The use of Kumpfer’s resilience framework in understanding the breastfeeding experience of employed mothers after returning to work: a qualitative study in China

BACKGROUND: The increasing numbers of women in the workforce is an inevitable trend in China. More and more employed women stop breastfeeding because of working stressors. Many mothers, however, overcome the challenges and insist on breastfeeding after returning to work. Their individual experience of breastfeeding may provide a new insight to promote and support breastfeeding on employed mothers. This study sought to understand mothers’ experience with insisting on breastfeeding after returning to work based on Kumpfer’s Resilience Framework in Chinese context. METHODS: This qualitative study was designed with semi-structured interviews. Purposive sampling and snowball sampling were employed to recruit 13 full-time working mothers with a stable job in the public sector who continued to breastfeed for 1 month or longer after returning to work in Haikou, Hainan Province, China. Interviews were conducted from January to March 2020 to capture participants’ experiences of breastfeed after returning to work. Grounded theory and Kumpfer’s Resilience Framework were used to analyze data via a systematic and iterative process. RESULTS: Employed mothers built resilience while continuing to breastfeed after returning to work. The core concept was "dynamic interaction". Other categories were the background and explanation of this phenomenon. For working mothers who continued to breastfeed, resilience involved "dynamic interaction", which started from "experiencing stressors" and "obtaining support", two environmental factors interacted with the individual to "build resilience qualities", which interact with environment led to “behavioral resilience”. And then the ongoing dynamic interaction between behavioral resilience and environment ultimately led to three different "weaning processes", including natural weaning, active weaning, and forced weaning. CONCLUSIONS: This study identified the framework of resilience in mothers who were in the adversity of breastfeeding after returning to work based on Kumpfer’s Resilience Framework. It provided a new insight into the resilience of employed mothers around the world to continue breastfeeding and showed the different culture of breastfeeding on employed mothers.