Young mothers’ negotiations of infant feeding. A qualitative study with ethnographic methods.

Background: In the UK, mothers under 20 are the group least likely to breastfeed. Recent public health interventions to promote breastfeeding in the under 20s have met with limited success. Suggested factors include cultural constructions of normative behaviour, environmental and practical barriers, and a lack of professional and community support. However, less is known about the journey through infant feeding and the interrelation of the various influences on the experiences of young mothers.
Methods: Ethnographic interviews and participant observation were used to explore the lived experience of ten young mothers aged 16-18 and their babies, from pregnancy to weaning. The data were analysed using Thematic Network Analysis and the emerging themes developed into a coherent description of the influences on infant feeding practices and why these influences seem to lead to formula feeding.
Results: The influences were found to relate to three broad thematic areas: the immediate context and the importance of family relationships; the external context of public spaces (which could include the public areas of the home) and the themes of the babies and the milk.
Discussion: Theories of the interplay of practical experiences of the young mothers with moral discourses of good motherhood were developed. Using the Ricœurdian theory of the narrative of the self (ipse identity) the work of becoming a mother and making feeding decisions in a morally charged environment are explicated. This approach has begun to reframe the discourse on health research on the public health approach to breastfeeding to encompass and integrate personal identities and social relationships with cultural norms of infant feeding.
Conclusions: The findings gave new insights into both why breastfeeding rates are low in this group and why existing interventions have not significantly changed behaviour. The need for a consideration of the social, cultural and moral meanings of infant feeding to young mothers has been highlighted. Practical suggestions for supporting young mothers who wish to breastfeed have also been developed from these research findings.