title: Is being resolute better than being pragmatic when it comes to breastfeeding? Longitudinal qualitative study investigating experiences of women intending to breastfeed using the Theoretical Domains Framework.
abstract: In the UK, initiating then discontinuing breastfeeding before two weeks post-partum is common. The aim of this longitudinal qualitative study was to explore which psychosocial factors may influence discontinuation.
  
  
  
  A sample of 10 pregnant women intending to breastfeed were recruited. A longitudinal qualitative design was used to capture views prior to and two weeks following birth. Semi-structured interviews were conducted underpinned by the Theoretical Domains Framework to explore a comprehensive list of psychosocial factors.
  
  
  
  Four women discontinued breastfeeding at the time of the second interview. Pre-partum differences were identified between maintainers and discontinuers; discontinuers appeared to have stronger intentions to breastfeed based on their self-determination, self-confidence and perception of fewer barriers to breastfeeding. Post-partum, discontinuers highlighted how they felt physically unable to carry on; their feeding experiences elicited negative emotions and pain. Negative emotions appeared to be exacerbated by original breastfeeding beliefs and advice given by healthcare professionals.
  
  
  
  The women in this study who discontinued breastfeeding showed less cognitive flexibility, which appeared to exacerbate post-partum emotional distress, when they encountered difficulties. Women with strong intentions and self-determination might benefit from support in anticipating potential barriers and identifying ways of overcoming them.
authors.affiliation: Public Health Department, NHS Dumfries & Galloway, Dumfries DG1 4TG, UK.
authors.forename: E E
authors.initials: EE
authors.lastname: Jardine
authors.affiliation: University of Stirling, Stirling FK9 4LA, UK.
authors.forename: J
authors.initials: J
authors.lastname: McLellan
authors.affiliation: Department of Health Psychology, University of Stirling, Stirling FK9 4LA, UK.
authors.forename: S U
authors.initials: SU
authors.lastname: Dombrowski
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D008137:Longitudinal Studies; D026684:Personal Autonomy; D011584:Psychology; D036301:Qualitative Research; D012649:Self Concept; D055815:Young Adult
keywords: Theoretical Domains Framework; breastfeeding; interviews; longitudinal; pregnant women; qualitative