We only talk about breast feeding: a discourse analysis of infant feeding messages in antenatal group-based education.

AIM: the aim of the study was to examine the dominant discourses that midwives draw on to present information on breast feeding in group-based antenatal education sessions. BACKGROUND: breast-feeding initiation rates are high among Australian women however, duration rates are low. Antenatal breast-feeding education is considered a key strategy in promoting breast feeding to childbearing women. The efficacy and effectiveness of such a strategy is equivocal and there is little qualitative work examining group-based antenatal breast-feeding education. METHODS: discourse analysis was used to explore the language and practises of midwives facilitating group antenatal breast-feeding education sessions at two Australian maternity facilities. Nine sessions were observed and tape recorded over a 12 month period. Each session lasted between 60 and 140 mins. FINDINGS: the analysis revealed four dominate discourses midwives used to promote breast feeding during group-based antenatal education session. The predominant discourses 'There is only one feeding option': breast feeding' and 'Selling the 'breast is best' reflected how midwives used their personal and professional commitment to breast feeding, within supportive and protective policy frameworks, to convince as many pregnant women as possible to commit to breast feeding. Sessions were organised to ensure women and their partners were 'armed' with as much information as possible about the value of breastmilk, successful positioning and attachment and practical strategies to deal with early breast-feeding problems. Antenatal commitment to breast feeding was deemed necessary if women were to overcome potential hurdles and maintain a commitment to the supply of breast milk. The latter two discourses, drawn upon to promote the breast-feeding message, presented infants as 'hard wired' to breast feed and male partners as 'protectors' of breast feeding. CONCLUSIONS: midwives clearly demonstrated a passion and enthusiasm for breast-feeding education. Examining the dominant discourses used by midwives during the antenatal sessions revealed, however, that their language and practices were often limited to convincing women to breast feed rather than engaging with them in conversations that facilitated exploration and discovery of how breast feeding might be experienced within the mother-infant relationship and broader social and cultural context. In addition, there was evidence that global breast-feeding policies, in resource rich countries such as Australia, may influence how midwives talk about breast feeding without them being fully cognisant of the potentially coercive nature of the messages women receive