First time mothers’ experiences of breastfeeding their newborn Hanne Kronborg *, Ingegerd Harder, Elisabeth O.C. Hall Section for Nursing, Department of Public Health, Aarhus University, Aarhus, Denmark ARTICLE INFO Article history: Received 10 February 2014 Received in revised form 4 August 2014 Accepted 20 August 2014 Keywords: Breastfeeding Postpartum period Mother–child relationship Postnatal care Professional–patient relations Communication A B ST R AC T Objective: Despite efforts to improve continued breastfeeding, the percentages of exclusively breastfeeding remain low. To help the breastfeeding mother and reshape professional practice, we need more knowl- edge of maternal experiences of breastfeeding in the first months. The objective was to explore mothers’ early breastfeeding experiences. Method: Qualitative content analysis was used to analyse data from 108 Danish first time mothers who had answered an open-ended question 6 months after birth. Results: All the mothers started breastfeeding. We identified three overlapping phases presented as dom- inant themes: (1) on shaky ground, characterised by breastfeeding interwoven with mothering, painful breastfeeding, and conflicting advice, (2) searching for a foothold, characterised by reading the baby’s cues, concerns about milk production, for or against breastfeeding, and looking for professional support, and (3) at ease with choice of feeding, characterised by a thriving baby, trust in breastfeeding capability, and approval of feeding preference. Together these themes and subthemes constituted the overall theme: being on a breastfeeding–bonding trajectory. Conclusion: Supporting the new breastfeeding mother should include facilitation of the transition to moth- erhood, learning to read the baby’s cues, developing a sense of the right attachment at the breast, and building up the mother’s confidence in her capability to care for the baby and produce a sufficient milk supply. © 2014 Published by Elsevier B.V. Introduction The benefits of breastfeeding are well-documented. The World Health Organization therefore recommends every woman who is giving birth to breastfeed for 6 months [1]. In Scandinavia, nearly all mothers start breastfeeding. However, despite efforts to improve continued breastfeeding the percentages of women who engage in exclusive breastfeeding until 4–6 months after birth remain low [2–4]. The aetiology of breastfeeding cessation is multi-factorial. Socio- demographic factors (such as age, parity, education, racial/ethnic group and income) and psychosocial factors (such as intention, con- fidence and knowledge) are well-known determinants of both the choice to breastfeed and the duration of breastfeeding [5]. Further, behavioural factors, such as unrestricted mother–infant contact [6], frequent feeding, and having mastered breastfeeding techniques [7] have been shown to play a role in successful breastfeeding. Breastfeeding is often described as the most difficult thing in the learning process of becoming a parent [8]. One in every two new mothers reports having experienced early breastfeeding problems [7,9]. Mothers may experience sore nipples and concerns about having enough milk and at the same time experience anxiety about becoming a parent with concerns about the safety of the new baby [10]. The expectations towards breastfeeding being a natural process are replaced by experiences of breastfeeding being difficult and re- quiring perseverance to succeed [11]. Giving up breastfeeding is often described by mothers as experiencing mixed feelings of guilt and failure [12]. The decision made by some mothers to cease breastfeeding may be based on family needs and individual atti- tudes towards breastfeeding [13] or necessary for the well-being of their child [11]. To help the breastfeeding mother, health care providers need ex- tensive knowledge of the maternal situation in the first months to provide individualised guidance and ensure that early breastfeeding problems are resolved [14]. The main barrier related to breastfeeding counselling may be deficits in knowledge among health profes- sionals [15]. A number of studies concerning the mothers’ needs for support call for reviewing practices that provide an individualised approach to meet the needs of the breastfeeding mother and guide her to feel secure in caring for her baby [10,13,16,17]. Individually adapted types of support seem to have a more positive outcome This study was approved by the Science Ethics Committee for the Counties of Ringkjoebing, Ribe and Soenderjylland, Denmark and the Danish Data Protection Agency. * Corresponding author. Tel.: +45 87167891. E-mail address: hk@nursingscience.au.dk (H. Kronborg). http://dx.doi.org/10.1016/j.srhc.2014.08.004 1877-5756/© 2014 Published by Elsevier B.V. Sexual & Reproductive Healthcare ■■ (2014) ■■–■■ ARTICLE IN PRESS Please cite this article in press as: Hanne Kronborg, Ingegerd Harder, Elisabeth O.C. Hall, First time mothers’ experiences of breastfeeding their newborn, Sexual & Reproductive Healthcare (2014), doi: 10.1016/j.srhc.2014.08.004 Contents lists available at ScienceDirect Sexual & Reproductive Healthcare journal homepage: www.srhcjournal.org