title: Learning the hard way: expectations and experiences of infant feeding support.
abstract: BACKGROUND
  Breastfeeding involves learning for women and their infants. For emotional, social, and developmental reasons this type of feeding is recommended for all newborn infants but for those in exceptional circumstances. The objective of this study was to gain a better understanding of what is needed in the early days to enable women to initiate and continue breastfeeding their infants.
  
  
  METHODS
  Data from a large-scale national survey of women's experience of maternity care in England were analyzed using qualitative methods, focusing on the feeding-related responses.
  
  
  RESULTS
  A total of 2,966 women responded to the survey (62.7% response rate), 2,054 of whom wrote open text responses, 534 relating to infant feeding. The main themes identified were "the mismatch between women's expectations and experiences" and "emotional reactions" at this time, "staff behavior and attitudes," and "the organization of care and facilities." Subthemes related to seeking help, conflicting advice, pressure to breastfeed, the nature of interactions with staff, and a lack of respect for women's choices, wishes, previous experience, and knowledge.
  
  
  CONCLUSIONS
  Many women who succeeded felt that they had "learned the hard way" and some of those who did not, felt they were perceived as "bad mothers" and women who had in some way "failed" at one of the earliest tasks of motherhood. What women perceived to be staff perceptions affected how they saw themselves and what they took away from their early experience of infant feeding.
authors.affiliation: Maggie Redshaw is a Senior Research Fellow and Social Scientist and Jane Henderson is a Health Service Researcher at the Maternal Health and Care Research Unit, National Perinatal Epidemiology Unit, Oxford, United Kingdom.
authors.forename: Maggie
authors.initials: M
authors.lastname: Redshaw
authors.forename: Jane
authors.initials: J
authors.lastname: Henderson
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data*; D004739:England; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008880:Midwifery; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D011181:Postnatal Care; D011369:Professional-Patient Relations; D011795:Surveys and Questionnaires