Date of Award

1-1-2000

Document Type

Thesis

Publisher

Edith Cowan University

Degree Name

Doctor of Philosophy

Faculty

Faculty of Communications, Health and Science

First Supervisor

Dr Vera Irurita,

Second Supervisor

Dr Lynne Hunt

Third Supervisor

Shirley Perry

Abstract

Breastfeeding involves phases of initiation, continuation, and weaning. Research to date has focused upon its initiation and continuation rather than the later phases, when the child is weaned from the breast. Selective aspects relating to weaning have been explored to determine infant feeding practices such as the timing of food introduction. However, that research has focused upon developing countries where the impact of infant feeding patterns and weaning practices have a significant impact on infant growth and child health. The weaning process or final phase of breastfeeding from the mothers' perspective has not been examined within the western world. In order to fully understand this important maternal task, all phases of the experience must be explored. The management of weaning is affected by cultural, social, developmental, and psychological factors and is reflected in distinct infant feeding practices across cultures. The purpose of this grounded theory study was to analyse the maternal process of managing the later stages of established breastfeeding and, ultimately, weaning the child from the breast within a Western Australian context. A minimum time of six weeks postpartum was regarded as established breastfeeding whereas weaning was defined as the process that begins when the mother and/or the child decide to stop breastfeeding. Using the constant comparative method, analysis of thirty-three participants' interview transcripts, field notes, nine postal questionnaires from fathers, and individual and discussion group interviews with child health nurses revealed a common social problem of incompatible expectations. All participants faced a dilemma in the management of their experience when personal expectations were found to be in opposition to others' expectations. Although the focus of this study was on weaning, a key finding was that participants' expectations on weaning could not be easily separated from their expectations regarding breastfeeding and mothering. Expectations in the areas of breastfeeding and weaning were interrelated as achievements or disappointments reflected upon mothering expectations. When faced with incompatible expectations from their child, partner, family, friends, health professionals, and society, these Western Australian mothers expressed feelings of confusion, self-doubt, and guilt. A process of constructing compatibility by adapting focus was adopted to compensate for this incompatibility and comprised three phases. Prior to engaging in this process, participants arrived at a turning point where individual tolerance levels of confusion, guilt, and self-doubt were reached. The first phase entitled shifting focus involved participants clarifying the relative importance they assigned to aspects of their breastfeeding. This clarification enabled them to take charge of their experience and reinforce personal expectations and goals. In the second phase, selective focusing, participants selectively chose to focus upon specific compatible sources to accentuate their influence and thereby diminish the impact of incompatible sources. When confronted with ongoing incompatible expectations throughout their experience, participants moved back to shifting focus to re-clarify personal expectations and reinforce subsequent decisions. During the final phase of confirming focus, mothers reflected upon their experiences and resolved decisions by verifying that their adapted focus achieved the desired compatibility. This substantive theory of the management of breastfeeding and weaning from the perspective of Western Australian mothers is discussed in relation to existing nursing and social science theories. Additionally, implications and recommendations based upon these findings are presented.

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