Mother's living on exclusive breastfeeding: grounded theory

Tássia Regine de Morais Alves1, Jovanka Bittencourt Leite de Carvalho1, Glauber Weder dos Santos Silva1, Valéria Dantas de Azevedo1

1Federal University of Rio Grande do Norte


Aim: Understanding the experience of mothers in interrupting Exclusive Breastfeeding. Method: It is a research delineated in the methodological resources of Grounded Theory. The research will be carried out in the Health Units that act as Family Health Strategy of the municipality of Caicó, in the State of Rio Grande do Norte, Brazil. Data collection will be done through in-depth individual interview. The data analysis will be divided into three phases: open coding, axial coding, and selective coding. Expected results: It seeks to foster reflections of health professionals about care, with a view to a care that transcends the biological dimension to the recognition of the multidimensionality of Exclusive Breastfeeding and valuation of subjective aspects of being a woman/mother.

Descriptors: Breast Feeding; Weaning; Maternal and child health.


Breastfeeding (BF) is an important phenomenon for maternal and child health, with its benefits consolidated in the scientific literature. Given its importance, the World Health Organization (WHO) recommends Exclusive Breastfeeding (EB) until the sixth month of life and, after this period, the introduction of appropriate and healthy complementary feeding, maintaining the continuity of breastfeeding up to two years or more. However, according to the latest National Health Survey conducted in 2013, the prevalence of this practice in relation to infants under six months is only 37.0%, which represents an unsatisfactory index(1).

A study carried out in Health Units in the city of São Paulo revealed negative feelings such as sadness, impotence and frustration when the EB was interrupted(2). In this area of knowledge, there are gaps in studies that theorize the experiences of mothers in the interruption of EB, considering the subjectivity and particularities of being a woman/mother.


How does the mother experience the interruption of exclusive breastfeeding?


Understand the experience of mothers in interrupting Exclusive Breastfeeding.


It is a research outlined in the methodological resources of Grounded Theory (GT). The GT is a method widely used by Nursing in the last years, which makes possible the elaboration of a theory from the empirical data derived from the social context(3).

The research will be carried out in the Health Units that act as Family Health Strategy (FHS), in the Urban Zone of the municipality of Caicó/RN, Brazil. The study participants will be defined through the composition of sample groups and theoretical sampling. The first sample group will be intentionally recruited from the following inclusion criteria: mothers with infants up to six months of age who are not exclusively breastfeeding and who reside in areas covered by the FHS of the aforementioned municipality. Exclusion criteria: mothers of babies with galactosemia and mothers with hearing impairment, due to the impossibility of establishing verbal communication, since the senses involved in language are also sought.

As the first collected data are analyzed, the other sample groups can be listed according to the need to deepen concepts, in order to fill gaps in emerging theory. Due to the circular character of the method, this is possible, since the data collection and analysis occurs concomitantly, aiming at a theorizing in an inductive-deductive manner until the theoretical saturation of the data reaches(3).

Collection will be done through individual interviews in depth, through a semi-structured script that allows obtaining more details and clarification on the mothers' experience in interrupting EB. The interviews will be held in a private place according to the preference of the participants, so that they feel at ease to express their experiences. The conversations will be recorded on an MP4 device and will have variable time.

The recordings will be stored and transcribed in full using Microsoft® Office Word 2016 and inserted into the NVIVO® 11 software for data organization. The data analysis will be divided into three phases: open, axial and selective coding.

Open coding is the first analytical step, consisting in the conceptualization of the data collected with words that denote action of the participants. In this coding phase, the researcher analyzes word by word, line by line, through a meticulous examination whose objective is to generate substantive codes, their properties and dimensions(3). The axial coding step, second from the analysis, is marked by regrouping the data, previously divided into the open coding. It is characterized by the process of relating categories to their subcategories, and it is called axial because it occurs around an axis of a category, integrating them with its properties and dimensions to generate clearer and more complete explanations about the research phenomenon(3).

Selective coding, the last stage of the analytical process, consists of refining and integrating categories and subcategories, with the purpose of revealing the main category, which will permeate all others and will consist of the central category or study theory. In this phase, the maximum theoretical abstraction potential of the already coded data is used to form a larger theoretical explanatory scheme, based on the theory of the paradigmatic study or model. In the most recent work of Straussian GT, the selective coding was called integration, a term considered more appropriate to the process performed in this stage(3). At the end of the coding steps, it was sought to elaborate a schematic model with the categories found.

The proposed research is a Master's thesis project of the Graduate Program in Nursing of the Federal University of Rio Grande do Norte (UFRN), approved by the Committee of Ethics in Research with Human Beings of UFRN, under opinion no. 2,574,139 and CAAE 83235117.2.0000.5537. It will obey the ethical foundations of Resolution 466/12 of the National Health Council and the collection will be preceded by the signing of the Informed Consent Form (IC).


This study may bring contributions to Nursing from the experience and meanings attributed by the mothers regarding the interruption of the EB. The results will encourage reflections of health professionals in terms of care, with a view to a care that transcends the biological dimension and the multidimensionality of this practice, besides the valuation of subjective aspects of being a woman/mother.


  1. Boccolini SC, Boccolini PMM, Monteiro FR, Venâncio EI, Giugliani ERJ. Tendência de indicadores do aleitamento materno no Brasil em três décadas. Rev Saude Publica. 2017;51(108): 1-9.
  2. Prado CVC, Fabbro MRC, Ferreira GI. Early weaning from breastfeeding from mothers’ perspective: a dialogical approach. Texto Contexto Enferm. 2016; 25(2): 1-9. DOI: 10.1590/0104-07072016001580015.
  3. Santos JLG, Cunha K, Adamy EK, Backes MTS, Leite JL, Sousa FGM. Data analysis: comparison between the different methodological perspectives of the Grounded Theory. Rev Esc Enferm USP. 2018; 52: 1-8. DOI: 10.1590/S1980-220X2017021803303.


To the Coordination of Improvement of Higher Level Personnel - CAPES, for fostering the development of the present study with the grant of a Master's degree.

All authors participated in the phases of this publication in one or more of the following steps, in according to the recommendations of the International Committee of Medical Journal Editors (ICMJE, 2013): (a) substantial involvement in the planning or preparation of the manuscript or in the collection, analysis or interpretation of data; (b) preparation of the manuscript or conducting critical revision of intellectual content; (c) approval of the version submitted of this manuscript. All authors declare for the appropriate purposes that the responsibilities related to all aspects of the manuscript submitted to OBJN are yours. They ensure that issues related to the accuracy or integrity of any part of the article were properly investigated and resolved. Therefore, they exempt the OBJN of any participation whatsoever in any imbroglios concerning the content under consideration. All authors declare that they have no conflict of interest of financial or personal nature concerning this manuscript which may influence the writing and/or interpretation of the findings. This statement has been digitally signed by all authors as recommended by the ICMJE, whose model is available in http://www.objnursing.uff.br/normas/DUDE_eng_13-06-2013.pdf

Received: 10/21/2018 Revised: 11/05/2018 Approved: 11/06/2018