title: Mothers' experience of not breastfeeding in a breastfeeding culture.
abstract: OBJECTIVE
  To describe women's experience of not breastfeeding in a breastfeeding culture.
  
  
  BACKGROUND
  Breastfeeding represents a fundamental cultural value in Norway and many other countries, and a mother may often have intense emotions about breastfeeding her child. Political and health authorities in many countries have given high priority to encourage breastfeeding among mothers. However, breastfeeding can be challenging and sometimes affects mothers' mental health and the joy of interaction.
  
  
  METHODS
  Qualitative design.
  
  
  METHODS
  Individual semistructured interviews with 12 mothers. Qualitative content analysis was used to analyse the interviews.
  
  
  RESULTS
  Three main categories emerged from the data: (1) desire to adapt to Norwegian culture, (2) feeling as though one was breaking the law and (3) lack of and unbalanced information. The mothers in this study wanted to breastfeed, both to do the best for their child and to fulfil cultural expectations. They knew about the advantages of breastfeeding. When breastfeeding was stopped, they needed social support because they felt it was difficult to do the opposite of what was most common in the culture.
  
  
  CONCLUSIONS
  Healthcare workers should consider the mother's individual situation when providing breastfeeding guidance. Information about the advantages should be adequately balanced and nuanced to prevent shame and guilt. Healthcare workers should have sufficient knowledge about how to ensure that infant formula is used correctly.
  
  
  CONCLUSIONS
  Healthcare workers should pay attention to the mother if she has limited social support, and they should organise peer support. Healthcare workers must ensure that mothers get balanced information about the benefits of breastfeeding and about the differences between breastmilk and infant formula. To ensure that infant formula is used correctly and to reduce stigma, healthcare workers should have sufficient knowledge about formula feeding and health authorities could provide information about how to prepare infant formula.
authors.affiliation: Health Authorities, Oslo Municipality, Oslo, Norway.
authors.forename: Ingjerd
authors.initials: I
authors.lastname: Hvatum
authors.affiliation: Department of Nursing, Diakonova University College, Oslo, Norway.
authors.forename: Kari
authors.initials: K
authors.lastname: Glavin
mesh_terms: D000069:Acculturation; D000328:Adult; D001290:Attitude; D001942:Breast Feeding / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D041943:Infant Formula; D007231:Infant, Newborn; D009035:Mothers / Q000523:psychology*; D009664:Norway; D064689:Nurses, Public Health / Q000523:psychology; D009741:Nursing Staff, Hospital / Q000523:psychology; D036301:Qualitative Research; D012944:Social Support
keywords: baby-friendly hospital; breastfeeding; culture; formula feeding; motherhood; qualitative study; well child clinic