Breastfeeding, motivation and culture: An exploration of maternal influences within midwife-led instruction in an Asian setting

Abstract

Background: Breastfeeding is a normal physiological behaviour influenced by layers of internal and external factors. Motivational and cultural influences play an important role in maternal decision making and behaviour, impacting both the initiation and duration of breastfeeding. Aim: The aim of this study was to identify and analyse cultural and motivational links within midwife-led instruction in an Asian setting. Method: Framed within a motivational instructional model and a cultural framework, an observational analysis of all routine breastfeeding instruction was completed (n=204). Systematic, theoretically based thematic and content analysis was completed. Breastfeeding motivational measurements were made, to gain a motivational profile of all breastfeeding mothers (n=183). Results: Cultural and motivational components embedded into routine instruction included congruent goal structures combined with maternally and culturally relevant breastfeeding instruction. Breastfeeding champions, a high organisational value and supportive policies and practices provided consistent maternal care. The motivational maternal profile suggested a higher than normal value for breastfeeding and midwife support. Conclusion: Maternal motivation lies at the heart of women’s decisions and experiences. Motivationally consistent and culturally relevant instruction is critical to the initiation and sustainment of breastfeeding. Identifying the underpinning positive and negative cultural values and influences will empower midwives to facilitate optimal breastfeeding achievement in mothers.