title: Australian, Irish and Swedish women's perceptions of what assisted them to breastfeed for six months: exploratory design using critical incident technique.
abstract: Breastfeeding initiation rates in some developed countries are high (98 % in Sweden and 96 % in Australia) whereas in others, they are not as favourable (46 % to 55 % in Ireland). Although the World Health Organization recommends exclusively breastfeeding for six months, 15 % of Australian women, 11 % of Swedish women and less than 7 % of Irish women achieve this goal. Awareness of what women in different countries perceive as essential breastfeeding support is a gap in our knowledge.
  
  
  
  Our aim was to explore Australian, Irish and Swedish women's perceptions of what assisted them to continue breastfeeding for six months. An exploratory design using critical incident techniques was used. Recruitment occurred through advertisements in local newspapers and on social networking platforms. Initial sampling was purposive, followed by snowball sampling. Telephone interviews were conducted with 64 Irish, 139 Swedish and 153 Australian women who responded to one question "what has assisted you to continue breastfeeding for at least six months?" Content analysis was conducted and common categories determined to allow comparison of frequencies and priority ranking.
  
  
  
  Categories reflected the individual mother, her inner social network, her outer social network (informal support either face to face or online), and societal support (health professionals, work environment and breastfeeding being regarded as the cultural norm). Categories ranked in the top five across the three countries were 'informal face to face support' and 'maternal determination'. Swedish and Australian women ranked "health professional support" higher (first and third respectively) than Irish women who ranked 'informal online support' as second compared to ninth and tenth for Swedish and Australian women.
  
  
  
  The support required to assist breastfeeding women is complex and multi-faceted. Although common international categories were revealed, the ranking of these supportive categories varied. We must recognize how the cultural context of breastfeeding support can vary for women in differing countries and acknowledge the resourcefulness of women who embrace innovations such as social media where face to face formal and informal support are not as accessible.
authors.affiliation: School of Nursing, Midwifery and Paramedicine, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. y.hauck@curtin.edu.au.|Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Bagot Rd, Subiaco, WA, 6008, Australia. y.hauck@curtin.edu.au.
authors.forename: Yvonne L
authors.initials: YL
authors.lastname: Hauck
authors.affiliation: Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden.|Centre for Clinical Research Sörmland, Uppsala University, Kungsgatan 41, 631 88, Eskilstuna, Sweden.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Blixt
authors.affiliation: Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden.
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Hildingsson
authors.affiliation: Trinity College Dublin, School of Nursing and Midwifery, 24 D'Olier Street, Dublin, Ireland.
authors.forename: Louise
authors.initials: L
authors.lastname: Gallagher
authors.affiliation: Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden.
authors.forename: Christine
authors.initials: C
authors.lastname: Rubertsson
authors.affiliation: School of Nursing, Midwifery and Paramedicine, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
authors.forename: Brooke
authors.initials: B
authors.lastname: Thomson
authors.affiliation: School of Nursing, Midwifery and Paramedicine, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.|Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Bagot Rd, Subiaco, WA, 6008, Australia.
authors.forename: Lucy
authors.initials: L
authors.lastname: Lewis
mesh_terms: D000328:Adult; D001315:Australia; D001942:Breast Feeding / Q000208:ethnology* / Q000523:psychology; D003469:Culture; D005260:Female; D006801:Humans; D007494:Ireland; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D010465:Perception; D011181:Postnatal Care / Q000523:psychology*; D011247:Pregnancy; D060756:Social Networking; D012944:Social Support; D013548:Sweden; D013647:Task Performance and Analysis; D055815:Young Adult
keywords: Breastfeeding; International; Prevalence; Professional support; Self-efficacy; Social support