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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 United Kingdom 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 5 weeks post-partum. We discuss a key theme within the data of 'Making use of expertise' and three subthemes that capture the way in which the women's orientation towards those assumed to have breastfeeding expertise varied according to whether the women (1) adopted a position of consulting experts vs. one of deferring to feeding authorities; (2) experienced difficulty interpreting their own and their baby's bodies; and (3) 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 health care 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.

Aim. To report a descriptive study of early infant feeding experiences focusing on accounts of women who expressed milk extensively in the first few weeks postpartum.\ud \ud Background. Relatively little is known about the reasons for expressing milk following healthy term births. Evidence indicates it is an increasingly common practice during early infant feeding in Westernized countries. A more comprehensive understanding of this practice will help midwives and nurses assist mothers negotiate early feeding challenges.\ud \ud Design. Qualitative data were collected in two phases in the first few weeks postpartum.\ud \ud Method. Audio-diary and semi-structured interview data from seven British women who extensively expressed milk in the first month postpartum were analysed. These data were drawn from a larger qualitative longitudinal study which took place in 2006–2007. Themes, discursive constructions and discourses are identified through the use of a feminist informed analysis.\ud \ud Findings. The practice of expressing was employed as a solution to managing the competing demands and dilemmas of early breastfeeding and ensuring the continued provision of breast milk, thereby deflecting potential accusations of poor mothering. In addition, the practice may afford a degree of freedom to new mothers.\ud \ud Conclusions. The need to maintain the ‘good maternal body’ can account for the motivation to express milk, although there may be reasons to be cautious about promoting expression as a solution to breastfeeding difficulties. Education for health professionals, which emphasizes the complexities and contradictions of mothering and which challenges prescriptive notions of ‘good mothering’ could better support new mothers in their feeding ‘choices’.

Although there is now a considerable body of literature which seeks to understand breastfeeding by exploring the perspectives of breastfeeding mothers, knowledge of how breastfeeding difficulties are managed in the very early post-partum period, and the impact of these difficulties on mothers, is still limited. In this paper we use a social constructionist version of interpretative phenomenological analysis to explore the experiences of eight first-time mothers who struggled with breastfeeding in the first post-partum week. Data were collected through semi-structured interviews and audio-diaries. The over-arching theme identified was of a tension between the participants’ lived, embodied experience of struggling to breastfeed and the cultural construction of breastfeeding as ‘natural’ and hence relatively trouble-free.

Understanding the establishment of breastfeeding by focussing on the mother-child dyad offers only a limited perspective. Instead, breastfeeding can be understood as becoming established or breaking down within broader networks of relationships (e.g. Dykes, 2006; Tiedje et al., 2002). Quantitative research has suggested that support from various others (lay and professional) can be an important factor in sustaining breastfeeding (Sikorski et al., 2003). However, those around the mother may orientate to breastfeeding in various ways. For example, fathers play a key role in decisions about infant feeding and in supporting breastfeeding, and yet need to define and adjust to their new parenting role and changed relationship with their partner in a way that accommodates breastfeeding (Bar-Yam & Darby, 1997). From the perspective of the mother, breastfeeding can be an important aspect of the transition to motherhood. However, becoming a mother is not an individual project but one that involves redefining roles and relationships with others (Mercer, 2004; Nelson, 2003), and negotiating mothering practices such as breastfeeding in the context of others’ expectations and cultural prescriptions for motherhood (McBride-Henry, 2010). \ud The present research aims to extend understanding of how breastfeeding mothers experience their relations with others and how these are implicated in their experiences of breastfeeding and their developing relationship with their infant. The data discussed here have been taken from a longitudinal qualitative study of 22 new mothers in the UK who expressed an intention to breastfeed and were interviewed during the first week following birth and one month later. At each time point they were also asked to keep an audio-diary of their experiences of feeding their baby for one week. \ud The analysis discussed here draws on symbolic interactionism and other theoretical perspectives which emphasise the relational nature of the self and assume that relations with others are part of, rather than external to, lived experience and mediate more distal cultural influences. The themes explored include the women’s sense of duty to balance what they saw as the needs of their baby, their own needs and the needs, demands and sensibilities of others, and the ways in which they negotiated these. We also discuss the way in which, as the participants were developing their new identities as breastfeeding mothers, others with expertise in breastfeeding or perceived to have knowledge regarding related norms and expectations took on a particular significance in the women’s lives. As such, these "experts" were experienced by the participants as in a powerful position to provide either validation or invalidation of them as breastfeeding mothers. We discuss (i) the implications of our analysis for facilitating supportive interactions between health professionals and breastfeeding mothers and their immediate networks and (ii) the implications for breastfeeding promotion of viewing ongoing engagement with the practices of infant feeding as mutually negotiated and enabled, rather than as the choice of individual women.

Although diary methods have a long tradition of use within psychology and appear to have considerable\ud potential in researching health-related processes and experiences, the use of unstructured diary methods to\ud generate detailed phenomenological accounts within contemporary health psychology has thus far been\ud limited. In this poster presentation, we describe a recently completed British study in which a sample of\ud first-time mothers used voice-recording technology to make daily diary entries about their infant feeding\ud experiences. We present a consideration of the benefits and challenges of this approach to data collection.\ud In particular, we focus on ethical and epistemological issues, drawing on the accounts of both participants\ud and members of the research team. We also explore the most suitable ways of analysing data derived from\ud diaries and consider the practical advantages and limitations of using audio-diaries. Finally, some of the\ud implications for developing the use of audio-diaries in health psychologists' research and practice are\ud considered.

The feminist literature on pumping and expressing breast milk has highlighted contradictory theorisation of these practices. On the one hand they have been argued to represent a form of ‘control’ placed upon breastfeeding in that they offer a way of managing future expectations about returning to ‘normal’ activities. Additionally, the use of breast pumps has been theorised as contributing to the commercialisation, medicalisation and mechanisation of breastfeeding. On the other hand, it has been noted that these practices have the potential to be empowering, in that they allow for greater paternal involvement in infant feeding and increased freedom for women. In this paper we report on an analysis of first-time mothers’ reasons for pumping and expressing breast milk drawn from a recent British qualitative study. Our analysis suggests that these practices were employed for a myriad of complex, multi-layered reasons which can be seen as potentially both empowering and disempowering. For instance, they were used as a way of managing breastfeeding difficulties and the perceived inefficiencies of the maternal body thus ensuring the continued provision of adequate breast milk. They were also constructed as practices which could be used to manage the realities of modern motherhood including facilitating shared parenting, feeding in public and managing returning to work. We illustrate this complexity by\ud drawing on detailed case studies of women who used these practices extensively. Implications for public health theory and practice which have the potential to support women in their infant feeding choices are discussed.