TABLE 2.

Breastfeeding Concern Main Categories and Subcategories

Main Categorya	Subcategories
1. Infant feeding difficulty	Problems with latch
Encompasses reported difficulties with how the infant is feeding at the breast	Infant sleepy or going too long between breastfeeds
	Infant refuses to breastfeed/nipple confusion
	Infant fussy or frustrated at the breast
	Problems with the frequency or length of infant’s breastfeeds
	Infant not feeding well
	Other difficulty feeding at the breast
2. Milk quantity	Inadequate maternal production or milk supply
Includes concerns that the mother is not producing or the infant is not getting sufficient breast milk	Infant not getting enough milk or unsure if getting enough milk
	Infant shows signs of hunger
	Milk not in
3. Uncertainty with own breastfeeding ability	Breastfeeding technique, positioning, or getting used to breastfeeding
Responses in which the mother questions her own breastfeeding skills or perseverance	Not sure how long breastfeeding duration or frequency should be
	Breast anatomy adequacy
	Milk quality or nutritional adequacy of exclusive breast milk diet
	Breastfeeding too difficult or time-consuming
	Wanting someone else to feed the infant
	Tired or exhausted
	Uncomfortable with the act or connotations of breastfeeding
	Not meeting breastfeeding goals
	Other uncertainty with breastfeeding ability
4. Pain while breastfeeding	Painful nipples
Includes nipple pain or any other pain associated with breastfeeding	General or unspecified breastfeeding pain
	Sore breasts, engorgement, or breast pain
	Cesarean delivery or other pain not related to breasts or nipples
	Mastitis
	Thrush or yeast infection
	Biting
5. Signs of inadequate intake	Weight loss
Includes references to medical signs in the infant of inadequate milk intake	Jaundice
	Urine and stool output or signs of dehydration
	Hypoglycemia
6. Mother/infant separation	Work or school
	Other separation
7. Maternal health/medication	Medications affecting infant through breast milk
References to medications or health conditions (whether true contraindications or not) interfering with breastfeeding	Medication and effect on milk supply
	Maternal health problem related to breastfeeding
8. Too much milk	General too much milk
Includes references to strong milk ejection reflex or leaking	Strong let-down
	Leaking
9. Other	Formula-feeding
Refers to feeding problems or concerns not directly related to feeding at the breast	Digestive issues, spitting up
	Burping
	Infant medical concern (other than sign of inadequate intake)
	Pacifier
	Pumping or expressing breast milk
	Breastfeeding aids or alternate feeding methods
	Overfeeding
	Other infant behavior (nonspecific to feeding)

^aOverall, 4179 distinct feeding problems or concerns were reported over 2946 combined interviews (prenatal and days 0, 3, 7, 14, 30, and 60 postpartum). At each interview, women were asked to describe any problems or concerns they had (currently or since the previous interview) about feeding their infant; postpartum interviews were only conducted with women who had breastfed or expressed their breast milk since the previous interview.