Women's experiences with breastfeeding in public: An integrative review

Abstract

© 2020 Australian College of Midwives

Background: Much evidence around public breastfeeding does not reflect experiences of the key stakeholder, the breastfeeding woman, and focuses upon the audience. Selective evidence has explored breastfeeding experiences revealing challenges with public breastfeeding as a serendipitous finding. Although women's experiences have been explored in specific contexts, insight into commonalities reflective of an international perspective is unknown. Objective: to explore, review and synthesise published literature on women's experience with public breastfeeding. Methods: An integrative review allows inclusion of findings beyond empirical evidence. Whittemore and Knafl's approach was used to capture and analyse evidence from varied sources to provide understanding of a phenomenon from diverse methodologies. PubMed, Medline, Ovid emBase, Scopus, Science Direct, the Cumulative Index of Nursing and Allied Health Literature and PsychINFO were searched. Inclusion criteria included publications in English after 2005 offering descriptions of women's experiences. Data evaluation included assessment of literature quality. A constant comparison approach involved comparing, analysing and drawing similar concepts into themes. Findings: Integration of women's experience with public breastfeeding from 27 publications covering 12 countries revealed two key themes, what women shared as ‘enhancing’ and ‘challenging’. Challenges included four subthemes: ‘drawing attention’, ‘sexualisation of breasts’, ‘awareness of others’ discomfort’, and ‘efforts not to be seen’. Enhancing incorporated subthemes: ‘supportive audience’ and ‘confidence’. Conclusion: Challenges confirm an international commonality that women encounter during public breastfeeding suggesting a multilayered approach addressing community and societal behaviours is required. Insight to enhance public breastfeeding experiences offers direction to improve support.