Six months exclusive breastfeeding : a relational behaviour influenced by actual and virtual social networks : a thesis presented in fulfilment of the requirements for the degree Doctor of philosophy in Midwifery, Massey University, Manawatu, New Zealand

Abstract

Despite widespread consensus regarding the health benefits of six months exclusive breastfeeding for mothers and infants, the prevalence of six months exclusive breastfeeding is very low in developed countries including New Zealand. This research contributes to the literature nationally and internationally through documenting influencing factors among New Zealand women and their family that relate to the practise of six months exclusive breastfeeding.

This research is a qualitative study involving face to face postpartum interviews with 30 mothers who prior to the birth of their infants were characterised as highly motivated to breastfeed exclusively for six months. The research participants were recruited from the lower North Island of New Zealand. Initial data were collected using a short questionnaire administered before the birth to record demographic information and to establish an antenatal intention to breastfeed exclusively. An initial postpartum face to face interview was conducted at around six weeks. Each participant was then followed via short monthly audio-recorded telephone interviews until giving up exclusive breastfeeding or until six months after the birth. Social construction is was used as the epistemological framework underpinning the research. A range of social theories, linked to the central theory of social constructionism, were used to highlight the importance of social relationships, social interactions and social support. The theory of “planned behaviour” proposed by Icek Ajzen (1991), the theory of stress, coping strategies and social support proposed by Thoits (1995), theories of “governmentality” and “biopower” developed by Michel Foucault (1972), arguments about the "strength of weak ties” proposed by Mark Granovetter (1973) and theories related to “landscapes of care” suggested by Milligan and Wiles (2010), were used in this thesis to illuminate the findings that resulted from the thematic analysis of the qualitative data. The research was reviewed and approved by the Massey University Human Ethics Committee.

The central finding of this research is that six months exclusive breastfeeding practice is not limited to the intentions or actions of the mother-infant dyad; it is socially constructed by actual and virtual social networks around the mother as well as the other relational influences such as historical, geographic, socioeconomic and social contexts of the mother’s life. Additional findings of this research related to the quality of breastfeeding support through social media such as Facebook, Skype and smartphone apps, makes a significant contribution to the New Zealand and international literature in this area.