Complex decisions: theorizing women's infant feeding decisions in the first 6 weeks after birth

This paper is a report of a grounded theory study of woman's infant feeding experiences and decisions in the first 6 weeks after birth.

Breastfeeding is considered the optimum method of infant feeding. Studies have identified numerous factors associated with infant feeding decisions. What remains unexplored are the mechanisms by which socio-demographic, biomedical and psychosocial factors influence infant feeding decisions. Research highlights the need for further investigation of the experiences and decision-making processes of both breastfeeding and formula-feeding women.

A constructionist grounded theory approach to data collection and analysis was used. Data for this study were collected and analysed between 2003 and 2004. Further data, collected in a previous study in 2000, were theoretically sampled and analysed in 2005. In-depth interviews with 37 women from various socio-demographic areas in New South Wales, Australia provided data.

The core category was 'deconstructing best'. 'Deconstructing best' was the infant feeding decision-making process in the first 6 weeks after birth. The process of 'deconstructing best' involved seven phases: planning, expecting, realizing, questioning, getting on with it, defending and qualifying. Four main categories -'it's really best to breastfeed', 'it's the unknown', 'it's not the only thing going on', and 'everybody's best is different'- comprised the context within which deconstructing best occurred.

Woman's infant feeding decisions cannot be viewed in isolation from other post-natal experiences and needs. Infant feeding decisions will only be understood and appropriately supported when they are seen in relation to the circumstances of a woman's life, her immediate sociocultural context and individual experience.