Nurturing the novice mother : a grounded theory of 'support' and its impact on building confidence with breastfeeding and parenting for first-time mothers

Breastfeeding confers many benefits for the health and wellbeing of mothers and babies and for the wider community. Yet, despite global initiatives and local and national policy directives, the universally endorsed aim of exclusive breastfeeding for 6 months remains an elusive aspiration for many women in Australia. Substantial research to try to determine the factors that affect breastfeeding duration has been undertaken and although some insight has been gained, it is clear that infant-feeding decision-making is more complex than previously recognised. The purpose of this research was to consider the contemporary circumstances in which infant feeding choices and practices occur and the perspectives that first-time mothers have about what is supportive, specifically in relation to sustaining breastfeeding. Using a contemporary approach to grounded theory, within a symbolic interactionist framework, this doctoral thesis examined women’s perceptions of interactions with ‘others’ within their support network and analysed the impact on their experience of breastfeeding. Fifteen first-time mothers and their selected family and friends were recruited for this study in a known area of socio-economic disadvantage within western Sydney, New South Wales, Australia. Data comprised audio-recordings, transcripts, contextual data and field notes of two family group conversations conducted with each mother and those persons (others) she deemed to be significant in her life, at around 34 to 36 weeks gestation and at 4-9 months after the birth. A one-to-one interview with each mother conducted after each family conversation allowed for the women’s individual views and candid perspectives of the impact of family and friends on their experience of breastfeeding and associated decision-making to be ascertained and analysed. The results showed that the experience of breastfeeding does not stand alone and is critically linked to the total process of learning to be a mother. The data analysis provided detailed evidence of the role of ‘others’ in facilitating or inhibiting the new mother’s ability to negotiate the mothering learning curve and manage the many challenges of the mothering role including breastfeeding. Significantly, neglecting and undermining support interfered with a process whereby the women learnt how to respond effectively to their baby’s communicated needs (conceptualised as ‘Learning to speak baby’) and this was linked to confidence with breastfeeding. In contrast, nurturing support facilitated ‘Learning to speak baby’, contributed to the women’s total wellbeing, provided role relief, validated the women in their mothering and breastfeeding efforts, and assisted in the continuation of breastfeeding. The grounded theory of ‘Nurturing the Novice Mother’, generated from the data analysis and refined by critical review of extant literature, provides new understanding of the complexities involved in becoming a mother for the first time. This research highlights the significance of family and support networks in determining how women feel about their parenting and breastfeeding ability as they learn to be a mother and strive for expertise. Providing nurturing support to novice mothers empowers them and helps move them to the position of seeing themselves as the ‘expert’ in regards to their own baby, which is important to assist them in reaching their goals for breastfeeding and vital to their self-identity as a mother