Maternal Health and Wellbeing

An exploration of infant feeding experiences of women in Lincolnshire in the early postnatal period

Project Duration

2011 – December 2012


NHS Lincolnshire

Project Staff

  • Rachael Spencer (PI) 1
  • Kathryn Hinsliff-Smith 1
  • Denis Walsh 1

Staff Institutions

  1. The University of Nottingham


  • To explore the experiences of Lincolnshire primip women who intend to breastfeed 
  • To gain an understanding of their infant feeding experiences six weeks post birth


To recruit 40 primip women from Lincolnshire who will receive their ante and postnatal care from Lincolnshire practitioners. Use of daily diaries and interviews with 10 women six weeks after birth.

Outcomes and Findings

Breastfeeding initiation and maintenance rates within Lincolnshire remain lower than the average for the East Midlands and England. Rates of initiation of breastfeeding at birth in 2010/2011 were 72% in Lincolnshire, compared to an initiation rate in England of 74%. The percentage of babies still being either partially or exclusively breastfed at 6 – 8 weeks dropped to 39% in Lincolnshire in comparison to 46% in England (NHS Lincolnshire, 2011).

The purpose of this qualitative research was to gain an understanding of primigravid women’s breastfeeding experience in the first 6 – 8 week postpartum period. Whilst valuable audit data is held on infant feeding methods in Lincolnshire this research focuses on offering insights into the experiences of new mothers in order to better understand their feeding experiences and decisions, with a view to understanding differences in rates.

Key Findings

  • Mothers experience a ‘roller coaster’ of emotions in relation to trying to establish breastfeeding
  • Mothers are unprepared for the realities of looking after a newborn baby and blame the incessant demands on breastfeeding
  • Mothers are aware that breast is best but when this is not as easy or as natural as anticipated, they feel guilty for stopping breastfeeding
  • Breastfeeding in Lincolnshire is less common than formula feeding so new mothers are very dependent on the advice and support from health care professionals
  • Mothers commented how support for breastfeeding from healthcare professionals appeared more about meeting targets
  • Mothers were particularly sensitive to negative comments regarding their efforts at establishing breastfeeding
  • Mothers identified difficulties with breastfeeding in public, including in front of family and friends
  • Postnatal breastfeeding support groups are not being accessed by new mothers in Lincolnshire

Key recommendations

  • Antenatal education should focus more on preparing women for the realities of breastfeeding their newborn, rather than an idealised version. This should include education on hand expression and its benefits.
  • Antenatal education should include a session with a mother who has recently breastfed.
  • Communication about breastfeeding needs to be realistic rather than idealistic, and include newborn behaviour, both in the antenatal period and throughout the early postnatal period.
  • Training should be provided for healthcare staff on how to communicate advice and support to new breastfeeding mothers in a way that empowers them.
  • Breastfeeding support in hospital postnatally should be proactive rather than reactive to requests for help. Predictable, scheduled, ongoing support, both on the postnatal ward and throughout the early postnatal period when discharged home is recommended.
  • After being discharged home, women who are breastfeeding should be contacted by a local peer support group representative and offered advice and support.
  • Consideration should be given to setting up specialist infant feeding teams in postnatal and paediatric wards, and the community.
  • A local campaign so that breastfeeding in public is less taboo is indicated.
  • Consideration of timings and venues of postnatal support groups to encourage attendance.

This project is now complete. Read the project report (PDF)

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Contact for further information

Rachael Spencer


HINSLIFF-SMITH, K, SPENCER, R and WALSH, D, 2013. Realities, difficulties, and outcomes for mothers choosing to breastfeed: Primigravid mothers experiences in the early post-partum period (6-8 weeks) Midwifery. 30(1), e14-e19

HINSLIFF-SMITH, K, SPENCER, R and WALSH, D, 2013. How breastfeeding can be an emotional rollercoaster: A qualitative study of primigravid women in Lincolnshire Maternal & Child Nutrition. 9(Special 2), 1 - 41




Maternal Health and Wellbeing Research Group

The University of Nottingham
School of Health Sciences
Queen's Medical Centre
Nottingham, NG7 2HA

telephone: +44 (0)115 823 0820