Table 4.
Themes and Supporting Quotes About the Understanding of Breastfeeding Among Pregnant Women at the Third Trimester and Postpartum Mothers
| |
Selected quotes |
|
|---|---|---|
| Themes | Pregnant women (focused group discussion) | Postpartum mothers (in-depth interview) |
| Awareness of some components of breastfeeding guidelines | ||
| 1. Know the general health benefit of breastfeeding | “[Breastfeeding is] good for baby's, especially the foremilk very good for baby's immune system. In addition, breastfeeding could improve the mother–baby relationship” (28 years old, 34th gestational week, teacher) | “Breastfeeding is the best. It is safe. You know the ‘melamine infant formula contamination incidentsa in 2008,’ I worry about the quality of formula” (28 years old, 6 months postpartum, mixed breastfeeding, company employee) |
| 2. Know the recommended duration for exclusive breastfeeding | “In the prenatal education, I knew exclusive breastfeeding should last for 6 months” (30 years old, 37th gestational week, dentist) | |
| Misunderstanding of breastfeeding | ||
| 3. Don't actually know the difference between breastmilk and formula; regard mixed feeding as the ideal way to ensure nutrition and convenience of weaning | “If baby is fed by a mixed way, the nutrition would be better. I know foremilk would help baby's immune system, but how about other nutrients? Formula has many nutritional elements…Furthermore, it would be easy for weaning…” (34 years old, 35th week gestational, teacher /dancer) | “Although I know breastfeeding is good, but what's the difference between breastmilk and infant formula? Formula includes many nutrients. Does breastmilk have enough [nutrients] too? I don't know” (34 years old, 2 months postpartum, mixed feeding, company employee) |
| 4. Unawareness of the recommended duration for breastfeeding and traditional idea about discontinuing breastfeeding | “Usually breastfeeding would last for 9–10 months, at most 1 year” (31 years, 36th week, teacher) | “I know from my doctor that breastfeeding should last for 10–12 months” (30 years old, 7 months postpartum, mixed breastfeeding, physician) |
| “After menstruation resumed, breastmilk would have no any nutrition value, just like water” (34 years old, 35th gestational week, teacher/dancer) | “Many people told me that after the menstruation resumed, breastmilk would have no any nutritional value” (31 years old, 4 months postpartum, exclusively breastfeeding, company employee) | |
| Feedback on breastfeeding service through perinatal care | ||
| 5. Don't have time to join in the prenatal education | “[I did not join in the prenatal education] since I have to work” (28 years old, 34th gestational week, company employee) | “There were prenatal classes in hospitals, but I just didn't have time to attend…I needed to work” (28 years old, 2 months postpartum, exclusively breastfeeding, physician) |
| 6. Don't have enough communication with MCH care providers | During prenatal care: “It was very fast for each antenatal check-up, less than 10 minutes. But I had to wait for [the doctor] more than 3 hours” (27 years old, 36th gestational week, company employee) | During childbirth in hospitals: “No specific guidance on breastfeeding when I lived in hospital after childbirth. They (health staff) just told us not to bring bottle milk to the hospital. Every day, nurses asked me whether I had breastmilk. If I had not, she then gave us a cup with a fixed quantity of formula to feed the baby every 4 hours. They didn't require me to breastfeed my baby and didn't teach me how to breastfeed the baby” (35 years old, 2 months postpartum, formula feeding, company employee) |
| “There are always a lot of patients. Doctors must be bored since every woman has a lot of questions” (28 years old, 34th gestational week, company employee) | During child health care: “At the kid health check-up, doctors just asked me whether my baby was having breastmilk or formula. They didn't say any others” (30 years old, 8 months postpartum, mixed feeding, unemployed) | |
| 7. Get the knowledge and information of breastfeeding mainly from Internet, books, friends, and families | “Some prenatal education will have charge. Internet is very convenient to get all information. No need to take the class” (29 years old, 35th gestational week, company employee) | “Usually I know [breastfeeding] from the Internet and one book. I was encouraged and decided to breastfeed by one book” (27 years old, 1 months postpartum, mixed feeding, company employee) |
| 8. Need support to deal with the difficult during breastfeeding | “No any health staff member told me how to deal with the insufficient breastmilk production. How can I produce enough breastmilk?” (34 years old, 2 months postpartum, mixed feeding, company manager) | |
| “The baby had a disease 1 month ago and he stopped breastfeeding himself” (29 years old, 8 months postpartum, having ceased breastfeeding, accountant) | ||
a
Infant formula contamination incidents. A food safety incident in China revealed in September 2008 that powdered formula, fresh milk, and other products in China were found to be adulterated with melamine, a synthetic nitrogenous product, to confound a test for determining crude protein content.
MCH, maternal and child health.