Breastfeeding experience, challenges and service demands among Chinese mothers: A qualitative study in two cities

Breastfeeding rates remain low in China despite decades of efforts at improving breastfeeding practices. The study aimed to explore mothers' breastfeeding experience throughout the breastfeeding period and to understand their challenges and support service needs at each stage. Qualitative research methods, individual in-depth interviews and focus group discussions were carried out with mothers and people who played various roles regarding breastfeeding such as service provider, researcher and policy maker. Mothers' breastfeeding practices can be categorized into five stages. In the 'preparatory stage', pregnant women had high intention towards breastfeeding but had inadequate knowledge and skills preparation. In the 'initial stage' in hospital for childbirth, mothers received inadequate support from hospital professionals due to the short hospital stay. In the 'self-exploratory stage' after being discharged from hospital, mothers mostly relied on non-professionals' support. In the 'transitional stage' between four and six months postpartum, most mothers gave up exclusive breastfeeding due to the lack of a supportive environment at workplace. At the 'complementary feeding stage', most mothers stopped breastfeeding and switched to formula between six and 12 months for reasons such as perceived non-nutritious value of breast milk after six months, returning to work, desiring returning to former lifestyle. This study shows that mothers encounter different problems and have specific needs for support at different stages of breastfeeding. Tailored support could be provided to encourage exclusive breastfeeding for the first six months and continued breastfeeding for up to 2 years.