Early breastfeeding cessation is a societal concern given its importance to the health of mother and child. More effective interventions are needed to increase breastfeeding duration. Prior to developing such interventions more research is needed to examine breastfeeding supports and barriers from the perspective of breastfeeding stakeholders. One such framework that can be utilized is the Socio-Ecological Model which stems from Urie Broffenbrenner’s early theoretical frameworks (1973–1979). The purpose of this study was to examine supports and barriers to breastfeeding across environmental systems. A total of 49 representatives participated in a telephone interview in Nebraska, USA in 2019. Interviewees represented various levels of the model, based on their current breastfeeding experience (i.e., mother or significant other) or occupation. A direct content analysis was performed as well as a constant comparative analysis to determine differences between level representatives. At the Individual level, breastfeeding is a valued behavior, however, women are hindered by exhaustion, isolation, and the time commitment of breastfeeding. At the Interpersonal level, social media, peer-to-peer, and family were identified as supports for breastfeeding, however lack of familial support was also identified as a barrier. At the community level, participants were split between identifying cultural acceptance of breastfeeding as support or barrier. At the organizational level, hospitals had supportive breastfeeding friendly policies in place however lacked enough personnel with breastfeeding expertise. At the policy level, breastfeeding legislation is supportive, however, more specific breastfeeding legislation is needed to ensure workplace breastfeeding protections. Future efforts should target hospital-community partnerships, family-centered education, evidence-based social media strategies and improved breastfeeding legislation to ensure breastfeeding women receive effective support throughout their breastfeeding journey.

中文翻译：

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通过社会生态学视角检查母乳喂养的支持和障碍：一项定性研究

鉴于其对母婴健康的重要性，早期停止母乳喂养是一个社会问题。需要更有效的干预措施来延长母乳喂养的持续时间。在制定此类干预措施之前，需要进行更多研究，从母乳喂养利益相关者的角度检查母乳喂养支持和障碍。可以利用的一个这样的框架是源于 Urie Broffenbrenner 的早期理论框架 (1973–1979) 的社会生态模型。本研究的目的是检查跨环境系统对母乳喂养的支持和障碍。2019 年，共有 49 名代表参加了在美国内布拉斯加州的电话采访。受访者根据他们目前的母乳喂养经历（即母亲或重要他人）或职业，代表了模型的各个级别。执行直接内容分析以及持续比较分析以确定级别代表之间的差异。在个人层面，母乳喂养是一种有价值的行为，然而，女性因疲惫、孤立和母乳喂养的时间投入而受到阻碍。在人际层面，社交媒体、点对点和家庭被确定为支持母乳喂养，但缺乏家庭支持也被确定为障碍。在社区层面，参与者在将母乳喂养视为支持还是障碍的文化接受之间存在分歧。在组织层面，医院制定了支持母乳喂养的政策，但缺乏足够的母乳喂养专业人才。在政策层面，母乳喂养立法是支持性的，但是，需要更具体的母乳喂养立法，以确保工作场所母乳喂养保护。未来的努力应针对医院-社区伙伴关系、以家庭为中心的教育、基于证据的社交媒体策略和改进的母乳喂养立法，以确保母乳喂养妇女在整个母乳喂养过程中得到有效支持。