title: A two-decade perspective on mothers' experiences and feelings related to breastfeeding initiation in Sweden.
abstract: OBJECTIVE
  The purpose was to examine mothers' experiences and feelings related to breastfeeding initiation from a two-decade perspective.
  
  
  METHODS
  A repeated cross-sectional survey was conducted at a maternity ward before and after introduction of Baby Friendly Hospital Initiative (BFHI) and in a follow-up survey. Women participated in 1992 (n = 83), 1993 (n = 74) and 2011 (n = 94).
  
  
  RESULTS
  The duration of time at the first suckling differed; in 2011, the baby sucked 24.4 minutes compared to 12.7 minutes in 1992 (p < .001) and 13.6 minutes in 1993 (p < .001). In 1992, 34.6% of the women reported using supplementary formula compared with 5.9% in 1993 and 9.3% in 2011 (p < .001). The mothers' contacts with the child or the father as well as their moods did not vary during the years. Mothers rated their feelings towards breastfeeding as being lower in 2011 than in 1992 and 1993 (p = .008). In 2011, mothers experienced breastfeeding as being more difficult and reported a higher degree of tension, insecurity and anxiety.
  
  
  CONCLUSIONS
  Supplementation was given to healthy newborn infants, which does not conform to BFHIs intentions. Routines and support in relation to breastfeeding initiation need to be continuously evaluated in order to strengthen and sustain the BFHI.
authors.affiliation: Department of Health and Caring Sciences, Linnaeus University, Sweden.
authors.forename: Karin S M
authors.initials: KS
authors.lastname: Holmberg
authors.affiliation: Department of Health and Caring Sciences, Linnaeus University, Sweden; Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
authors.forename: Ulla M C
authors.initials: UM
authors.lastname: Peterson
authors.affiliation: Department of Health and Caring Sciences, Linnaeus University, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Sweden. Electronic address: marie.oscarsson@lnu.se.
authors.forename: Marie G
authors.initials: MG
authors.lastname: Oscarsson
mesh_terms: D000328:Adult; D000339:Affect; D001007:Anxiety; D001294:Attitude to Health; D001942:Breast Feeding / Q000523:psychology* / Q000639:trends; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D019538:Health Care Surveys; D006761:Hospitals; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008297:Male; D009035:Mothers / Q000523:psychology*; D013391:Sucking Behavior; D013548:Sweden; D055815:Young Adult
keywords: Baby Friendly Hospital Initiative; Breastfeeding; Initiation; Mothers’ experiences