Maternal accounts of contributors to their infant feeding practices following hospital discharge to home

Background Many mothers deviate from their breastfeeding goals in the early postpartum period. Understanding maternal accounts of contributors to their feeding practices is essential to enhancing perinatal support and better enabling positive outcomes. Methods In this cross-sectional qualitative study in the southeastern United States, 40 individuals completed an online questionnaire and semi-structured interview by telephone two weeks after giving birth at an academic medical center. Interviews were audio-recorded and professionally transcribed and translated. Responses were inductively coded. Results Participants were primarily Hispanic (17/40, 44%) or non-Hispanic Black (12/40, 31%). Most gave birth vaginally (24/40, 60%) after at least 37+0 gestational weeks (38/40, 95%). When asked “How has feeding your baby been going?” participants’ responses spanned descriptions of their experiences, reports of feeding practices, lists of feeding problems, how the infants were doing, recall of goals, and contributors to infant feeding. Breastfeeding facilitators included maternal motivation, previous breastfeeding experience, maternal knowledge, partner and family support, prenatal and in-hospital education, lactation consultants, breast pump availability and instruction, and access to lactation-supportive food. Breastfeeding challenges included health complications, separation, low milk supply, latching difficulties, physical pain from feeding, stress, and mental toll. Discussion Infant feeding practices were influenced by multi-level factors over time. These findings highlight the intersection between individual, interpersonal, and systemic factors shaping postpartum feeding decisions. Maternal motivation, experience, and knowledge emerged as individual-level facilitators, suggesting that prenatal counseling aimed at building confidence and managing expectations may help mothers sustain breastfeeding after discharge. Partner and family support reinforced the importance of involving support networks in lactation education. Conversely, physical pain, low milk supply, health complications, and the emotional toll of feeding difficulties reflect barriers that can undermine feeding goals. Findings underscore the need for culturally responsive, multilingual postpartum support. Future research should explore longitudinal feeding trajectories and test interventions addressing influences.