title: An exploration of the experiences of mothers who breastfeed long-term: what are the issues and why does it matter?
abstract: BACKGROUND
  The World Health Organization (WHO) promotes breastfeeding for 2 years and beyond. Despite this, only 25% of women in the United Kingdom are breastfeeding at all by 6 months postpartum, with a minority of women breastfeeding beyond the first year. Those who do often report feeling ridiculed or alienated in their choice. Here, the aim was to examine the experiences of women who chose to breastfeed longer term and to seek insight into the ways they felt breastfeeding could be normalized past infancy.
  
  
  METHODS
  The study combined two qualitative datasets that explored maternal attitudes and experiences toward longer-term breastfeeding. In Study 1 a combination of methods was used, including interviews, to explore the challenges, attitudes, and experiences faced by women who had breastfed for over 6 months postpartum. In Study 2, 1,319 mothers who were pregnant or had an infant 0-2 years old completed an open-ended questionnaire exploring their attitudes toward longer-term breastfeeding.
  
  
  RESULTS
  Mothers who had experience of longer-term breastfeeding described how they faced negative attitudes and criticism from others, including the perceptions that longer-term breastfeeding was comical, bizarre, and pointless. Mothers discussed ways in which longer-term breastfeeding could be normalized rather than promoted, targeting health professionals and society instead of encouraging mothers themselves. Key ideas included greater visual representation, increasing knowledge and removing stigma.
  
  
  CONCLUSIONS
  Longer-term breastfeeding needs to be normalized to increase acceptance and in turn reduce the negative attitudes that mothers often face despite following WHO guidance. Greater support is needed from health professionals and in health policy.
authors.affiliation: Department of Nursing and Midwifery, University of the West of England, Bristol, United Kingdom.
authors.forename: Sally
authors.initials: S
authors.lastname: Dowling
authors.forename: Amy
authors.initials: A
authors.lastname: Brown
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data; D002675:Child, Preschool; D002755:Choice Behavior; D003657:Decision Making; D005260:Female; D017408:Guidelines as Topic; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008429:Maternal Welfare; D008913:Minority Groups / Q000523:psychology* / Q000706:statistics & numerical data; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D049590:Postpartum Period; D011247:Pregnancy; D011639:Public Opinion; D012944:Social Support; D011795:Surveys and Questionnaires; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D014944:World Health Organization