Normalizing Breastfeeding: An Exploratory-Descriptive Qualitative Study to Identify Maltese Mothers’ Perspectives to Improve Breastfeeding Outcomes

Abstract

Background:

Breastfeeding offers well-documented short- and long-term benefits for both infants and mothers, yet Malta lags behind national targets. Only 46.3% of Maltese infants are exclusively breastfed at hospital discharge, and fewer than 10% continue exclusive breastfeeding for 6 months. Determinants of breastfeeding in Malta are not well understood.

Research Aim:

This study aimed to explore the perspectives of Maltese mothers during the early postpartum period to identify factors influencing the initiation, continuation, and cessation of breastfeeding.

Method:

An exploratory-descriptive qualitative design was employed. Thirteen recently postpartum mothers attending the Breastfeeding Clinic at Mater Dei Hospital were recruited through purposive sampling. Semi-structured interviews, conducted face-to-face or online, explored reasons for continuation or discontinuation of breastfeeding; experiences of breastfeeding; and perceptions around improvements needed to support breastfeeding in Malta. Audio/video files were transcribed and analyzed thematically.

Results:

Three overarching themes emerged: (1) internal factors, including maternal determination, perceived benefits, doubts in self-efficacy, and pain; (2) external influences, including family, partners, public perceptions, and healthcare professional advice; and (3) demand for appropriate support, including workplace accommodations, tailored education, and community resources. Maternal determination and supportive healthcare guidance facilitated breastfeeding, whereas inconsistent advice, social pressures, and insufficient workplace policies hindered it.

Conclusion:

Breastfeeding practices in Malta are limited by systemic, cultural, and practical barriers. Interventions that strengthen maternal self-efficacy, provide consistent professional support, foster familial and societal acceptance, and enhance policy support for parental leave and workplace accommodations may improve breastfeeding initiation, exclusivity, and duration.

Keywords

breastfeeding breastfeeding barriers breastfeeding centre/clinic breastfeeding practices interviews Malta mothers qualitative methods thematic analysis women

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