title: Breast-feeding difficulties experienced by women taking part in a qualitative interview study of postnatal depression.
abstract: OBJECTIVE
  to explore how women experience breast-feeding difficulties. This theme emerged unexpectedly during a study of women's experiences of screening with the Edinburgh postnatal depression scale (EPDS) and subsequent care from primary health-care professionals.
  
  
  METHODS
  qualitative in-depth interview study.
  
  
  METHODS
  postnatal women of 22 general practices within Oxford City Primary Care Group area.
  
  
  METHODS
  39 postnatal women from a purposeful sample were interviewed at an average of 15 months postnatal. They were chosen from different general practices and with a range of emotional difficulties after birth, judged using EPDS results at eight weeks and eight months postnatal, and whether they received 'listening visits' from health visitors.
  
  
  RESULTS
  a qualitative thematic analysis was used, including searches for anticipated and emergent themes. Fifteen women had breast-feeding difficulties. Five themes emerged which explore the difficulties. Firstly, commitment to breast feeding and high expectations of success; secondly, unexpected difficulties; thirdly, seeking professional support for difficulties; fourthly, finding a way to cope; and fifthly, guilt.
  
  
  CONCLUSIONS
  in this study breast-feeding difficulties were common, caused emotional distress and interactions with professionals could be difficult. Current breast-feeding policy, such as the 'Baby Friendly Initiative', may be a contributing factor. This needs to be explored in a further study.
authors.affiliation: Summertown Health Centre, 160 Banbury Road, Oxford OX2 7BS, UK. judy@shake-speare.demon.co.uk
authors.forename: Judy
authors.initials: J
authors.lastname: Shakespeare
authors.forename: Fiona
authors.initials: F
authors.lastname: Blake
authors.forename: Jo
authors.initials: J
authors.lastname: Garcia
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000009:adverse effects / Q000523:psychology*; D019052:Depression, Postpartum / Q000523:psychology*; D004739:England; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008880:Midwifery / Q000592:standards*; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D011181:Postnatal Care / Q000379:methods; D011247:Pregnancy; D013315:Stress, Psychological / Q000209:etiology / Q000451:nursing*; D011795:Surveys and Questionnaires