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Table 4 What was challenging and helpful around breastfeeding in public

From: Helpful and challenging aspects of breastfeeding in public for women living in Australia, Ireland and Sweden: a cross-sectional study

Challenging

Helpful

Theme & Definition

Supporting quotes from women

Theme & Definition

 

Unwanted attention

Includes ‘fear of’ unwanted attention as well as ‘actual’ unwanted attention, blatant and overt staring, being judged, disapproving comments especially when breastfeeding an older infant / toddler

Worrying about judgemental looks from others and that someone will say something [Aus]

Fear of someone commenting and then getting upset [Aus]

Fear of someone saying something to you - never happened to me in over 5 years total feeding but we’ve all heard stories or seen inflammatory stories in magazines, online etc about mothers being verbally abused for feeding [Irish]

Fear of disapproval and being confronted - although I didn’t encounter it [Irish]

The risk of being confronted while having to show my breasts [Swe]

People do have a lot to say about breastfeeding and they do speak out giving comments. I don’t want that attention [Swe]

Supportive network

Having a supportive person with you such as a partner, family member or friend AND having access to online peer support around breastfeeding in public

My partner’s support and whoever else I may be with [Aus]

Reassurance – having a support person the first few times, if someone said something negative they could respond and I could focus on feeding and they can remind me it’s okay to be feeding [Aus]

Support from partner, friends, family, public health nurse [Irish]

Being part of an online community of breastfeeding mothers [Irish]

Company that supports you and reassures you [Swe]

Understanding people around you [Swe]

No comfortable place to sit

A comfortable chair is not available

Somewhere to sit [Aus]

Lack of appropriate seating [Aus]

A physically comfortable place to nurse [Irish]

Finding suitable seating especially when I don’t necessarily want to pay for the privilege, go to a café [Irish]

I needed an arm chair and support for my back [Swe]

None or very uncomfortable seating [Swe]

Quiet private suitable environment

Designated parents room that is clean, has water available, able to contain older children, can accommodate a pram / stroller, changing facilities, not smelly, suitable temperature, shaded if outside, noise level [quiet & non-distracting]

Having a quiet / private place to go [Aus]

More parks with fences for toddlers so you can breastfeed [Aus]

I look for a breastfeeding friendly sign on door [Irish]

Somewhere private or enclosed [Irish]

To be able to find a nice place not in other people’s sight [Swe]

A special public place set aside [Swe]

Environment not suitable

The environment could be perceived to be noisy, unclean, smelly, crowded, people were smoking, there was no privacy, the temperature inside or outside being too hot or cold and there was no room for a stroller / pram

Being outside in undesirable weather [Aus]

Noisy busy environment [Aus]

There were hardly any feeding rooms anywhere [Irish]

Facilities, some places have awful feeding rooms, they stink, overflowing nappy bins in them, or no rooms or chairs or anywhere where you can sit quickly and feed [Irish]

The weather, too cold [Swe]

Crowded, noisy and stressful environment [Swe]

Comfortable seating

Chair with a supportive back & armrests

Comfy chairs! [Aus]

Somewhere comfortable to sit [Aus]

Comfortable seating area [Irish]

Somewhere to sit down [Irish]

Comfortable chair [Swe]

A nice bench to be able to sit outside [Swe]

Awkward audience

This audience included men, teenagers, older generation who are perceived as disapproving, other mothers infant formula feeding in parents room, or religious setting such as a place of worship

Older generation looking uncomfortably at me [Aus]

Lots of men / strangers around [Aus}

Attitude of Irish public to breastfeeding (has improved but still some backward views) [Irish]

If there are male teenagers about, I would find it slightly more uncomfortable. Age demographic in general- would also be a little bit more wary in front of older people [Irish]

Older generation with a different opinion about breastfeeding [Swe]

Young men or teenagers [Swe]

Understanding and acceptance of others

Receiving smiles, encouragement & reassurance from general public; offers to help with pram, toddler or getting refreshments such as water

General acceptance within the community [Aus]

Strangers who would say ‘good on you’ when feeding in public [Aus]

Waiting staff being helpful e.g. topping up my tea, getting water etc [Irish]

Pleasant non-intrusive encouragement [Irish]

It would be helpful if others showed a more positive attitude to breastfeeding [Swe]

A warm accepting smile from others and NO comments [Swe]

Not wearing appropriate clothing

If the woman was not in appropriate clothing to allow breastfeeding discreetly or did not bring a suitable cover

Making sure I dress in a way that is easy to breastfeeding without exposing too much [Aus]

How accessible my breast is; what clothing I have worn [Aus]

Clothing and self-image. I wouldn’t care about BF would it would bother me if I didn’t have my stomach covered [Irish]

Exposing my tummy is a worry for me if I have the wrong clothes on [Irish]

To always have to think about appropriate clothing in advance to be able to breastfeed [Swe]

Wearing “the right” clothes without exposing too much [Swe]

Seeing other mothers breastfeed

Seeing other mothers breastfeed is supportive & helps to normalise breastfeeding

Seeing other mums breastfeeding with confidence [Aus]

Being surrounded by other mothers who also feed wherever they need to [Aus]

Normalisation of feeding - seeing others feeding [Irish]

Sisters and cousins normalised it for me, once I saw them I was more confident to go ahead in public too [Irish]

A mother friendly accepting culture, positive response and lots of mothers breastfeeding in public spaces [Swe]

Seeing other mothers breastfeeding gives confidence [Swe]

Potential for baby to be distracted

This applied particularly to older infant who more aware of surroundings and could come off and on the breast to look at the distraction

When baby started becoming more alert to surrounds and was more easily distracted in public [Aus]

Having an older child that is easily distracted and comes on and off frequently [Aus]

As baby gets older and they become nosey I’d want the place not to be too busy so as to limit [Irish]

My toddler being free to roam as I had the baby tethered to me, that was the only issue I ever had, chasing the toddler and then expose myself [Irish]

My baby is too curious, comes on and off too often [Swe]

My baby gets distracted and had difficulties attaching [Swe]

Wearing suitable clothing or having a cover

Having suitable clothing and/or a cover/wrap to facilitate being able to breastfeed discreetly if that is desired

Feeding clothes designed for feeding are essential for me [Aus]

Breastfeeding tops without clips make it easier to feed in public and to get my breast out [Aus]

Wearing two tops. So a vest could cover my belly and the other top could be pulled up so minimum skin is shown [Irish]

Breast feeding apron [Irish]

Comfy clothes to not show the nipples [Swe]

Nice clothes designed for breastfeeding. You want to be able to dress nicely as a mother! [Swe]

Struggling with feeding issues

Struggling with feeding issues such as using a nipple shield, positioning, attachment issues, or reflux

Putting nipple shield on, then latching baby [Aus]

I have a strong let down and it can go everywhere or I leak from the opposite side [Aus]

When baby is young and we are both getting to grips with BF-ing it can be difficult with latching baby on, leakage, sore nipples etc while trying not to expose myself [Irish]

I had fast let down so it would mean the baby would cough and spitter, so I would have to take him off the breast and milk would spray out! It put me off feeding in public for a little while until I was able to manage it better [Irish]

From the beginning when the milk was all over, very embarrassing [Swe]

Struggling with the nipple shield [Swe]

Preparation and confidence

Preparation and confidence referred to situation where the mother breastfed previously, or received timely support to gain skills and build confidence

Support from a lactation consultant to feed properly which helped with my overall confidence in feeding [Aus]

Midwife to suggest nipple shields to be able to breastfeed in the first place [Aus]

Having bit of practice at home in the first few days/weeks so baby latches easily enough and more confidence [Irish]

Booklet from maternity hospital or public health nurse on how to adapt your clothes for feeding what works and hacks no need for nursing cloths all of the time as regular cloths can be adapted and can be a lot more discreet at times too [Irish]

Myself being confident breastfeeding [Swe]

To do it with self-confidence even if it was a little complicated (outside my comfort zone)[Swe]

Managing a distressed baby

The mother has to manage a baby who is distressed due to hunger or impatience

How hungry my son is [Aus]

How fussy my baby is being [Aus]

If baby is crying [Irish]

Having an over hungry/crying baby drawing attention to it [Irish}

A fussy baby and all the mess [Swe]

Shame if the baby is crying and fussy [Swe]

Breastfeeding is overtly welcomed

Signage; welcome stickers displayed or breastfeeding / family friendly venues

Having a sign saying breastfeeding accepted [Aus]

Sign saying breastfeeding welcome [Aus]

Parent baby movie screenings, a great way to get out and about with a new baby and bf in public for first time without feeling “watched”. [Irish]

Sign saying breastfeeding welcome here, such a small thing but makes a big difference [Irish]

A sticker “You are welcome to breastfeed here”[Swe]

A sign sayingBreastfeeding welcome herethat you can point out if someone gives you negative comments [Swe]

Having to manage other children

Not having a safe environment to contain other children within the mother’s sight

Having something to contain and entertain my 2 year old while I’m tied down [Aus]

Making sure my 3 year old is safe and entertained while feeding his brother [Aus]

Managing a toddler at the same time [Irish]

Toddler running wild when outside the home and it was hard to manage if feeding [Irish]

To be able to handle siblings simultaneously [Swe]

Difficult when alone, taking care of more than one child [Swe]

Knowledge of mother’s and children’s rights

Knowing you have rights as a breastfeeding mother and are protected by law

Knowledge of my rights to breastfeed whenever, wherever my baby want to [Aus]

Knowledge of the law and breastfeeding! New mothers need to know their breastfeeding rights [Aus]

The law [Irish]

Educate staff that breastfeeding is completely legal anywhere [Irish]

Children’s rights to get food when they need [Swe]

Legal rights to breastfeed in public [Swe]