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Past research suggests that whether pregnancies are wanted, unwanted, or mistimed may influence breastfeeding behavior. The purpose of this chapter is to develop a more precise understanding of this relationship. Specifically, this chapter asks three questions: first, do pregnancy intentions matter most in sustaining breastfeeding for long or for short durations postpartum; second, at what time postpartum are rates of breastfeeding discontinuation most differentiated by pregnancy intentions; and third, how does poverty (measured here by Medicaid receipt) moderate the relationship between pregnancy intentions and breastfeeding duration.

Logistic regression analysis of survey data from a national sample representative of US mothers is used to determine the relationship of pregnancy intentions to whether breastfeeding continues for various durations and through various intervals after birth. Interaction terms between pregnancy intentions and mother’s Medicaid status are used to test for relationships specific to poor or nonpoor mothers between pregnancy intentions and breastfeeding duration.

Results show that pregnancy timing matters most for sustaining breastfeeding for durations past 6 months and that differences in rates of breastfeeding discontinuation between mothers with wanted, unwanted, and mistimed pregnancies are most pronounced in the 3–7 months postpartum period. In addition, findings show that Medicaid recipients (but not nonrecipients) are less likely to exclusively breastfeed for 6 months when their pregnancies are mistimed.

The literature on fundamental causes of health disparities typically suggests that poverty impairs access to resources necessary for effective planning to achieve desirable health outcomes. This study’s results, however, show that planning of pregnancies is more critical for poor mothers to sustain exclusive breastfeeding. Further research is needed to explain this relationship. The results also suggest that policy interventions to help mothers with unplanned pregnancies to sustain breastfeeding should target the period from 3 to 7 months postpartum.

These findings can help shape policies for facilitating the continuation of breastfeeding for durations recommended by health authorities and advance our understanding of the effects of poverty on health behaviors.

Since the 1990s, public health agencies as well as nutrition and child health experts have recognized breastfeeding as the most appropriate infant-feeding mode for optimal health and psycho-emotional development. Consequently, breastfeeding has become a standard of good mothering, internalized by mothers, who implement a demanding self-discipline to perform breastfeeding. This dedication reflects the delegation of biopolitics to individuals in modern neoliberal societies: authoritative experts inform new parents, who then bear the responsibility of their children's health risk management. They are expected to choose appropriate practices as part of a collective strategy of risk management and anticipation of the future by changing current behaviours, aiming at the emergence of a ‘healthy body and mind’ society. Among these practices, breastfeeding holds a central place due to medical consensus about its benefits. In my ethnography of postpartum consultations by independent midwives in Switzerland, I studied the breastfeeding practices and experiences of home birth parents as part of the ‘holistic care’ provided by these midwives. Shadowing midwives during their postpartum visits between 2014 and 2017, I witnessed parents committing to the body and emotional work required to carry out their ‘breastfeeding project’, designed in continuity with their out-of-hospital birth choice. During their follow-ups, midwives engage with parents in a shared construction of meanings around breastfeeding, anchoring parenting identities in the body. I explore in this chapter the issues raised by the production of lactating maternal bodies and how women engage in body and emotional work to achieve it.

This paper draws the connection between constructivist methods and critical theory and offers examples of the wide reach and analytical power of critical theorizing.

I lay out the potential for the scope of critical theory, and then I illuminate that scope by analyzing two vastly different subjects – the global indigenous rights movement and breastfeeding policies in the United States – through a constructivist lens.

How political identities and practices are constructed has important implications for the work they do in shaping our conceptions of legitimacy.

This paper brings critical theory to bear on the politics and policies of breastfeeding in the United States, unmasking the work that breastfeeding does in producing and reproducing identities, status, race, class, and competitive labor.

The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of a child's life. However, while the national coverage was 61.33%, the coverage in Sukoharjo was 39.33%. Effective intervention is needed to promote the importance of exclusive breastfeeding, and this requires knowledge of the barriers and support structures in place. This study analyzed the supports and barriers of exclusive breastfeeding in Sukoharjo, Central Java, Indonesia.

This qualitative study used in-depth interviews conducted from December 2017 to March 2018. The population consisted of 33 informants (29 mothers with babies over six months of age, a pregnant mother, two midwives working in the community health center and a staff member in the district health department).

There were barriers to and support for exclusive breastfeeding in Sukoharjo, Central Java province, Indonesia. The district already has support systems in place, while the barriers emerge from society, the baby's condition, environmental and other sources. The government has tried to overcome the barriers.

The limitation of this study was that the triangulation method was not utilized. However, the use of various informants strengthened the findings.

The district government, especially the health department, needs to establish a program to evaluate existing exclusive breastfeeding support programs thoroughly. Smarter and more comprehensive interventions may be needed, for example, by integrating various supports into one activity. For researchers, the findings of this study imply that they can conduct experimental community research using the framework of the two aforementioned theories of behavior change. For example, investigation of combining the support of trained peers with the presence of family members such as the grandmothers of the babies. If both types of support are conducted concurrently, it may strengthen support and reduce barriers from either inside or outside the home.

The district government, especially the health department, needs to establish a program to evaluate existing exclusive breastfeeding support programs thoroughly. Smarter and more comprehensive interventions may be needed, for example, by integrating various supports into one activity. For researchers, the findings of this study imply that they can conduct experimental community research using the framework of the two aforementioned theories of behavior change. For example, investigation of combining the support of trained peers with the presence of family members such as the grandmothers of the babies. If both types of support are conducted concurrently, it may strengthen support and reduce barriers from either inside or outside the home.

There are barriers to exclusive breastfeeding in Sukoharjo, but the government has made effective attempts to overcome them. The support systems in place were in line with the theory of planned behavior (TPB) and social cognitive theory (SCT).

This qualitative study was to understand the factors affecting successful adoptive breastfeeding among women who underwent induced lactation process.

This study conducted in-depth interviews among induced lactation women in five states based on five regions [South (Johor), Central (Selangor), North (Penang), East (Kelantan) and East Malaysia (Sabah)]. The interviews have been consented, audio-recorded then transcribed verbatim, followed by identification of emerging themes.

Data saturation was achieved after interviewing a total of 23 induced lactation women. There were six main themes that emerged to describe factors affecting successful induced lactation process: (1) support and encouragement, (2) diet supplementation, (3) breastfeeding devices support, (4) incorporating treatment plan in the daily schedule, (5) high determination and pleasant attitude and (6) being informed on induced lactation process.

There can be recall bias among the respondents since the information was collected retrospectively, one to two years after the induced lactation practice completed. Due to that, we cannot rule out recall bias in the responses given in the interviews. In this study, induced lactation women barely were ethnic Malay Muslims. Thus, comparisons to other ethnic groups were not possible. This was due to the difficulty to get participation from induced lactation mother of other ethnic groups in the study. Even though the success is demonstrated, a significant limitation is that the ratio between Muslims and non-Muslims cannot be performed for the reason that the respondents only consists of Muslims alone.

The benefits of breastfeeding by an adoptive woman are numerous for both the mother and baby. There are multifactors involved in successful induced lactation process. After experiencing induced lactation, all respondents agreed that it has prepared them to be real mothers and breastfeeding is a pleasurable experience. All respondents corresponded to breastfeeding have a positive influence in the aspect of affection and touch. A mother who feels confident in her ability to lactate and is reassured by those around her will be most likely to feel successful in this great attempt.

Ireland has one of the lowest rates of breastfeeding in Europe with exclusive breastfeeding rates of 44 per cent at discharge from hospital. Increased awareness and debate on breastfeeding and its issues is needed. The purpose of this paper is to describe an evaluation of the piloting of a forum theatre production in increasing awareness of breastfeeding.

A mixed methods approach was taken. Research participants were identified through the four organisations in which the play was performed. Approximately 160 people watched a performance of the play. Quantitative data were collected from 110 audience members who completed a postcard survey. Qualitative data were collected from 42 people prior to seeing the play and 47 people after seeing the play, through focus groups and individual interviews.

Over 90 per cent of participants thought the play was a good way of discussing breastfeeding and they thought it was more effective than usual health promotion of giving out leaflets. Qualitative interviews found that the play heightened people's awareness of breastfeeding, highlighted the importance of support and engaged people in discussion and debate around breastfeeding.

The concept of promoting breastfeeding through drama is quite novel and this evaluation shows a potential for using such techniques in health promotion on varied nutrition‐related topics.

This purpose of this paper is to report on a study of the possible role of social marketing in encouraging breastfeeding amongst teenage mothers. UK teenage mothers are particularly prone to low levels of breastfeeding and there has been a lack of response to traditional health education approaches. The purpose of this paper is to report on an in‐depth, qualitative exploration into the use of social marketing to address this problem.

Qualitative interviews were conducted in 2009 with 58 pregnant teenagers, young mothers and their influencers to explore feeding decisions and examine social marketing options. The Theory of Planned Behaviour (TPB) emerged as the most appropriate framework to explain the major influences on breastfeeding. This was used to structure a solution that highlighted three strategic priorities for social marketing based on the TPB's three components: changing attitudes, altering social norms and increasing confidence.

Health benefits of breastfeeding were not disputed, but neither were they found to be a strong motivator for this age group. Personal benefits oriented to the mother were explored, some of which seem more promising in maintaining breastfeeding and the quality of ante‐ and postnatal service was critical. Finally, the “public” image of breastfeeding was often a negative, with the perceived lack of social acceptance of breastfeeding in public places acting as a barrier to continued practice.

This paper offers insights into the experiences of this group of young mothers and the findings were shared with the health trust funding the research, to help in a clinical pathway redesign. A separate social marketing‐based solution to counter this is proposed, with the long‐term aim to make breastfeeding the default societal norm.

This paper aims to investigate breastfeeding and complementary feeding practices among children less than five years old and living in a rice surplus area in Demak Regency, Central Java.

From December 2014 to February 2015, a cross-sectional survey was carried out in Demak, which had a high proportion of undernourished children despite high rice production. In total, 384 mothers having children below five years old from farmer family background were interviewed using a structured questionnaire about sociodemographic parameters and child feeding practices. Food habits were also investigated among these women during two focus group discussions in two selected sub-districts.

Only 10.9 per cent of the children were exclusively breastfed for six months. About 60 per cent of the mothers practiced supplementary feeding in addition to breastfeeding and started complementary feeding too early. Duration of exclusive breastfeeding practice and child’s age at onset of complementary feeding were positively correlated (p = 0.04). The main reasons of supplementary feeding and too early introduction of complementary food were based on the elderly women’s opinions, and the very short duration of maternity leave for employed mothers. Mothers with a low education level had a higher chance of not reaching the optimum score of complementary feeding practices (p = 0.012).

Despite a high level of food security in the project area, inadequate knowledge of young child feeding practices has contributed to sub-optimal breastfeeding practices. Higher educated women were more likely to follow optimal complementary feeding practices. Therefore, promotion of breastfeeding and complementary feeding practices targeting all key actors should be implemented in the study area to prevent undernutrition among infants.

The purpose of this paper is, as the health benefits of breastfeeding for mother and child have already been fully ascertained, to highlight the differences on why short- and long-term breastfeeding mothers adopt their respective behaviours. Based on these findings, a model for long-term breastfeeding is put forward here. The aim is to identify the specific variables and processes that create confidence during the early days in breastfeeding mothers so that social marketing campaigns can be deployed more effectively to sustain this behaviour over time.

The validity and reliability of the scales used were tested using Cronbach’s alpha and exploratory and confirmatory factor analyses. Differences in cognition, attitudes and behaviour with respect to breastfeeding between the short- and long-term breastfeeding mothers were analysed with ANOVA and multi-group structural equation modelling. An independent self-administered questionnaire was given to 311 breastfeeding mothers in 2008. The surveys were carried out at the Maternity Hospital together with five other medical centres on the island of Gran Canaria (5 per cent error and 95 per cent reliability). This can be considered to be a fair representation of trends in breastfeeding in Spain, as most births take place in similar state hospitals.

As expected, short- and long-term breastfeeding mothers differed over the key variables. While attitudes toward, and knowledge of, breastfeeding produce the adoption of breastfeeding, long-term commitment seems to relate more to general knowledge on health and other intangibles.

In light of these results, specific marketing efforts should be designed to achieve the continuation of breastfeeding. Interventions that focus on attitudes toward, and knowledge of, breastfeeding may prove ineffective.

As many worldwide research projects suggest, the extremely large percentage of mothers who discontinue breastfeeding before the infant reaches six months of age represent a greater challenge than the relatively low percentage of mothers who choose not to breastfeed from the beginning. This paper focuses on long-term commitment and outlines a possible model to promote the same.

There is a dominance of cognitive models used by marketers when studying social phenomena, which denies the complexity of the behavior under investigation. Complex social behaviors are typically emotionally charged and require a different perspective. The purpose of this research is to challenge the planned behavior approach and reframe marketers’ perspectives on how to study complex social phenomenon such as breastfeeding.

An online survey of 1,275 American and Australian women was undertaken to test the Model of Goal Behavior in a breastfeeding context. Structural equation modeling and multi-group analysis of novice (first-time mothers) and experienced mothers is used to test the hypotheses.

The findings demonstrate emotion and experience matter when understanding a complex social behavior such as breastfeeding. The emotional variables in the model had significant relationships, while the cognitive variables of instrumental and affective attitude did not. As women progress through their customer journey (from novice to experienced), the behavioral drivers change.

This research demonstrates an emotion, and experience-focused approach should guide the design of social marketing interventions aimed at changing complex social behaviors.

This research presents empirical evidence to challenge the pervasive use of planned behavior models and theories in marketing. Importantly, in social behavior models, emotion rather than attitudes have a larger role in determining intentions and behaviors.