“Navigating Emotional Turbulence of Exclusive Breastfeeding”: A qualitative study

Background Exclusive breastfeeding (EBF) during the first six months of life is vital to infant health, yet remains as low as 34% in South Africa. While clinical and systemic challenges to EBF are well documented, emotional experiences particularly among first-time mothers are underexplored. Guided by Mercer’s Maternal Role Attainment theory, this study aimed to explore the emotional journey of first-time mothers as they initiate and maintain EBF in Buffalo City Municipality, Eastern Cape. Methods A qualitative, exploratory, descriptive, and contextual design study was conducted with ten purposively selected first-time mothers who had chosen to breastfeed exclusively. In-depth semi-structured interviews were conducted in isiXhosa or English. Transcripts were thematically analysed using Tesch’s approach. Trustworthiness was enhanced through corroboration with the participants and by engaging with colleagues or experts to review interpretations and findings, minimising researcher’s bias. Results Two key themes emerged: (1) the emotional journey during the initiation of EBF and (2) emotional dynamics in the maintenance of EBF. Mothers reported both positive emotions (pride, fulfilment, joy) and negative emotions (frustration, guilt, shame, confusion). Perceived milk insufficiency, infant distress, and conflicting advice from healthcare workers and family were major emotional triggers. Emotional resilience was reinforced by peer and professional support. These stages of emotional development reflected Mercer’s theory of maternal role attainment. Conclusions The emotional fluctuations first-time mothers experience during EBF are real and justified. Mercer’s theory confirms that maternal role development is an evolving psychosocial process. EBF support must therefore address not only technical knowledge but also emotional adaptation. Policies should integrate emotional and psychosocial support into breastfeeding promotion frameworks.