Q-methodology identifies distinctive viewpoints of the facilitators and barriers to six-month exclusive breastfeeding in Northeast Thailand

Background: The six-month exclusive breastfeeding (EBF) rate almost halved between 2009 and 2013 in Northeast Thailand for no clear reason. Specific facilitators and barriers to six-month EBF have been identified for Thailand, but mothers’ views on these factors to continuing EBF breastfeeding until six months have not been explored in this region. Aim: This study aimed to prioritize mothers’ views on the identified facilitators and barriers of continuing six-month exclusive breastfeeding. Methods: Q-methodology was applied. This research was conducted at Well Baby Out-Patient Department of Khonkaen Hospital, Numphong Hospital and a private hospital. Thirty-four mothers, who had recently delivered infants aged between four and six months, were breastfeeding/had breastfed, were 20 to 40 years old, participated. Demographic data were analysed descriptively, and Q-method analysis was conducted using the PQ Method software 2.35. Results: There was consensus that having knowledge about the advantages of EBF was the most important facilitator of six-month EBF, and ‘not having any other responsibilities besides caring for her infant’ was the least important facilitator of six-month EBF. Three viewpoints emerged identifying different groups/clusters of mothers, namely, (1) caring for self, (2) requiring support and (3) breastfeeding knowledge. Conclusions: Despite some consensus among participants, three distinct viewpoints emerged regarding which facilitators and barriers were important to mothers. It is clear that a programme to improve the six-month EBF rate in Northeast Thailand would need to incorporate interventions or activities that address the different viewpoints identified.