title: It takes a mother to practise breastfeeding: Women's perceptions of breastfeeding during the period of intention.
abstract: BACKGROUND
  In the Netherlands, 81% of mothers initiate breastfeeding. After one month the percentage of mothers still breastfeeding drops, despite positive intentions. Little is known about women's perceptions of breastfeeding during the period of intention.
  
  
  OBJECTIVE
  This qualitative study aimed to gain insight into these perceptions among first-time mothers from middle and high socioeconomic backgrounds in the northern part of the Netherlands.
  
  
  METHODS
  We used the theory of planned behaviour as the deductive model. In 2008, 16 in-depth interviews were conducted with 8 mothers who intended to breastfeed. The interviews were conducted at two time points (prepartum and postpartum) and covered the same period (that is, from the time when the intention was formed until after childbirth). The interviews were transcribed verbatim and analysed using grounded theory.
  
  
  RESULTS
  Five inductive themes were identified: combining breastfeeding with work, learning about breastfeeding, making arrangements for childbirth, reflecting on the intention, and becoming a mother. During the extended period of intention, the women anticipated breastfeeding, but were cautious in expressing their intentions. They felt that the experience of becoming a mother would be critical to their breastfeeding outcomes.
  
  
  CONCLUSIONS
  The theory of planned behaviour has been widely used in breastfeeding research. However, the period of intention is relatively long for breastfeeding. Rather than recommending an intensification of antenatal breastfeeding education, recommendations must incorporate the awareness that practising breastfeeding should not be considered the continuous outcome of the intention to do so - it takes a mother to practise breastfeeding.
authors.affiliation: Population Research Centre, Department of Demography, Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 AD Groningen, Netherlands; Research and Innovation Group in Health Care and Nursing, School of Health, Hanze University of Applied Sciences, Eyssoniusplein 18, 9714 CE Groningen, Netherlands. Electronic address: a.t.oosterhoff@rug.nl.
authors.forename: Alberta
authors.initials: A
authors.lastname: Oosterhoff
authors.affiliation: Population Research Centre, Department of Demography, Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 AD Groningen, Netherlands.
authors.forename: Inge
authors.initials: I
authors.lastname: Hutter
authors.affiliation: Population Research Centre, Department of Demography, Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 AD Groningen, Netherlands.
authors.forename: Hinke
authors.initials: H
authors.lastname: Haisma
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology*; D036861:Delivery, Obstetric; D004644:Emotions; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D008425:Maternal Behavior / Q000523:psychology*; D009035:Mothers / Q000193:education / Q000523:psychology*; D009426:Netherlands; D036801:Parturition; D010465:Perception; D049590:Postpartum Period; D011247:Pregnancy; D036301:Qualitative Research; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Becoming a mother; Breastfeeding; Qualitative research cycle; The Netherlands; Theory of planned behaviour