title: Women's perceptions of breastfeeding barriers in early postpartum period: a qualitative analysis nested in two randomized controlled trials.
abstract: OBJECTIVE
  This study examined women's perceptions of early infant feeding experiences and identified early postpartum barriers to successful breastfeeding.
  
  
  METHODS
  We conducted semistructured exit interviews at 6 months postpartum with a subsample of participants (n=67) enrolled in two randomized controlled trials of breastfeeding promotion. Study arms included (1) routine pre- and postnatal visits with an International Board Certified Lactation Consultant (IBCLC) (LC group), (2) electronically prompted guidance from prenatal care providers (EP group), (3) EP+LC combined, and (4) standard of care (control group). Interview transcripts were coded using grounded theory and analyzed in MAXqda. Code matrices were used to identify early postpartum breastfeeding barriers and were further examined in relation to treatment group using a mixed methods analysis.
  
  
  RESULTS
  The majority of the participants reported experiencing at least one barrier to breastfeeding. Barriers to breastfeeding were more commonly reported in the early postpartum than late postpartum period. The most common barrier during the early postpartum period was the perception of inadequate milk supply ("lactational") (n=18), followed by problems with latch, medical problems that were perceived as precluding breastfeeding, and medical staff and hospital practices. Participants frequently reported that the IBCLCs assisted them in anticipating, managing, and overcoming these barriers.
  
  
  CONCLUSIONS
  Our findings underscore the importance of integrating IBCLCs into routine pre- and postpartum care because they provide critical support that effectively addresses early postpartum barriers to breastfeeding.
authors.affiliation: 1 Department of Family and Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine , Bronx, New York.
authors.forename: Alice S
authors.initials: AS
authors.lastname: Teich
authors.forename: Josephine
authors.initials: J
authors.lastname: Barnett
authors.forename: Karen
authors.initials: K
authors.lastname: Bonuck
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology*; D005069:Evaluation Studies as Topic; D005247:Feeding Behavior; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D010465:Perception; D011181:Postnatal Care; D049590:Postpartum Period; D014930:Women / Q000523:psychology*; D055815:Young Adult