Breastfeeding duration has declined in the Kingdom of Saudi Arabia (KSA) in recent decades, although accurate national data about different breastfeeding indicators by infant age are lacking. This qualitative study, the first in KSA, aimed to understand the factors affecting mothers’ decisions and experiences regarding any breastfeeding practices. A qualitative phenomenological approach was used to investigate mothers’ experiences of breastfeeding. Non-probability convenience sampling and snowballing strategies were designed to recruit participants. Semi-structured interviews were conducted with 16 mothers, from two hospitals and three primary health clinics in Al-Madinah city, from December 2017 to March 2018. Interpretative phenomenological analysis was the analysis framework. Three themes were identified: 1) ‘Up against the system’: policies, staff and systems were the main barriers to exclusive breastfeeding; 2) ‘Social support and negativity’: family support in the first 40 postpartum days protected breastfeeding continuation and was highly appreciated, but negative comments limited breastfeeding practices thereafter; and 3) ‘Managing tensions’: mothers’ religious beliefs about breastfeeding boosted their decisions; however, the challenge of managing tensions influenced mothers to stop breastfeeding earlier than they wished. The study revealed that mothers had no doubts about wanting to breastfeed their babies; but continuation was adversely affected by unhelpful hospital policies and staff actions, the lack of ongoing social support, and by others people’s negativity, rather than by the mothers’ own views. Stopping breastfeeding earlier than planned was a complex decision for most mothers. However, mothers said that they intended to breastfeed their next baby successfully. Healthcare professionals (maternity staff, paediatricians and pharmacists) need education and training to support exclusive breastfeeding effectively. Increasing the number of hospitals with Baby Friendly Hospital Initiative accreditation, which includes staff practice changes, is needed to protect and support exclusive breastfeeding. Ongoing professional and peer support, and improving conditions at workplaces and universities, are needed to help mothers to continue breastfeeding successfully. Effective, coordinated national policies can support mothers’ decisions in relation to breastfeeding. Such changes will reduce the tensions experienced by women and help them to achieve their breastfeeding goals and to breastfeed for longer.

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了解影响沙特阿拉伯王国一个城市母乳喂养实践的因素：一项解释性现象学研究

近几十年来，沙特阿拉伯王国 (KSA) 的母乳喂养持续时间有所下降，但缺乏关于不同婴儿年龄的不同母乳喂养指标的准确国家数据。这项定性研究是沙特阿拉伯的第一项研究，旨在了解影响母亲关于任何母乳喂养做法的决定和经验的因素。使用定性现象学方法来调查母亲的母乳喂养经历。非概率便利抽样和滚雪球策略旨在招募参与者。2017 年 12 月至 2018 年 3 月，对来自麦地那市两家医院和三个初级保健诊所的 16 位母亲进行了半结构化访谈。解释性现象学分析是分析框架。确定了三个主题：1）“反对系统”：政策，员工和系统是纯母乳喂养的主要障碍；2）“社会支持和消极”：产后前 40 天的家庭支持保护了母乳喂养的继续并受到高度赞赏，但负面评论限制了其后的母乳喂养实践；3) “管理压力”：母亲对母乳喂养的宗教信仰促进了她们的决定；然而，处理紧张局势的挑战影响了母亲提前停止母乳喂养。研究表明，妈妈们对想要母乳喂养婴儿毫不怀疑；但是，无益的医院政策和员工行为、缺乏持续的社会支持以及其他人的消极情绪，而不是母亲自己的看法，对继续治疗产生了不利影响。对于大多数母亲来说，提前停止母乳喂养是一个复杂的决定。然而，母亲们表示，她们打算成功地母乳喂养下一个婴儿。医疗保健专业人员（产科工作人员、儿科医生和药剂师）需要教育和培训来有效地支持纯母乳喂养。需要增加获得爱婴医院倡议认证的医院数量，包括员工实践的改变，以保护和支持纯母乳喂养。需要持续的专业和同伴支持，并改善工作场所和大学的条件，以帮助母亲继续成功地进行母乳喂养。有效、协调的国家政策可以支持母亲在母乳喂养方面的决定。