Research Article| Volume 66, e61-e66, September 2022

Breastfeeding practices and coping strategies adopted by lactating nurses and midwives: A qualitative study


      • Nurses and midwives are experts , but some find it difficult to maintain exclusive breastfeeding.
      • Consumption of “rice-water” porridge and groundnut soup mayimprove breastmilk production.
      • Support from family and co-workers, may help lactating mothers manage breastfeeding stress .



      This study aimed to explore the breastfeeding practices and coping mechanisms of nurses and midwives to navigate the breastfeeding experience as health professionals.

      Design and methods

      A descriptive qualitative design was employed. Twenty-five registered nurses' and midwives' breastfeeding habits and coping methods were explored through five focus group discussions, each with five members. A purposive sampling approach was used to recruit participants. Only women who were currently breastfeeding an infant between the ages of 3 and 18 months were considered. For thematic content analysis, MAXQDA qualitative software was used.


      Breastfeeding practices and breastfeeding coping mechanisms emerged as the two main themes. Theme 1: Breastfeeding practices had four sub-themes: breastfeeding positions, breastfeeding duration, lactation nutrition, and expressed breast milk. Theme 2: breastfeeding coping strategies had four subthemes, support from family and co-workers, crying, praying, and communicating with infants.


      Due to work and other related pressures, our study indicates a disparity in exclusive breastfeeding practice among registered nurses and midwives. Working lactating health professionals can use some of the study's coping strategies and beneficial breastfeeding practices to enhance effective breastfeeding.

      Practice implications

      Breastfeeding in the ideal sitting posture, eating the right diet to increase milk flow, and freezing breast milk to feed the infant while at work are all strategies proposed to help practicing nurses, midwives, and other working women navigate breastfeeding.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


        • Ahishakiye J.
        • Bouwman L.
        • Brouwer I.D.
        • Vaandrager L.
        • Koelen M.
        Prenatal infant feeding intentions and actual feeding practices during the first six months postpartum in rural Rwanda: A qualitative, longitudinal cohort study.
        International Breastfeeding Journal. 2020; 15: 1-14
        • Awoke S.
        • Mulatu B.
        Determinants of exclusive breastfeeding practice among mothers in Sheka zone, Southwest Ethiopia: A cross-sectional study.
        Public Health in Practice. 2021; 2100108
        • Ayalew T.
        Exclusive breastfeeding practice and associated factors among first-time mothers in Bahir Dar city, North West Ethiopia, removed: A community based cross sectional study.
        Heliyon. 2020; 6e04732
        • Bäckström C.A.
        • Wahn E.I.H.
        • Ekström A.C.
        Two sides of breastfeeding support: Experiences of women and midwives.
        BMC International Breastfeeding Journal. 2010; : 1-8
        • Belotto M.J.
        Data analysis methods for qualitative research : Managing the challenges of coding , interrater reliability, and thematic analysis.
        The Qualitative Report. 2018; 23: 2622-2633
        • Berger P.K.
        • Lavner J.A.
        • Smith J.J.
        • Birch L.L.
        Differences in early risk factors for obesity between African American formula-fed infants and white breastfed controls.
        Pilot and Feasibility Studies. 2017; 3: 1-8
        • Bewket Zeleke L.
        • Welday Gebremichael M.
        • Mehretie Adinew Y.
        • Abebe Gelaw K.
        Appropriate weaning practice and associated factors among infants and young children in Northwest Ethiopia.
        Journal of Nutrition and Metabolism. 2017; 2017
        • Bonia K.
        • Twells L.
        • Halfyard B.
        • Ludlow V.
        • Newhook L.A.
        • Murphy-Goodridge J.
        A qualitative study exploring factors associated with mothers’ decisions to formula-feed their infants in Newfoundland and Labrador, Canada.
        BMC Public Health. 2013; 13
        • Cook E.J.
        • Powell F.
        • Ali N.
        • Penn-Jones C.
        • Ochieng B.
        • Randhawa G.
        Improving support for breastfeeding mothers: A qualitative study on the experiences of breastfeeding among mothers who reside in a deprived and culturally diverse community.
        International Journal for Equity in Health. 2021; 20: 1-14
        • Creswell J.W.
        Qualitative methods.
        Research Design: Qualitative, Quantitative and Mixed Methods Approaches. 4th ed. Sage Publications Ltd., Thousand Oaks, CA: Sage2014
        • Dachew B.A.
        • Bifftu B.B.
        Breastfeeding practice and associated factors among female nurses and midwives at North Gondar Zone, Northwest Ethiopia: A cross-sectional institution based study.
        International Breastfeeding Journal. 2014; 9: 1-7
        • Davies C.
        • Fisher M.
        Understanding research paradigms.
        Research in Brief. 2018; : 21-26
        • Ekström A.C.
        • Thorstensson S.
        Nurses and midwives professional support increases with improved attitudes - design and effects of a longitudinal randomized controlled process-oriented intervention.
        BMC Pregnancy and Childbirth. 2015; 15: 1-9
        • Hanson L.Å.
        Breastfeeding provides passive and likely long-lasting active immunity.
        Annals of Allergy, Asthma and Immunology. 1998; 81: 523-534
        • Inoue M.
        • Binns C.W.
        • Otsuka K.
        • Jimba M.
        • Matsubara M.
        Infant feeding practices and breastfeeding duration in Japan: A review.
        International Breastfeeding Journal. 2012; 7
        • Islam M.
        • Kabir R.
        Prevalence and associated factors of early cessation of exclusive breastfeeding practice in Noakhali , Bangladesh : A mixed-method study.
        Journal of Pediatric Nursing. 2021; 58: e44-e53
        • Katsinde S.M.
        • Srinivas S.C.
        Breast feeding and the sustainable development agenda.
        Indian Journal of Pharmacy Practice. 2016; 9: 144-146
        • Moran V.H.
        • Dykes F.
        • Burt S.
        • Shuck C.
        Breastfeeding support for adolescent mothers: Similarities and differences in the approach of midwives and qualified breastfeeding supporters.
        International Breastfeeding Journal. 2006; 1: 1-11
        • Mugambi M.N.
        • Musekiwa A.
        • Lombard M.
        • Young T.
        • Blaauw R.
        Probiotics, prebiotics infant formula use in preterm or low birth weight infants: A systematic review.
        Nutrition Journal. 2012; 11: 1-18
        • Ngo L.T.H.
        • Chou H.F.
        • Gau M.L.
        • Liu C.Y.
        Breastfeeding self-efficacy and related factors in postpartum Vietnamese women.
        Midwifery. 2019; 70: 84-91
        • Nick
        Microsoft Word - IJQM 8.3 Onwuegbuzie. 1–21.
        • Schmied V.
        • Gribble K.
        • Sheehan A.
        • Taylor C.
        • Dykes F.C.
        Ten steps or climbing a mountain: A study of Australian health professionals’ perceptions of implementing the baby friendly health initiative to protect, promote and support breastfeeding.
        BMC Health Services Research. 2011; 11: 1-10
        • Taye A.A.
        • Asegidew W.
        • Taderegew M.M.
        • Bizuwork Y.G.
        • Zegeye B.
        Formula feeding practice and associated factors among mothers with infants 0–6 months of age in Addis Ababa, Ethiopia: A community-based cross-sectional study.
        Italian Journal of Pediatrics. 2021; 47: 1-9
        • Thomas E.
        • Kuo C.
        • Cohen S.
        • Hoare J.
        • Koen N.
        • Barnett W.
        • Stein D.J.
        Mental health predictors of breastfeeding initiation and continuation among HIV infected and uninfected women in a south African birth cohort study.
        Preventive Medicine. 2017; 102: 100-111
        • Tobin G.A.
        • Begley C.M.
        Methodological rigour within a qualitative framework.
        Journal of Advanced Nursing. 2004; 4: 388-396
        • Wanjohi M.
        • Griffiths P.
        • Wekesah F.
        • Muriuki P.
        • Muhia N.
        • Musoke R.N.
        • Kimani-Murage E.W.
        Sociocultural factors influencing breastfeeding practices in two slums in Nairobi, Kenya.
        International Breastfeeding Journal. 2017; 12: 1-8
        • Wieczorek C.C.
        • Marent B.
        • Dorner T.E.
        • Dür W.
        The struggle for inter-professional teamwork and collaboration in maternity care : Austrian health professionals ’ perspectives on the implementation of the baby-friendly hospital initiative.
        BMC Health Services Research. 2016; 1–15