Making use of expertise: A qualitative analysis of the experience of breastfeeding support for first time mothers

There is now a body of research evaluating breastfeeding interventions and exploring mothers’ and health professionals’ views on effective and ineffective breastfeeding support. However, this literature leaves relatively unexplored a number of questions about how breastfeeding women experience and make sense of their relationships with those trained to provide breastfeeding support. The present study collected qualitative data from 22 breastfeeding first-time mothers in the UK on their experiences of, and orientation towards, relationships with maternity care professionals and other breastfeeding advisors. The data were obtained from interviews and audio-diaries at two time points during the first five weeks post-partum. We discuss a key theme within the data of ‘Making use of expertise’ and three subthemes which capture the way in which the women’s orientation towards those assumed to have breastfeeding expertise varied according to whether the women (i) adopted a position of consulting experts versus one of deferring to feeding authorities (ii) experienced difficulty interpreting their own and their baby’s bodies and (iii) experienced the expertise of health workers as empowering or disempowering. Although sometimes mothers felt empowered by aligning themselves with the scientific approach and ‘normalising gaze’ of healthcare professionals, at other times this gaze could be experienced as objectifying and diminishing. The merits and limitations of a person-centred approach to breastfeeding support are discussed in relation to using breastfeeding expertise in an empowering rather than disempowering way.