A Qualitative Study Exploring Breastfeeding Mother’s Perceptions and Experiences of Appraisal Support Needs in Iran

Background & aim: The rate of exclusive breastfeeding has declined in the world and therefore protection, promotion, and support of breastfeeding are considered to be a public health priority. This study was conducted to explore breastfeeding mother’s perceptions and experiences of appraisal support needs. Methods: A qualitative study carried out between 2017 and 2019, in five health centers, four hospitals, and two physicians’ offices affiliated to Mashhad University of Medical Sciences, Mashhad, Iran. Thirty-three breastfeeding mothers, family members, and healthcare providers selected, purposively, for individual semi- structured in-depth interviews. Data were analyzed using directed content analysis adopting Elo and Kyngas approach. Results: Four categories and nine subcategories emerged in this study. The first category was 'affirmation from significant others' which contained two subcategories of ‘the need for approval from healthcare providers’ and ‘the need for affirmation from the husband and family members’. The second category was ‘the necessity of avoiding social comparisons due to unpleasant corollaries’, which had two subcategories: ‘unpleasant feelings caused by being compared to others’ and ‘being blamed when compared with others’. The third category was ‘offering constructive feedback’ with two subcategories of ‘providing positive feedback’ and ‘not giving negative feedback’. The fourth category was ‘persuasion’ which had three subcategories of ‘the need to encourage, ‘the need to be admired and ‘the need to be praised by significant others. Conclusion: Mothers need appraisal support to protect, promote and maintain established breastfeeding. Significant others have an important role in meeting the appraisal support needs of breastfeeding mothers.