Investigating Sustained Breastfeeding: A Grounded Theory Study

OBJECTIVE: Despite the well-documented barriers to breastfeeding and reasons for cessation, a group of resilient women residing in low breastfeeding initiation regions are defying the odds. They continue to breastfeed for longer than six months. This research aimed to identify the common factors and social processes contributing to their longer breastfeeding duration. METHODS: A Grounded Theory study investigated sustained breastfeeding in women who attended a support group in neighborhoods where breastfeeding initiation was low. Breastfeeding women (N = 10) who had provided human milk for more than six months were recruited. In semi-structured interviews, participants responded to questions formulated to understand common factors and social processes for these women. Constant comparative analysis continued until all emerging concepts became saturated. RESULTS: The emergent theoretical framework for sustained breastfeeding is a complex social process comprised of internal and external influences. The individual lens of the breastfeeding person filters perceptions of barriers, hardships, sources of support, and their external environment. The critical social process for sustained breastfeeding among this group of women was personally constructing breastfeeding-supportive environments in which they could thrive. CONCLUSIONS FOR PRACTICE: The findings underscore the importance of establishing individualized breastfeeding-supportive environments early in the breastfeeding journey. This insight can guide lactation professionals in assisting breastfeeding persons in finding the right community to sustain breastfeeding. Open conversations about breastfeeding exposure, social supports, and positive/negative influences on breastfeeding can be instrumental in this process.