rsquo;s always available. The baby\u0026rsquo;s there. You\u0026rsquo;re there.\u0026rsquo;\u0026rsquo;\u003c/p\u003e\u003cp\u003eNone of the participants mentioned the cost difference between breastfeeding and bottle feeding, probably because they felt that their time spent is also valuable, as described by Clematis in the section \u0026lsquo;\u0026lsquo;\u003cem\u003eAll of your time\u0026rsquo;\u0026rsquo;\u003c/em\u003e. Carnation also mentioned the connection, which leads to another reason why breastfeeding is magical.\u003c/p\u003e\n\u003ch3\u003eBecause the connection is amazing\u003c/h3\u003e\n\u003cp\u003eAll participants felt lucky that they were able to experience this magical journey, as it felt amazing to them. Sunflower stated: \u0026lsquo;\u0026lsquo;I feel I\u0026rsquo;m so lucky. [\u0026hellip;] I will say: \u0026lsquo;You are a lucky girl, without knowing. You\u0026rsquo;re going to have some good experience in that life\u0026rsquo;\u0026rsquo;. Participants also realised that breastfeeding was not only about nutrition but also a deep bonding connection. According to Jackson and Hallam (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), breastfeeding can be a tool to settle a baby to sleep and reconnect after a mother has returned to work.\u003c/p\u003e\u003cp\u003ePeony described the way her body physically responded to her baby, highlighting the biological bond. She expressed awe at the experience, repeatedly calling it \u0026lsquo;\u0026lsquo;amazing\u0026rsquo;\u0026rsquo;. The act of hearing her baby suck and feeling the closeness created an emotional attachment. Peony said:\u003c/p\u003e\u003cp\u003eI think the connection you have [\u0026hellip;] with your baby, like how linked you are. [\u0026hellip;] You get the flow or you get this thing and you like he\u0026rsquo;s hungry or you hear him cry and your boobs react, like you react physically to your baby. You are so connected. And then having that like\u0026hellip;, Hearing him suck, like, I don\u0026rsquo;t know, like, hearing him suck and like, holding my boob. My huge, humongous boob that was like bigger than his head when he\u0026rsquo;s a baby. Oh, my God. I don\u0026rsquo;t know. It\u0026rsquo;s amazing.\u003c/p\u003e\u003cp\u003eSimilarly, Begonia described the intimate and peaceful moments shared with her baby, even in the quiet hours of the night, making breastfeeding a cherished experience:\u003c/p\u003e\u003cp\u003eJust that having that one-on-one closeness. That\u0026rsquo;s just gonna be stuck in my memory as the, the best probably of all of it. It\u0026rsquo;s just that quiet time, even if it\u0026rsquo;s four in the morning, it\u0026rsquo;s just you and the baby, you know, it\u0026rsquo;s, it was amazing.\u003c/p\u003e\u003cp\u003eGladiolus focused on the unbreakable bond formed through breastfeeding, emphasising how it created a connection with her child that continued even years later:\u003c/p\u003e\u003cp\u003eThen it was so amazing, like it was such a bond. I loved how he looked up at me. I loved holding him. I think our bond, you know, still to this day, he\u0026rsquo;s nearly seven now, there\u0026rsquo;s something about what we went through.\u003c/p\u003e\u003cp\u003eEdelweiss also reinforced the emotional closeness and the process of growing: \u0026lsquo;\u0026lsquo;It was more about like, yeah, the connection as well. Not only like he needs to grow. You know what I mean? Like, I need to feed him. It was that whole process.\u0026rsquo;\u0026rsquo;\u003c/p\u003e\u003cp\u003eChrysanthemum reflected on another aspect when she spoke about trust and the safe place her baby was in when \u0026lsquo;\u0026lsquo;milk drunk\u0026rsquo;\u0026rsquo; and that this was part of the motherhood experience:\u003c/p\u003e\u003cp\u003eWhen they\u0026rsquo;re little and they fall asleep drunk on your boob and they look so happy and just like, so safe, they just trust you completely. [\u0026hellip;] I loved it. Like them gazing up at you. I thought it was a nice bonding experience. [\u0026hellip;] It\u0026rsquo;s part of the whole motherhood experience.\u003c/p\u003e\u003cdiv id=\"Sec36\" class=\"Section2\"\u003e\u003ch2\u003eBreastfeeding is an emotional rollercoaster\u003c/h2\u003e\u003cp\u003eWhile all participants expressed how happy they felt to breastfeed and that they experienced a sense of pride and magic, they also felt many negative emotions. They felt overwhelmed by the huge responsibility of solely feeding this tiny human being. At times, they felt trapped. They felt like \u0026lsquo;\u0026lsquo;it\u0026rsquo;s us against the world\u0026rsquo;\u0026rsquo;, while being isolated at the same time. They felt shame as well as doing a natural thing like \u0026lsquo;\u0026lsquo;a real mum\u0026rsquo;\u0026rsquo;. They felt judged as well as being all their baby needs. These contradictory emotions were also found by Davis et al. (2025), who described the breastfeeding period as a journey with \u0026lsquo;\u0026lsquo;mixed and intense emotions\u0026rsquo;\u0026rsquo;. The most often mentioned emotions are discussed below.\u003c/p\u003e\u003cdiv id=\"Sec37\" class=\"Section3\"\u003e\u003ch2\u003eInsecurity and anxiety\u003c/h2\u003e\u003cp\u003eMost participants felt uncertain and worried about whether they were breastfeeding optimally, if they had enough milk, and whether their baby was drinking enough. There is no manual or clear evidence to indicate whether a baby is getting enough milk when being breastfed, other than wet nappies and contentment (NHS, 2025). When a baby is fussy or discontented, some mothers interpreted this as having insufficient milk (Brown \u0026amp; Arnott, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Approximately 45% of breastfeeding mothers self-reported insufficient milk supply (SRIM, also known as perceived insufficient milk supply (PIMS)), as the most important reason to stop breastfeeding (P\u0026eacute;rez-Escamilla et al., \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Huang et al., 2024), despite SRIM being generally an incorrect interpretation of an unsettled baby (P\u0026eacute;rez-Escamilla et al., \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Fewtrell et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) and there being no evidence that the mother does not have enough milk (Huang et al., 2024). If mothers received more education about infants and their development, a mother may be less worried about sleep patterns, crying, and posseting (P\u0026eacute;rez-Escamilla et al., \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Garc\u0026iacute;a et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). These behaviours cause stress and negatively influence the self-efficacy of the mother, ultimately leading her to stop breastfeeding (P\u0026eacute;rez-Escamilla et al., \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Menekse et al., \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Brown \u0026amp; Arnott, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Huang et al. (2024) also found that crying was mentioned as the most important symptom of PIMS and the reason to discontinue breastfeeding, while only 5% of mothers actually have insufficient supply.\u003c/p\u003e\u003cp\u003eBegonia described insecurity as the worst part of breastfeeding, including self-doubt over whether her baby was feeding enough and whether she should supplement with CMF. Uncertainty over whether she was producing enough milk created stress. She said:\u003c/p\u003e\u003cp\u003eAnd you go like: \u0026lsquo;\u0026lsquo;Are they really feeding? Do I have enough? Should I offer formula?\u0026rsquo;\u0026rsquo; Because they are just, just off the breast, an hour later and they want to go back in and it\u0026rsquo;s just normal for them. But for us, it makes us feel like, \u0026lsquo;\u0026lsquo;do I have milk?\u0026rsquo;\u0026rsquo;. It\u0026rsquo;s just, you start to question itself. So that\u0026rsquo;s the worst, the worst part.\u003c/p\u003e\u003cp\u003eEdelweiss also shared a personal internal struggle. Despite receiving positive reassurance from others, she worried that her baby\u0026rsquo;s short latch times meant that she was not producing enough milk. This insecurity seemed to stem from her own fears and lack of experience rather than comments from others.\u003c/p\u003e\u003cp\u003eThey said it was very good that I was trying to. It was, it was, she was growing very well. I was doing a great job. Like everyone was very positive about that. I was just only concerned that because she was not latching for a long time. Like, I know maybe some babies latch for like an hour or 40 minutes. This one is like 5 minutes. \u0026lsquo;\u0026lsquo;What am I doing something wrong?\u0026rsquo;\u0026rsquo; My only concern that I wasn\u0026rsquo;t going to produce enough milk, for enough, for a long period of time.\u003c/p\u003e\u003cp\u003eChrysanthemum also reflected on how experience helped reduce her insecurity. In the early days, breastfeeding felt overwhelming and uncertain, and she wanted reassurance. She contrasted the uncertainty of breastfeeding with bottle-feeding, where intake was measurable:\u003c/p\u003e\u003cp\u003eAlso, there\u0026rsquo;s that deep down thing; mother\u0026rsquo;s instinct. Do you know? Like, I knew [my first child] was a fat little baby. He was happy. He was fine. But you just want that reassurance. [\u0026hellip;] And I think the further long you go and the more kids you have, the less insecure you are. [\u0026hellip;] Because I remember being a bit concerned with how much they\u0026rsquo;re eating like because with the bottles, with the bottle, you know exactly how often they\u0026rsquo;re being fed.\u003c/p\u003e\u003cp\u003eMost women, especially primiparas, experience breastfeeding issues at the onset, which can lead to insecurity (Lindblad et al., \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Garc\u0026iacute;a et al. (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) found that mothers who experienced issues, were more likely to supplement with CMF, which could interfere with the baby\u0026rsquo;s capacity to suckle. Poor suckling capacity could then be interpreted by the mother as \u0026lsquo;\u0026lsquo;the baby does not want the breast\u0026rsquo;\u0026rsquo; or \u0026lsquo;\u0026lsquo;I do not have enough milk\u0026rsquo;\u0026rsquo;, leading to further supplementation with CMF and ultimately leading to breastfeeding cessation. This vicious circle could be broken if a mother receives adequate support early on (Garc\u0026iacute;a et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec38\" class=\"Section2\"\u003e\u003ch2\u003eConfidence\u003c/h2\u003e\u003cp\u003eEach participant expressed concerns about whether they were breastfeeding correctly and whether their babies were getting enough nourishment. In contrast, confidence in their ability would have made all the difference in the participants\u0026rsquo; eyes. To the question, \u0026lsquo;\u0026lsquo;What would you tell yourself if you could go back to the start of your breastfeeding journey?\u0026rsquo;\u0026rsquo; participants all answered similarly: \u0026lsquo;\u0026lsquo;to relax and enjoy the experience\u0026rsquo;\u0026rsquo;, rather than being worried about the process. For example, Edelweiss said:\u003c/p\u003e\u003cp\u003eTo relax with [my first child]. Because it makes a difference, it makes a difference for a baby, it makes a difference for like, for the quality of milk that you\u0026rsquo;re producing, you know it, is not a stressful milk but it\u0026rsquo;s a relaxed milk. Baby will latch at some point. And you will have enough milk, because we are biological like made to do this, right? It\u0026rsquo;s a natural thing.\u003c/p\u003e\u003cp\u003eClematis, Carnation and Gladiolus all expressed similar thoughts: \u0026lsquo;\u0026lsquo;I guess just to enjoy it\u0026rsquo;\u0026rsquo; (Clematis), \u0026lsquo;\u0026lsquo;You just need to relax and enjoy the moment\u0026rsquo;\u0026rsquo; (Carnation), and \u0026lsquo;\u0026lsquo;Just to say to myself, \u0026lsquo;\u0026lsquo;You're doing great, and you're enough\u0026rsquo;\u0026rsquo; (Gladiolus). This feeling of \u0026lsquo;\u0026lsquo;I am enough\u0026rsquo;\u0026rsquo; and \u0026lsquo;\u0026lsquo;What I am doing is enough\u0026rsquo;\u0026rsquo; was also shown by the different experiences mothers had the second time around. Complementing the theme of \u0026lsquo;\u0026lsquo;Breastfeeding is hard\u0026rsquo;\u0026rsquo;, participants who had a second baby all found that experience easier. They had the assurance, knew how to do things, had been here before, expected it to be hard but fulfilling, trusted their bodies, were not worried about milk supply and had different expectations; these feelings align with research by Fewtrell et al. (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). The confidence was evident, for example, by being more comfortable with delaying breastfeeding until a more convenient time, compared with the first baby with which they sat \u0026lsquo;\u0026lsquo;on dirty steps next to cigarette butts\u0026rsquo;\u0026rsquo; and \u0026lsquo;\u0026lsquo;on the floor of the mall, with my husband keeping me out of sight with their coat\u0026rsquo;\u0026rsquo;. As Edelweiss reflected on her second experience: \u0026lsquo;\u0026lsquo;I enjoyed the whole thing more because I was more relaxed.\u0026rsquo;\u0026rsquo;\u003c/p\u003e\u003cp\u003eClematis also described how confidence helped her, stating that she was much more relaxed. She described how, with her first child, she was more rigid and careful, ensuring she followed the \u0026lsquo;\u0026lsquo;right\u0026rsquo;\u0026rsquo; way to breastfeed (e.g. posture). With her second child, she felt more at ease, indicating self-assurance. Initially, she experienced physical discomfort, but over time, she became \u0026lsquo;\u0026lsquo;desensitised\u0026rsquo;\u0026rsquo; to the pain and learned to adjust to her baby\u0026rsquo;s needs. Clematis said:\u003c/p\u003e\u003cp\u003e[My second child] was a bigger baby, so it physically was a bit less comfortable to begin with, but then I was much more relaxed about it in general. So I would, with [my first child], I would, I would sit upright and definitely feed in the right way and I wouldn\u0026rsquo;t let myself fall asleep. With [my second child] it wasn\u0026rsquo;t like that. \u0026lsquo;\u0026lsquo;Just lie down next to me and I\u0026rsquo;ll feed you again.\u0026rsquo;\u0026rsquo; I just need to get as much sleep as I can. Yes. Yeah, I think you\u0026rsquo;ve become much more confident in yourself.\u003c/p\u003e\u003cp\u003eThe above aligns with findings that multiparity is positively related to exclusive and continued breastfeeding, due to previous experience, intention and self-efficacy (Gusm\u0026atilde;o et al. 2013, as cited by Muelbert \u0026amp; Giugliani, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Kronborg et al., \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). In contrast, primiparous mothers experienced more doubts, and twice as many felt anxious at six weeks postpartum (Lindblad, 2022).\u003c/p\u003e\u003cdiv id=\"Sec39\" class=\"Section3\"\u003e\u003ch2\u003eSelf-consciousness and embarrassment\u003c/h2\u003e\u003cp\u003e Other emotions mentioned by several participants were self-consciousness, shame and embarrassment. The following quote highlights the initial self-consciousness that was experienced while breastfeeding, especially in public. Chrysanthemum described feeling uncomfortable about exposing her body while breastfeeding and mentioned how her mother\u0026rsquo;s and partner\u0026rsquo;s reactions reinforced that self-consciousness and how she pushed past the embarrassment:\u003c/p\u003e\u003cp\u003eYou feel a bit subconscious and a bit embarrassed about doing it. [\u0026hellip;] I remember her being quite sensitive to, because I remember with my first child being a bit embarrassed about getting my boobs out. [\u0026hellip;] But I remember him sort of trying to cover me up and I said: \u0026lsquo;No, don\u0026rsquo;t do that. Don\u0026rsquo;t do that. Like, if I don\u0026rsquo;t feel, feel self-conscious, don\u0026rsquo;t make me feel self-conscious.\u0026rsquo; I think it\u0026rsquo;s just a new experience and I just decided not to worry about it. And he definitely, it took him a while to get used to that.\u003c/p\u003e\u003cp\u003eParticipants also described that if it was time to feed their baby but they could not feed immediately for any reason, this was uncomfortable and sometimes caused leaking, which heightened their embarrassment. This feeling also relates to judgement and taboo, as described in earlier sections. More on this topic is provided in the section \u003cem\u003e\u0026lsquo;\u0026lsquo;Expectations from yourself and others\u0026rsquo;\u0026rsquo;\u003c/em\u003e.\u003c/p\u003e\u003cp\u003e\u003cb\u003eIsolation\u003c/b\u003e\u003c/p\u003e\u003cp\u003e Several participants mentioned that they felt isolated at times. Peony expressed feelings of being alone and on her own in the current Western world, which is very individualised and without the support that once existed. She contrasted modern motherhood with the past, when women lived in close-knit communities with their families available to share knowledge and offer guidance. Without this, she felt \u0026lsquo;\u0026lsquo;completely alone\u0026rsquo;\u0026rsquo; in navigating breastfeeding challenges. Her husband was at work, but she perceived him as unhelpful in any case due to his lack of experience. While she had an antenatal group, everyone had different approaches, making it difficult to find consistent advice. She also described how clinic visits did not capture the struggles she faced at home, leading to frustration and a sense that no one truly understood her difficulties, which led to even more feelings of loneliness. She connected feelings of isolation and struggling with the risk of postpartum depression, emphasizing how a lack of community affected her, just as Garc\u0026iacute;a et al. (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) found that low levels of support led to low self-efficacy, which could lead to depression and anxiety symptoms.\u003c/p\u003e\u003cp\u003ePeony said:\u003c/p\u003e\u003cp\u003eYou are completely by yourself. I\u0026rsquo;m on my own in my house. My husband is at work. And completely useless anyway: he\u0026rsquo;s never gone through this. [\u0026hellip;] I only have my NCT. And everyone does it differently. [\u0026hellip;] The clinic. Yes, but again, every time I went there, he fed. [\u0026hellip;] And I feel like that is, I feel, so isolated. [\u0026hellip;] You\u0026rsquo;re alone in the hospital. [\u0026hellip;] Then you miss out on all the women\u0026rsquo;s experiences that are so crucial for like bringing like knowledge down generations and generations. [\u0026hellip;] We don\u0026rsquo;t have our parents, we don\u0026rsquo;t have our sisters, we don\u0026rsquo;t have anyone. We are completely on our own. And then postpartum depression becomes a real risk.\u003c/p\u003e\u003cp\u003eGladiolus also spoke about her feelings of isolation and of not feeling supported. She described experiencing not feeling like she was enough, which showed a lack of confidence at the start of her journey: \u0026lsquo;\u0026lsquo;I felt very alone, and I felt very, very sad at times.\u0026rsquo;\u0026rsquo;\u003c/p\u003e\u003cp\u003eIn contrast, Sunflower mentioned that the baby helped her feel less isolated and alone, as described in the section \u003cem\u003e\u0026lsquo;\u0026lsquo;Breastfeeding is magical\u0026rsquo;\u0026rsquo;\u003c/em\u003e.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\n\u003ch3\u003eSupport is everything\u003c/h3\u003e\n\u003cp\u003eAs previously mentioned, the warm chain of support for breastfeeding mothers consists of their partner, family (e.g. their own mother or mother-in-law), HCPs, and other mothers. Support is sometimes helpful and at other times counterproductive. In this section, the positive and negative experiences are presented.\u003c/p\u003e\u003cp\u003e\u003cb\u003eExpectations from yourself and others\u003c/b\u003e\u003c/p\u003e\u003cp\u003eEmmott and Mace (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2015\u003c/span\u003e) suggested that social pressure to breastfeed can be seen as a way of social support. The following quotes illustrate how expectations from others shaped the participants\u0026rsquo; experiences with breastfeeding; they highlight the assumptions and perceptions surrounding breastfeeding.\u003c/p\u003e\u003cp\u003eChrysanthemum reflected on how she \u0026lsquo;\u0026lsquo;expected herself\u0026rsquo;\u0026rsquo; to breastfeed because it was the norm in her family. Even though no one pressured her, she assumed her mother and husband would expect it, showing how family norms influence decisions:\u003c/p\u003e\u003cp\u003eIt\u0026rsquo;s not that she expects me. It is a societal... I expected myself to do it. I expected her to expect me to do it like. I knew [my husband] was breastfed. Yeah, I just kind of\u0026hellip; It\u0026rsquo;s just assumed that I would do it, not that I felt pressure to do it, but just it\u0026rsquo;s sort of the norm in our family.\u003c/p\u003e\u003cp\u003eBegonia reinforced this idea, explaining that she thought breastfeeding was widely practiced in Brazil, which may be partly due to her SES and that of her friends. It felt like the obvious choice even though she had not lived in Brazil for over a decade, which shows how cultural norms create expectations. She said: \u0026lsquo;\u0026lsquo;I think culturally as well in Brazil, a lot of people breastfeed, at least for some time, so that also you know, it\u0026rsquo;s just something obvious that, that\u0026rsquo;s what you would do.\u0026rsquo;\u0026rsquo;\u003c/p\u003e\u003cp\u003ePeony also highlighted how society played a role. Seeing other mothers breastfeed for a long time made it feel more normal to her as has been described previously (Lehane et al., \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). However, she also pointed out that societal attitudes shift over time. In her view, reactions became more awkward the longer she breastfed. Jackson and Hallam (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) also found that society did not accept breastfeeding beyond infancy, and their participants received judgement, especially from strangers. Peony said:\u003c/p\u003e\u003cp\u003eLike, it impacts me to know what other people have done. I think. It makes, like, what is normal, it impacts what is normal for me. [\u0026hellip;] When at 12 months, everyone was like, \u0026lsquo;\u0026lsquo;Wow, amazing\u0026rsquo;\u0026rsquo;. And then that kind of stops and then people are like, \u0026lsquo;\u0026lsquo;Are you still breastfeeding?\u0026rsquo;\u0026rsquo; [\u0026hellip;] And I used to joke, I was like: \u0026lsquo;\u0026lsquo;I\u0026rsquo;m breast\u0026ndash;, still breastfeeding and it\u0026rsquo;s reached a point that it\u0026rsquo;s become awkward to say\u0026rsquo;\u0026rsquo;. Like, people\u0026rsquo;s reactions change.\u003c/p\u003e\u003cp\u003eGladiolus contrasted different cultural expectations around postpartum recovery and breastfeeding. She explained how, in her Korean culture, new mothers are treated like \u0026lsquo;\u0026lsquo;warriors\u0026rsquo;\u0026rsquo; and given time to heal. In contrast, the UK\u0026rsquo;s fast-paced postpartum expectations \u0026ndash; such as getting back to exercise \u0026ndash; created intense pressure. She noted that many women \u0026lsquo;\u0026lsquo;drop breastfeeding\u0026rsquo;\u0026rsquo; because they are overwhelmed by the need to \u0026lsquo;\u0026lsquo;make everything else work\u0026rsquo;\u0026rsquo;:\u003c/p\u003e\u003cp\u003eI think that \u0026ndash; and I can only speak from my experience here \u0026ndash; but different cultures that I\u0026rsquo;ve encountered, the way that they absolutely, you know, make the women feel like a superhero warrior for having done what they do, like in my culture, you don\u0026rsquo;t move for the first month, you stay inside, you just nourish yourself because of what you\u0026rsquo;ve gone through. In the UK, you\u0026rsquo;re expected to go into a spinning class after five days or something and do the shopping and be, be this and be that. It is so much pressure. I\u0026rsquo;m not surprised women drop breastfeeding as the first thing because they\u0026rsquo;re just like, \u0026lsquo;\u0026lsquo;I\u0026rsquo;ve got to make everything else work\u0026rsquo;\u0026rsquo;. I\u0026rsquo;m not surprised at all.\u003c/p\u003e\u003cp\u003eIn the UK, there seems to be a focus on mental health; for example, people are urged to leave the house to get exercise and fresh air when they experience depressive symptoms (NHS, 2025). Mothers are also expected to visit their HCPs rather than vice versa because HCPs have many cases and are under time pressure (Chambers et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Kronborg et al., \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). Indeed, Jackson and Hallam (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) report that contact with HCPs becomes more limited as the child gets older.\u003c/p\u003e\u003cp\u003e\u003cb\u003eSupport from partner\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAnother part of the warm chain is the partner. Despite mothers in a long-term relationship being more likely to breastfeed for longer (Levinienė et al., \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2013\u003c/span\u003e), the support of a partner was not seen as crucial by participants in this study. This finding could be due to different reasons; for example, it could be due to sample selection, or that having a partner allows a mother to be on maternity leave longer. In the interviews most participants described a partner who had a passive role. Their partners accepted their breastfeeding, not actively supporting it but also not being against it, and not putting them under pressure. Ultimately. it was the mothers\u0026rsquo; decision.\u003c/p\u003e\u003cp\u003eFor example, Clematis described a sort of silent approval from her husband. She felt that he was taking her lead on all matters related to the pregnancy:\u003c/p\u003e\u003cp\u003eI think he, with the pregnancy and the birth, he became clearer in his own mind that it\u0026rsquo;s my body and I get to choose what I do with that. [\u0026hellip;] I think, I led the way, and I sort of said \u0026lsquo;\u0026lsquo;I\u0026rsquo;m going to breastfeed\u0026rsquo;\u0026rsquo;, and that was it.\u003c/p\u003e\u003cp\u003eGladiolus emphasised how overwhelming and isolating the first weeks were, and described how her husband\u0026rsquo;s support was beneficial:\u003c/p\u003e\u003cp\u003eHe saw the struggle of latching, you know, combi-feeding. [\u0026hellip;] He also saw how exhausted I was because I just never got any sleep. And so, I think that side and the toll it takes on women. [\u0026hellip;] So, I feel like the first month when we were in the hospital, we were actually really like allies.\u003c/p\u003e\u003cp\u003eCarnation had a more negative experience and reflected on the lack of involvement from her partner in the decision-making process. She felt that it was her responsibility as a mother. Instead of turning to her partner, she sought advice from \u0026lsquo;\u0026lsquo;female friends\u0026rsquo;\u0026rsquo;, which could imply that she either did not feel supported by her partner or did not see him as supportive:\u003c/p\u003e\u003cp\u003eNo, I wouldn\u0026rsquo;t have been taken his view because it, it\u0026rsquo;s not about him. As a mother it\u0026rsquo;s about you and the baby. And you know, I really did think it was the best, the best thing for them. So, I didn\u0026rsquo;t really discuss it with him, I discussed it with my female friends more.\u003c/p\u003e\u003cp\u003eWhile most participants described silent approval from their partners, Peony experienced pressure from her partner to stop breastfeeding because he felt that it was stopping the baby \u0026lsquo;\u0026lsquo;from eating properly at mealtimes\u0026rsquo;\u0026rsquo;. Not relying on partners can also be due to new mothers tending to rely more on HCPs and/or people who have been through the same experiences, such as their mothers. As Peony stated under the section \u003cem\u003e\u0026lsquo;\u0026lsquo;Isolation\u0026rsquo;\u0026rsquo;\u003c/em\u003e, \u0026lsquo;\u0026lsquo;partners are useless in that way\u0026rsquo;\u0026rsquo; because they do not have the same lived experience.\u003c/p\u003e\u003cp\u003eKozachenko et al. (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) also found that the support of a partner is not critical for breastfeeding, as there were no differences in breastfeeding duration between mothers with or without a partner in their study. However, Levinienė et al. (\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2013\u003c/span\u003e) report that partners who are more aware of breastfeeding benefits are more supportive; however, if they are not, it can result in new mothers having feelings of isolation, anxiety and helplessness. Another study found that when a mother breastfed beyond infancy, fathers became less supportive and found this weird or limiting their social lives (Jackson \u0026amp; Hallam, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cb\u003eSupport from own mother\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe second important component of the warm chain is the mother\u0026rsquo;s mother. In this study, all participants were breastfed by their mother, aligning with Cole et al.\u0026rsquo;s (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) research that being breastfed leads to breastfeeding. Peony\u0026rsquo;s mother breastfed her but stopped because she had twins and found it too demanding. Peony also did not ask her mother for much support. She reasoned that she was older when she had children and that there was some resentment towards her mother. Begonia was also not breastfed for long, because her mother wanted to use bottle to be \u0026lsquo;\u0026lsquo;more in control\u0026rsquo;\u0026rsquo; and see how much her baby was drinking. In her interview, Begonia also did not expand on any particular support she received from her mother. In contrast, she did mention how her father \u0026ndash; as a paediatrician \u0026ndash; gave her some practical tips; this contributes to the idea of new mothers taking advice from HCPs, as discussed in the following section.\u003c/p\u003e\u003cp\u003eMost participants asked their mother for support, although that support varied from living with her for a few months just after birth (in Sunflower\u0026rsquo;s case) to not asking anything specific but knowing that her mother would support her if she needed anything (Clematis) to active support as \u0026lsquo;\u0026lsquo;supporting her in everything\u0026rsquo;\u0026rsquo; (Carnation). Three participants (Peony, Edelweiss and Gladiolus) wanted to be more independent, figuring things out on their own or doing it their way. This was probably also because their mothers had them in different countries and a different era, so their experiences relating to babies were perceived as no longer relevant.\u003c/p\u003e\u003cp\u003eWhile grandmothers\u0026rsquo; attitudes can positively influence a mother\u0026rsquo;s breastfeeding journey (Negin et al., \u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Scelza \u0026amp; Hinde, \u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), mothers who lived with their mother breastfed less frequently and stopped earlier (Emmott \u0026amp; Mace, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Muelbert \u0026amp; Giugliani, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Such findings may relate to the practical support (e.g. babysitting) that grandmothers can offer (Emmott \u0026amp; Mace, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2015\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cb\u003eSupport from HCPs\u003c/b\u003e\u003c/p\u003e\u003cp\u003eMost participants gave birth in a BFHI hospital, as described in the Introduction. Hospital staff promoted breastfeeding by telling them that breastfeeding was important and encouraged them to continue even when it became hard. Some received practical support and attended drop-in sessions while still in hospital. For example, Begonia said: \u0026lsquo;\u0026lsquo;Some of them were breastfeeding consultants, so they looked at the latch and that was reassuring.\u0026rsquo;\u0026rsquo; Begonia also mentioned the different levels of support from HCPs:\u003c/p\u003e\u003cp\u003eThere is some misinformation. [\u0026hellip;] I think more training and more people available to, to speak to the, to the mums, and the dads for that matter, informing the dads, I think, is very helpful because in these moments of crisis, the two parents are there.\u003c/p\u003e\u003cp\u003eHowever, Carnation experienced the opposite with HCPs speaking badly about breastfed babies (as discussed in the section \u003cem\u003e\u0026lsquo;\u0026lsquo;Judgement from others\u0026rsquo;\u0026rsquo;\u003c/em\u003e). The reason for this might be that she had babies about 15 years earlier than the other participants. Carnation also had a bad experience with HCPs not taking her seriously when she expressed concerns about her breasts:\u003c/p\u003e\u003cp\u003eBut what they did not ask or did not discuss was when I said I had a dimple on my breast. [\u0026hellip;] They dismissed it, and I was really annoyed because I waited 7\u0026frac12; months, and then the cancer had spread. [\u0026hellip;] It wasn\u0026rsquo;t until I did La Leche course, and I was looking at this, the breast and everything else, I started wondering, and I went to my GP. And that\u0026rsquo;s when the whole thing happened.\u003c/p\u003e\u003cp\u003eThe above quotes align with the literature. For example, Hoddinott et al. (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2012\u003c/span\u003e) described how mothers prefer support immediately after birth rather than before. However, physical support (touch) from HCPs was experienced as negative (Thomson et al., \u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Jackson and Hallam (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) described how mothers experienced HCPs sometimes lacking knowledge and support, which became manifest in their advice and language. McNaughton et al. (\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) found that some HCPs promoted CMF.\u003c/p\u003e\u003cp\u003eChrysanthemum suggested that continuity of care by HCPs would be helpful. Seeing the same HCP would create a bond, and the HCP would be able to follow the progress of mother and baby, especially because growth is not always linear and one-off visits do not paint the full picture (as described by Peony under \u003cem\u003e\u0026lsquo;\u0026lsquo;Isolation\u0026rsquo;\u0026rsquo;)\u003c/em\u003e. Hoddinott et al. (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2012\u003c/span\u003e) also found that mothers prefer continuity of care. Chrysanthemum mentioned the healthcare system in the Netherlands, where new mothers receive free care from a maternity care assistant in their home during the first eight days. Despite a shorter maternity leave (16 weeks paid leave), their exclusive breastfeeding rate at six months is 39% (Theurich et al., \u003cspan citationid=\"CR78\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). However, Van Minde et al. (\u003cspan citationid=\"CR81\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) found that, afterwards, there was a lack of handover care from the maternity care assistant to the GP. Chrysanthemum said:\u003c/p\u003e\u003cp\u003eA bit more support would be helpful. [\u0026hellip;] Like in the Netherlands, where you get someone who maybe is there for a week. It\u0026rsquo;s the same person who sees what you\u0026rsquo;re doing, sees how you\u0026rsquo;re struggling, sees what\u0026rsquo;s working.\u003c/p\u003e\u003cp\u003e\u003cb\u003eDifferent opinions\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAs described by Chrysanthemum, the lack of continuity of care creates that mothers meet different HCPs, each with their own opinion, which has also been found in earlier studies (Hoddinott et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2012\u003c/span\u003e; Lehane et al., \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Gladiolus highlighted the sometimes contradictory support that HCPs provided and described feeling overwhelmed by their conflicting advice, which contributed to frustration and emotional exhaustion in an already stressful situation. Instead of feeling supported, she felt criticised which impacted her mental state. Her experience also underlined the importance of how HCPs communicate. While their intentions may be to help, the way information was delivered impacted her well-being, especially in her sleep-deprived and stressed state. Gladiolus showed frustration when she said:\u003c/p\u003e\u003cp\u003eEvery time a nurse came in, they would correct my position. [\u0026hellip;] That was hard. Where people always had different opinions. And sometimes they expressed it nicely. Sometimes they didn\u0026rsquo;t, and then it was just a bit like it was tiring, you know? [\u0026hellip;] It\u0026rsquo;s not really what they\u0026rsquo;re saying, it is how they say it that is so detrimental to your mental state.\u003c/p\u003e\u003cp\u003eDifferent opinions can also be found on social media, although Jackson and Hallam (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2020\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) concluded that social media offered support to women, especially those who breastfeed beyond infancy. However, social media is known to contain a lot of judgement (Thomson et al., \u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). The following quotes illustrate different perspectives on online support: one related to seeking validation and connection through social media and the other reflecting concerns about the reliability of \u0026lsquo;\u0026lsquo;the internet\u0026rsquo;\u0026rsquo;.\u003c/p\u003e\u003cp\u003eFirst, Clematis found support in social media by looking for information and connecting with others. For her, even if the information was not necessarily helpful, the act of viewing others\u0026rsquo; experiences made her feel less isolated, emphasising how emotional support can come from connecting with others who share similar challenges. The sense of shared experience helped reduce feelings of loneliness:\u003c/p\u003e\u003cp\u003eI did sort of use Instagram a bit and social media to look for information and I don\u0026rsquo;t know if that was necessarily helpful at the time, but it felt like there were other people out there. Therefore, they can maybe make me feel less alone when you are dealing with the difficulties.\u003c/p\u003e\u003cp\u003eOn the other hand, Carnation expressed scepticism about online advice, particularly for new mothers: \u0026lsquo;\u0026lsquo;People say stupid things, and I just, I just wish mothers would not take as much advice off the Internet because I think it just makes people more stressful.\u0026rsquo;\u0026rsquo; Her perspective underscored that support should not just be about the availability of information but also its quality. One reason for the difference in these perspectives was likely the age difference between the participants.\u003c/p\u003e\u003cp\u003e\u003cb\u003eSupport from other mothers\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe last element of the warm chain is the support of other mothers, several studies have found to be essential (Jackson \u0026amp; Hallam, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2019\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Chang et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Jeon et al., \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Peer support can be helpful because mothers are going through the same thing, at the same time, in the same place. Because their experience is also recent, it is also more relevant (in contrast to, for example, a new mother\u0026rsquo;s own mother), which became clear from the following quotes.\u003c/p\u003e\u003cp\u003ePeony felt encouraged by knowing that other mothers were breastfeeding for a longer time: \u0026lsquo;\u0026lsquo;Everyone else is doing it. So, it's possible.\u0026rsquo;\u0026rsquo; This quote showed that she most likely socialised with mothers with the same characteristics as her (as mentioned in the Introduction). Peony highlighted the importance of sharing experiences with other mothers and expressed frustration that this topic was not discussed openly, which led to insecurity. When she found others who were experiencing similar challenges, such as the change in the milk\u0026rsquo;s colour when the baby was unwell, it reassured her and reduced her feelings of isolation:\u003c/p\u003e\u003cp\u003eI want to spread that knowledge. I want people women to know that, that journey is special but hard. [\u0026hellip;] That it can be beautiful, and it can be really long. [\u0026hellip;] Maybe more knowledge about that. Like I stopped with [my first child] at seven months because I was like, \u0026lsquo;\u0026lsquo;Oh my God, the, the, the colour is changing\u0026rsquo;\u0026rsquo;. More knowledge of it. Why did it change?\u003c/p\u003e\u003cp\u003eClematis also described how the support from other mothers in her antenatal group provided a sense of community which she needed especially during challenging moments like the first nights. Her group met once a week for a year which complements the continuity of care described above. Clematis said: \u0026lsquo;\u0026lsquo;When you're up in those night feeds, the NCT group was such a lifeline.\u0026rsquo;\u0026rsquo; Similarly, Edelweiss pointed out that her experience was shaped by being in a non-judgemental community where breastfeeding was normalised. The fact that she was surrounded by other mothers who breastfed made her feel less isolated and more confident. She also shared the influence of her friend\u0026rsquo;s experience with twins, reinforcing the importance of supportive advice from peers:\u003c/p\u003e\u003cp\u003eI never felt judged by anyone, especially because I was always around other mums, and everyone was breastfeeding and it was kind of normal. [\u0026hellip;] So, at the beginning [my first child] did not latch very well. And because of my friend\u0026rsquo;s experience. [\u0026hellip;] She told me: \u0026lsquo;\u0026lsquo;Just keep doing it if you want to breastfeed, because otherwise the milk won\u0026rsquo;t come\u0026rsquo;\u0026rsquo; and so I was like, \u0026lsquo;\u0026lsquo;OK, I need to breastfeed there\u0026rsquo;\u0026rsquo;.\u003c/p\u003e\u003cp\u003eLastly, Carnation reflected on the importance of peer support in a hospital setting, where other mothers helped her through the early stages of breastfeeding. She contrasted the peer support with the busyness of the hospital staff, suggesting that sometimes other mothers were more relatable and available. This observation relates to the Community Mothers project, as described in the Introduction, as well as to research that showed that support is most helpful immediately after birth (Hoddinott et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2012\u003c/span\u003e; Hauck \u0026amp; Irurita, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2002\u003c/span\u003e). Carnation said:\u003c/p\u003e\u003cp\u003eHaving sort of a peer support in hospital when mums are first trying to latch on because the nurses are too busy and, and again, those night staff were, you know, very against it. Different people were really encouraging. [\u0026hellip;] So, my friend [friend's name] had older children. So, there were some things that I talked to about with her. [\u0026hellip;] And it was, it was very accepted amongst my friends that we were all breastfeeding. So, there\u0026rsquo;s times when I remember sitting in a room with my friend, and we both fed our babies.\u003c/p\u003e\u003cp\u003e\u003cb\u003eAlternative ways of support\u003c/b\u003e\u003c/p\u003e\u003cp\u003ePhone support is another option that may be cheaper and easier to provide than the current system of HCPs. Karimi et al.\u0026rsquo;s (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) study of new mothers with COVID\u0026ndash;19 in Iran suggested that telephone support as an early intervention might positively encourage mothers to exclusively breastfeed. However, there were no significant differences in the fourth and sixth months after birth, suggesting that the effects decrease, or that a different intervention is needed for those mothers to continue exclusive breastfeeding if they wish to do so. Karimi et al. concluded that new mothers experience more self-efficacy in breastfeeding when their mental health is addressed. This point is critical because self-efficacy is related to stress levels; when a mother experiences more stress, her self-efficacy diminishes. When her stress is expressed and dealt with through counselling, her self-efficacy improves, resulting in longer breastfeeding journeys (Karimi et al., \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eA telephone support intervention called CHAT was also used in Australia (Xu, 2024), and similar results were found. Thomson et al. (\u003cspan citationid=\"CR76\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) also found that telephone support provided beneficial support for breastfeeding; sometimes, this support boosts the confidence of new mothers and helps them to continue breastfeeding. Reassurance from the helpline meant that mothers reported that they felt calmer and/or relieved after talking to someone (Thomson et al., \u003cspan citationid=\"CR76\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eOther themes and codes\u003c/h3\u003e\n\u003cp\u003eSurprisingly, cultural differences were not often mentioned during the interviews. Once established, breastfeeding seemed to be a universal experience of bonding and magic. Mothers\u0026rsquo; experiences crossed boundaries, so while cultural differences were mentioned, this was not often enough to become a theme.\u003c/p\u003e\u003cp\u003eOther codes and themes that were developed from the data include: 1) knowledge and education, 2) policies like maternity leave, 3) financial aspects and 4) the promotion of CMF. However, these topics were mentioned less during the interviews, and they did not align as much with the other themes as the four discussed previously. These external aspects are also more difficult to be directly influenced by one study. For all these reasons, these topics were not further developed into themes.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe focus of this research was how to support women in breastfeeding more and longer. The findings indicate that the initiation of breastfeeding is driven mainly by internal motivation as well as socioeconomic circumstances and that the continuation is also impacted by education and the support of others (Xu et al., \u003cspan citationid=\"CR91\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eFirst key finding\u003c/h3\u003e\n\u003cp\u003eA key finding is that support is crucial in breastfeeding. When a mother\u0026rsquo;s confidence is enhanced, she feels more empowered to breastfeed and cope with the challenges. Community-based interventions that educate fathers and grandmothers are also beneficial (P\u0026eacute;rez-Escamilla et al., \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; De Brito Angelo et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). More promotion through the partner and grandmother will mean that they will give proper support, which leads to enhanced self-efficacy among mothers and longer breastfeeding journeys. Fathers can give practical support, such as changing diapers, practising skin-to-skin and providing snacks and water for the mother. Most of all, they can encourage her. Furthermore, a grandmother\u0026rsquo;s positive attitude towards breastfeeding also increases a mother\u0026rsquo;s willingness to breastfeed.\u003c/p\u003e\u003cp\u003eWhile the support of spouses and family members is important, the most critical support comes from peers and healthcare staff. Peer support is crucial for new mothers, as it offers a space where they can share their challenges and feel reassured by others who are going through similar experiences at the same time, who live in the same neighbourhood and are of similar age. Sharing relevant and recent experiences is helpful. When mothers feel understood and listened to, they are more willing to take advice. Participants also expressed that they want to spread their knowledge in order to help others avoid the same difficulties.\u003c/p\u003e\u003cp\u003eThere is also a need for more consistent and compassionate support from healthcare professionals. Ensuring that guidance is clear is fundamental, but emotional support is even more important than sharing information. Support via phone/video call can be as valuable as face-to-face, as this provides cost-effective support and reassurance for the new mother without her having to leave the house with her newborn. In this way, the HCPs can also attend to more people.\u003c/p\u003e\n\u003ch3\u003eSecond key finding\u003c/h3\u003e\n\u003cp\u003eA second key finding concerns breastfeeding education and knowledge, which are provided in, for example, antenatal classes. Knowledge influences attitudes and behaviours (Di Mario et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) as mothers can make more informed choices. New mothers must understand that breastfeeding can be hard and emotionally fulfilling at the same time. They will be better equipped at the start of the journey if they are aware that people will give different opinions and that it can be challenging to know what is correct, and if they are resilient and so less impacted by others while sleep-deprived and going through all the emotions of the newborn stage. When mothers-to-be know what to expect, it will be easier to have this resilience, and they will have higher levels of self-efficacy.\u003c/p\u003e\u003cp\u003eAnother topic that should be addressed with better knowledge sharing is SRIM or PIMS, as almost 50% of mothers give this as a reason to discontinue breastfeeding, despite only 5% of mothers actually having an insufficient milk supply (Huang et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eCurrently, however, the amount of breastfeeding education given in antenatal classes is not tracked. Proper governance is needed, especially because the newer generation of mothers will most likely get more information online. Education should emphasise three key aspects of breastfeeding: health benefits, convenience, and bonding (Cole et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eOther recommendations\u003c/h3\u003e\n\u003cp\u003ePolicies supporting breastfeeding (e.g. longer maternity leave) are also needed, as well as fewer misconceptions about CMF. CMF is promoted by the companies that market it, making the promotion biased and highlighting the advantages while neglecting the risks (Di Mario et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eStrengths and limitations\u003c/h3\u003e\n\u003cp\u003eThe current study offers unique perspectives on how mothers can be supported to breastfeed for longer. However, it also has a few limitations. First, the sample size is small, as is common with RTAs, especially since it consists of long-term breastfeeding mothers who are an uncommon group. Second, the participants were relatively homogeneous, having a similar SES and partnership status and living in the same area. Due to their higher education, they were also aware of the benefits of breastfeeding. Third, the participants might have had recall bias as their breastfeeding journeys were made several years ago; therefore, emotions and feelings might be romanticised.\u003c/p\u003e\u003cp\u003eIn general, much research on this topic is done by female researchers, which leads to a certain bias. In addition, the researcher\u0026rsquo;s attitude influenced how the data were collected and analysed, and her knowledge and experience of the topic may also have resulted in bias. Besides this, the researcher was biased due to her friendships with most of the participants. However, due to the awareness of these biases and continually asking for feedback from others while writing the report, bias effects were reduced.\u003c/p\u003e\u003cp\u003eNonetheless, while this study represents a small group of breastfeeding women, findings can still contribute to the understanding of breastfeeding mothers and the difficulties they experience. The study demonstrates that small-scale research can be useful to support new mothers due to the suggested solutions. It also highlights how breastfeeding can impact a mother\u0026rsquo;s mental health and well-being.\u003c/p\u003e\n\u003ch3\u003eFuture research\u003c/h3\u003e\n\u003cp\u003eLow breastfeeding rates emphasise that more funding is needed to continue research into breastfeeding and support around this topic. Ultimately it would save the economy money if more women breastfed. Future research could focus on younger and/or lower-educated mothers as they are less likely to breastfeed, and if they do, it is often for a shorter time. This comment also relates to most of the research being done in high-income countries, but birth rates are higher in low-income countries (P\u0026eacute;rez-Escamilla et al., \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Therefore, more research in low-income countries will be helpful in gaining insights and raising awareness.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eThe research was conducted in accordance with the Helsinki Declaration and the Code of Conduct of the British Psychology Society.\u003c/p\u003e\n\u003cp\u003eEthics approval - ethics approval was received by the School of Psychology Ethics Committee of the University of East London.\u003c/p\u003e\n\u003cp\u003eConsent to participate - Participants\u0026rsquo; informed consent to participate was received in participant\u0026rsquo;s signed consent forms (available).\u003c/p\u003e\n\u003cp\u003eConsent for publication \u0026ndash; Participant\u0026rsquo;s informed consent to publicise was received in participant\u0026rsquo;s signed consent forms (available).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll participants gave written informed consent for their personal or clinical details along with any identifying images to be published in this study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIdentifying images \u0026ndash; not applicable\u003c/p\u003e\n\u003cp\u003eAvailability of data \u0026ndash; interview transcripts uploaded in section Related Files.\u003c/p\u003e\n\u003cp\u003eCompeting interests \u0026ndash; not applicable\u003c/p\u003e\n\u003cp\u003eFunding \u0026ndash; not applicable\u003c/p\u003e\n\u003cp\u003eAuthors\u0026apos; contributions \u0026ndash; not applicable\u003c/p\u003e\n\u003cp\u003eAcknowledgement \u0026ndash; The authors are very grateful to all the participants who were willing to be open and share their personal stories.\u003c/p\u003e\n\u003cp\u003eThe interview was developed for this study, the questions have been uploaded.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAmir, L.H., Crawford, S.B., Cullinane, M. \u003cem\u003eet al.\u003c/em\u003e (2024). 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Modifiable predictors of breastfeeding status and duration at 6 and 12 months postpartum. \u003cem\u003eBirth, 49\u003c/em\u003e(1), 97-106. https://doi.org/10.1111/birt.12578\u003c/li\u003e\n\u003cli\u003eYuan, Z.W., Ma, L., Chen, YL., Ge, W.L., Zhao, H. Du, Y. \u0026amp; Li, X.X. (2024). Knowledge and attitude of spouses of puerperas towards breastfeeding. \u003cem\u003eBMC Women\u0026apos;s Health,\u003c/em\u003e \u003cem\u003e24\u003c/em\u003e, 289. https://doi.org/10.1186/s12905-024-03116-w\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"breastfeeding journey, self-efficacy, peer support, support from grandmothers, partners and healthcare professionals","lastPublishedDoi":"10.21203/rs.3.rs-7243754/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7243754/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eAlthough breastfeeding provides many benefits for infants as well as mothers, the UK has one of the lowest breastfeeding rates worldwide. While 54.3% of mothers start breastfeeding after birth, only 1% exclusively breastfeed for the first six months and barely anyone continues for up to two years as, recommended by the World Health Organization and UNICEF.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eEight interviews were conducted with mothers who breastfed for at least nine months of their baby\u0026rsquo;s life. The participants were between 38 and 52 years old and originated from different countries. They all had a similar level of education and partnership status while breastfeeding, and all lived in East London at the time of the study.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eFour themes were created from the interview transcripts: \u0026ldquo;Breastfeeding is hard\u0026rdquo;, \u0026ldquo;Breastfeeding is magical\u0026rdquo;, \u0026ldquo;Breastfeeding is an emotional rollercoaster\u0026rdquo;, and \u0026ldquo;Support is everything\u0026rdquo;.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThere are two key findings. First, support is crucial when it comes to breastfeeding. Support may be given by the mother\u0026rsquo;s partner or by her own mother, but the support from other mothers and healthcare professionals is especially important. This support can even be provided by phone/video call to conserve the resources off the healthcare professional and the energy of the new mother. Second, education and knowledge about breastfeeding will better prepare a mother and increase her self-confidence, enabling her to make an informed choice about breastfeeding.\u003c/p\u003e","manuscriptTitle":"Experiences and attitudes of breastfeeding mothers related to support on their breastfeeding journeys: a reflexive thematic analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-11 07:53:48","doi":"10.21203/rs.3.rs-7243754/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-10-20T10:29:37+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-28T07:04:19+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-16T23:53:46+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-14T21:16:38+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-12T06:32:23+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"247437455739294073357147521931583736104","date":"2025-09-12T04:42:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"42605845500891584880100484855561462271","date":"2025-09-12T04:17:25+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"80163632539800727111304416885353254587","date":"2025-09-10T15:13:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"229521850212257450902797820196759633033","date":"2025-09-05T22:18:40+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-04T07:29:35+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-02T11:19:38+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-08-12T13:10:08+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-12T06:41:24+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pregnancy and Childbirth","date":"2025-08-12T06:37:15+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6ea2abf9-1ef4-423f-bd2d-082c1bac7c5e","owner":[],"postedDate":"September 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-03-30T16:16:54+00:00","versionOfRecord":{"articleIdentity":"rs-7243754","link":"https://doi.org/10.1186/s12884-026-08800-3","journal":{"identity":"bmc-pregnancy-and-childbirth","isVorOnly":false,"title":"BMC Pregnancy and Childbirth"},"publishedOn":"2026-03-27 16:08:52","publishedOnDateReadable":"March 27th, 2026"},"versionCreatedAt":"2025-09-11 07:53:48","video":"","vorDoi":"10.1186/s12884-026-08800-3","vorDoiUrl":"https://doi.org/10.1186/s12884-026-08800-3","workflowStages":[]},"version":"v1","identity":"rs-7243754","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7243754","identity":"rs-7243754","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}