title: A qualitative study exploring factors associated with mothers' decisions to formula-feed their infants in Newfoundland and Labrador, Canada.
abstract: BACKGROUND
  Breastfeeding has numerous health benefits. In 2010, the province of Newfoundland and Labrador had the lowest breastfeeding initiation rate (64.0%) in Canada. Formula feeding is associated with well-known health risks. Exclusive formula feeding is the "cultural norm" in some regions of the province. Women appear resistant to changing their infant feeding behaviors and remain committed to their decision to formula-feed. The primary aim of this qualitative study was to examine individual factors that shaped mothers' decisions to formula-feed their infants. Nineteen mothers who were currently formula feeding their children participated in the study.
  
  
  METHODS
  Qualitative research in the form of focus groups was conducted in three communities in the province in 2010. A thematic content analysis identified the main themes that influenced mothers' decisions to formula-feed their infants.
  
  
  RESULTS
  The main themes included issues concerning the support needed to breastfeed, the convenience associated with formula feeding, and the embarrassment surrounding breastfeeding in public.
  
  
  CONCLUSIONS
  These findings help to better understand why mothers choose formula feeding over breastfeeding and may help to inform the development of public health interventions targeted at this population of mothers.
authors.affiliation: Research and Evaluation, Newfoundland and Labrador Centre for Health Information, 70 O’Leary Avenue, St. John’s, Newfoundland and Labrador A1B 2C7, Canada.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Bonia
authors.forename: Laurie
authors.initials: L
authors.lastname: Twells
authors.forename: Beth
authors.initials: B
authors.lastname: Halfyard
authors.forename: Valerie
authors.initials: V
authors.lastname: Ludlow
authors.forename: Leigh Anne
authors.initials: LA
authors.lastname: Newhook
authors.forename: Janet
authors.initials: J
authors.lastname: Murphy-Goodridge
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology; D002755:Choice Behavior; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000008:administration & dosage*; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D009523:Newfoundland and Labrador; D036301:Qualitative Research; D012959:Socioeconomic Factors; D055815:Young Adult