Determinants of successful breastfeeding by young mothers in New Zealand : a thesis presented in partial fulfillment of the requirements for the degree of Masters in Science in Nutrition and Dietetics at Massey University, Albany, New Zealand
Background: International research has shown that younger mothers are less
likely to initiate/maintain breastfeeding (BF) than older women. Optimising BF
maintenance in young mothers is important because early cessation of BF has been
associated with negative health outcomes for the infant, which may extend beyond
infancy into adulthood. Despite this, little is known about the facilitators of
successful BF in this group. Therefore, the purpose of this study was to investigate
the factors that enabled a group of mothers who gave birth at a young age to
successfully breastfeed for at least 4 months.
Objective: To gain an in-depth understanding of the factors that led to a successful
breastfeeding experience in mothers who gave birth at a young age.
Methods: Seventeen positive deviants were identified. These were mothers who
gave birth under the age of 25 years, who had successfully BF for at least 4 months.
Participants were recruited through various support groups and breastfeeding
networks. Semi-structured in-depth interviews were conducted in person or over
the phone with each of the seventeen mothers. The interviews were recorded and
transcribed, which enabled theme identification. Demographic information was
also collected using a short questionnaire. A thematic analysis was used to analyse
the qualitative data obtained from each mother’s breastfeeding experiences.
Interpretative phenomenology was used to extract themes from the transcripts,
these were then double-checked by two researchers in the research team.
Results: Participants were located throughout the North Island of New Zealand
(NZ). Eleven mothers identified themselves as NZ European, three mothers
identified as NZ European and Māori, and one mother identified as NZ European
and Hawaiian. The mothers had given birth between the age of 15 through to 24
years and these births occurred between 2004 and 2017.
Despite purposive sampling, of mothers who had successfully BF, participants
identified core barriers to BF. These barriers were explored in depth before
enablers of BF could be identified and examined. The key barriers include lack of
breastfeeding knowledge, expectations, which differed from the lived experience,
the quality of the initial support for BF, lack of ongoing support for BF and initial
difficulties with the practice BF.
Once the core barriers to BF had been fully explored, it was possible to identify and
examine the enablers of successful BF. It became evident through the data analysis
that the mothers found alternative solutions to overcome these barriers. These
solutions were categorised into three key enablers, resilience in the face of
adversity, a positive breastfeeding culture and the economy of BF. These factors
facilitated the mothers to overcome the barriers they were faced with, which
enabled them to successfully breastfeed.
Conclusion: Intrinsic motivation amongst positive deviants appears to be a driver
of information and support seeking behaviour, which enhances self-efficacy and
breastfeeding resilience amongst young mothers.