The existing literature on breastfeeding in public has primarily concentrated on societal perceptions. However, women are the central figures in breastfeeding in public spaces. In particular, first-time breastfeeding mothers may feel incapable of breastfeeding or may have different perceptions of breastfeeding based on what they see or hear around them. Breastfeeding in public places may be difficult for these mothers. Therefore, it is essential to examine the perceptions of first-time breastfeeding mothers regarding breastfeeding in public to gain a better understanding of their thoughts and concerns, and to identify the factors influencing breastfeeding practices, particularly in public.

This study was conducted to examine the views, feelings, and thoughts of first-time mothers regarding breastfeeding in public. This qualitative descriptive study was conducted using in-depth, semi-structured interviews at Kahramanmaras Sütcü İmam University Health Practice and Research Hospital in Türkiye between May and September 2024. All interviews were audio-recorded and transcribed. In analysis, the researchers followed Colaizzi’s seven-step analysis method and identified and organized clusters of themes from the statements in the transcribed interviews. The MAXQDA software was used for coding and identifying relationships between themes and sub-themes.

Data saturation was reached with 34 participants. The analysis revealed four primary themes and 13 subthemes that represented the views, feelings, and thoughts of first-time mothers: (1) Confronting breastfeeding in public; (2) Challenging emotions related to breastfeeding in public; (3) Demotivating factors for breastfeeding in public; (4) Needs related to breastfeeding in public. The acceptability of breastfeeding in public varied among the participants, with negative narratives being more prevalent. A significant number of participants expressed a desire to avoid societal condemnation, viewing breastfeeding without a cover as improper. Additionally, certain culturally specific beliefs were identified as barriers to breastfeeding in public.

This study found that first-time mothers’ views, feelings and thoughts about breastfeeding in public were influenced by the community’s attitude. Additionally, the findings underscored the crucial role of culturally specific beliefs in shaping mothers’ motivation to breastfeed in public. Therefore, proactive interventions targeting both new mothers and their environment are essential to change mothers’ negative perceptions of breastfeeding in public.

Worldwide, although the World Health Organization recommendations for exclusive breastfeeding have been adopted, there are significant differences and wide variations in breastfeeding prevalence in many countries [1, 2]. Social differences in attitudes towards breastfeeding may contribute to these differences in breastfeeding prevalence [3]. Many studies examining factors associated with breastfeeding behaviour have traditionally focused on maternal demographic characteristics, obstetric characteristics, treatment or health care factors [4, 5]. However, psychosocial and cultural factors, which have been studied less frequently and more recently, may be strongly associated with breastfeeding practices [6, 7].

A variety of individual and socio-cultural factors, including postnatal support, physical and mental health, breastfeeding knowledge, and concerns about insufficient milk supply, have been identified as key influences on breastfeeding behaviors [8, 9]. Additionally, social factors that affect the attitudes, feelings, and perceptions of mothers toward breastfeeding play a crucial role in achieving optimal breastfeeding outcomes. The comfort of the mother with breastfeeding has been found to directly impact her breastfeeding behavior [10, 11]. The World Health Organization (WHO) has advocated for societies to “support mothers to breastfeed anytime, anywhere” to promote the acceptance of breastfeeding in public spaces [12]. It is vital for maternal and newborn health that mothers continue exclusive breastfeeding. In order to achieve this, mothers should be encouraged to breastfeed their babies in public sphere. In this respect, it is important that maternal and child health nurses and other health professionals who are breastfeeding partners (midwives, physicians, community-based nurses, lactation consultants etc.) provide informed advice about breastfeeding.

Although the existing literature has explored various aspects of breastfeeding, there has been less focus on mothers’ perspectives and practices towards the phenomenon of breastfeeding in public. In some communities, women often try to avoid breastfeeding or choose bottle feeding over breastfeeding in public [13]. The discomfort associated with breastfeeding in public, coupled with social norms that do not adequately support breastfeeding mothers, can hinder the initiation or continuation of breastfeeding [14, 15]. Only one cross-sectional study evaluating women’s perspectives on breastfeeding in public was found in Türkiye. In this study, it was found that although mothers were aware of the importance of breastfeeding, they often did not breastfeed in public due to cultural influences and lack of private breastfeeding areas [16]. Therefore, in the present study, we aimed to fill that gap by investigating views, feelings, and thoughts of first-time breastfeeding mothers regarding breastfeeding in public in Türkiye.

The objective of this study was to provide a comprehensive evaluation and understanding of the views, feelings, and thoughts of first-time mothers regarding breastfeeding in public. To achieve this, a qualitative research design utilizing a descriptive approach was employed. This design is particularly well-suited for exploring and interpreting the mothers’ attitudes, as it allows for a deeper understanding of their personal perspectives on breastfeeding in public. To ensure the rigor and clarity of the research process, the study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ), which provided a framework for clear and comprehensive reporting of the individual in-depth interviews [16].

The present study was conducted at a university hospital in Kahramanmaraş province, Türkiye. The study population consisted of women in the postpartum period who were hospitalized in the obstetrics and gynecology inpatient service of Kahramanmaras Sütcü İmam University Health Practice and Research Hospital between May and September 2024. Typically, newly delivered mothers stay in this service for 24–48 h unless there are postpartum complications. The hospital is designated as a Baby-Friendly Hospital, and midwives and nurses working as breastfeeding counselors provide brief information about breastfeeding to mothers.

The study included first-time women who were exclusively breastfeeding and agreed to participate in the research. First-time mothers may feel incapable of breastfeeding because they have not experienced breastfeeding. The difficulties and barriers that these mothers perceive regarding breastfeeding in the community have a negative impact on exclusive breastfeeding. In this study, we focused on exploring first-time breastfeeding mothers’ perceptions of breastfeeding in public and to better understand the factors that influence breastfeeding practices in public. A purposive sampling method was employed to select participants, as it enables careful selection of cases that facilitate comprehensive qualitative data collection and enhances the reliability of the research findings [17]. The study was concluded with the participation of 34 mothers, at which point data saturation was reached [18].

A descriptive information form and a semi-structured in-depth interview questionnaire were used for data collection.

The form was developed by the researchers based on the relevant literature and included ten questions covering age, parental education and employment, family income, place of residence, planned pregnancy, and prior breastfeeding education [1, 8, 9].

The questionnaire was developed by the researchers based on the relevant literature and included nine open-ended questions to explore the views, feelings, and thoughts about breastfeeding in public [10, 11, 14, 15, 19]. Expert opinions were sought from academicians, and the questionnaire was revised according to their recommendations (Table 1).

Data were collected through in-depth, face-to-face interviews conducted in the obstetrics and gynaecology inpatient service where the participants stayed after delivery. Each interview lasted between 45 and 60 min. Before the interview, participants were informed that their confidentiality would be preserved and that they could withdraw from the study at any time. Informed consent was obtained from all participants. To ensure data reliability, all interviews were conducted by a single researcher in the participants’ native Turkish language. Interviews were audio-recorded, and the nonverbal messages expressed by participants were carefully documented.

The analysis of quantitative data was performed using the Statistical Package for Social Sciences (SPSS) version 29.0.2.0 (IBM SPSS Statistics for Windows, Armonk, NY, USA). Descriptive statistics, including frequency, percentage, mean, and standard deviation, were used to present the data. The qualitative data obtained from the individual in-depth interviews were analyzed using Colaizzi’s seven-step analysis method [20]. Initially, the audio recordings were transcribed by a researcher, with participants anonymized using identifiers (PW1-PW34). Each transcript was then read numerous times until a meaning was derived by the two researchers for them, emphasising important statements. The researchers formulated the meanings extracted from each important statement and created codes and theme clusters. The first-time mothers’ views, feelings and thoughts were written down in detail and then summarised in more precise statements. In utilizing Colaizzi’s analytical method, MAXQDA Analytic Pro (24.6.0) software program were used to ensure efficient management of the professionally transcribed data and systematically categorise theme clusters and themes. Both researchers discussed any disagreements regarding the emerging themes and sub-themes. Both researchers discussed any disagreements regarding the themes and sub-themes. The data analysis process was completed once all main and sub-themes had been established, accompanied by corresponding quotations.

To ensure rigor and trustworthiness, the criteria of credibility, confirmability, transferability, and dependability were applied [21]. The senior researcher, a specialist in women’s health nursing with a state-approved breastfeeding counselor certificate, played a crucial role in building trust with participants by addressing their questions regarding the breastfeeding process. All stages of the research and interviews were conducted in Turkish, the native language of the participants. The translation of the quotations was performed after all data had been collected, as is recommended in qualitative research. The author translated the data and then had a second translator check whether the meaning present in the source language was preserved in the target language after translation [22, 23]. Nevertheless, pilot interviews were conducted with three mothers to ensure the accuracy of the participants’ intended meanings in their native language. The responses of the pilot interview conducted with three mothers were not included in the final analysis. An interview guide was employed to maintain consistency in the interview questions, and all interviews were recorded and transcribed verbatim using a voice recorder. Reflexive notes were taken during the interview process to enhance verifiability, and nonverbal cues were also noted. To validate the findings, the results were shared with participants for verification [20]. The participants made no changes in the validation. The findings were reported following the Consolidated Criteria for Reporting Qualitative Research (COREQ).

Table 2 presents the descriptive characteristics of the participants. The mean age of the participants was 28.64 ± 4.37 years. Accordingly, 73.6% of the participants had an education level of high school or below, 70.6% were unemployed, all participants’ spouses were employed, and all pregnancies were planned. Only 17.6% of the participants received breastfeeding education, with nurses being the primary source of information.

The qualitative data of the study were analyzed through content analysis, which resulted in the identification of four main themes in relation to breastfeeding in public: confronting breastfeeding in public, challenging emotions related to breastfeeding in public, demotivating factors for breastfeeding in public, and needs related to breastfeeding in public. The themes and subthemes are presented in Table 3.

The initial theme pertained to the perspectives articulated by mothers when confronted with the act of breastfeeding in public settings. The resulting opinions were then categorized into subthemes, including social condemnation, mahremiyet (privacy), association with sexuality, and natural versus unpleasant/disgusting appearance.

The first theme addressed the views expressed by mothers when faced with breastfeeding in public. The resulting positive or negative opinions were categorized into the subthemes of social condemnation, privacy, association with sexuality, a natural act and unpleasant/disgusting appearance.

Social condemnation

The vast majority of participants reported that breastfeeding in public is considered as a situation that is likely to be condemned by the community members. They stated that they thought they would be subjected to uncomfortable glances while breastfeeding outdoors. Additionally, some participants expressed support to social condemnation.

“I don’t approve of it, and I don’t think society does either. However, we do see women on the internet, more or less, sitting in shopping malls and breastfeeding openly.” (PW6).

“I avoid breastfeeding in public because I know people will judge me. In our society, when someone sees a mother breastfeeding openly, they tend to look down on it and disapprove. People often stare, as if they think you’re doing it intentionally, rather than simply attending to your child’s needs.” (PW11).

“People generally look at you with judgment, as if you’re doing something shameful. No one ever comes over to praise you for doing something good; instead, they just stare.” (PW21).

Mahremiyet (privacy)

The participants expressed that breastfeeding in public constitutes an infringement on bodily privacy and that it is inappropriate for others to witness such acts. Additionally, they suggested that the perception of privacy is deeply entrenched in their families or culture

“For example, I couldn’t just go and breastfeed in that corridor; I wasn’t raised that way. Even in a family setting, I will turn my back to breastfeed, except for my husband—it’s something private.” (PW6).

“There’s no need for anyone to see me breastfeeding; it’s a private matter, and others shouldn’t be exposed to it.” (PW20).

“I don’t want anyone to witness that special moment… I make sure to cover myself in some way. In my opinion, breastfeeding in a public setting is inappropriate; it just feels wrong to me. I will always try to cover up.” (PW26).

Association with sexuality

According to the participants, the breast is widely regarded as a sexual organ within society. As a result, they associated breastfeeding with sexuality and emphasized the impropriety of breastfeeding in public.

“The breast is viewed as a sexual organ for men. I believe it shouldn’t be exposed because it has been objectified.” (PW8).

“Ultimately, it’s inappropriate, and the breast is considered an obscene organ. I wouldn’t breastfeed openly, but perhaps I would with a nursing cover.” (PW10).

“Even though breastfeeding is essential for the child, I wouldn’t prefer to do it. Even if it’s for the child’s health, it could be perceived as exhibitionism.” (PW15).

A natural act

Some participants stated that breastfeeding in public is a natural act, defining it as a means of meeting their babies’ needs, regardless of the location.

“Some women are really shy about it. Because they’re so worried, they end up being afraid to breastfeed, which can harm the baby. I believe that, no matter what, they should breastfeed because the child’s health is the most important thing; other people’s opinions shouldn’t matter. I focus only on my child’s health, and if someone feels uncomfortable, they can just look away. There’s nothing to be ashamed of; it’s entirely natural. If we’ve given birth to this child, we must meet their natural needs.” (PW22).

“Of course, as mothers, our child’s health is what matters most to me. I don’t care about what others see or want to see; my priority is my child.” (PW29).

The participants also reported a willingness to breastfeed, despite the lack of societal approval.

“If I speak for myself, I’d say that women should be able to breastfeed wherever they want without any problem, but unfortunately, society is against it. For example, I know people who’ve tinted their car windows for this reason, or I’ve heard of women parking in side streets to breastfeed. Honestly, I think I would breastfeed if necessary, and if that’s the only way to calm my baby, then I should do it.” (PW3).

Unpleasant & disgusting appearance

Some participants refrained from breastfeeding in public due to the perception that it presented an unpleasant or a disgusting appearance

“It’s disgusting, I mean, exposing your breast and breastfeeding in front of everyone, with milk coming out… I definitely think it’s wrong.” (PW2).

“I don’t think it’s very appropriate; everything around would get covered in milk. It’s not pleasant at all, and I believe it looks bad. Personally, I wouldn’t do it.” (PW4).

The second theme addressed participants’ feelings about breastfeeding in public. These feelings were predominantly negative, often serving as a deterrent for mothers to breastfeed in public. This theme was further subdivided into the following subthemes: discomfort, embarrassment, and concerns about hygiene.

Discomfort

The majority of participants reported that they would not feel comfortable breastfeeding in public. Furthermore, mothers highlighted the challenges associated with breastfeeding in public. According to these mothers, society expected breastfeeding women to feel uncomfortable and to behave accordingly.

“I think it varies from country to country. For example, in Turkey, it can be a bit challenging. Like, I feel like I have to cover up, you know? Or I need to turn away like I’m sitting right now. I don’t like it when others look; it makes me uncomfortable.” (PW5).

Furthermore, the subjects’ discomfort in public settings was identified as a substantial contributing factor to the observed delays in breastfeeding.

“I think I would feel a bit uneasy about breastfeeding in front of my father or other elders in the family. I might tend to feel a bit overwhelmed in environments where there are men or in crowded places. If I have to breastfeed in such situations, I will have to end up making the baby wait.” (PW24).

Embarrassment

Another reason that deterred participants from breastfeeding in public was embarrassment. Participants reported experiencing feelings of embarrassment, particularly due to the gaze of strangers.

“I think I will feel embarrassed. If I knew people wouldn’t give me strange looks, I’d feel more comfortable breastfeeding in public. I just wish I had more support!” (PW25).

“Breastfeeding outside the home will be a bit of a challenge. I will feel a bit hesitant to do it on public transportation or in marketplaces. Even if I use a nursing cover, there will be still a bit of a hesitation that comes with it.” (PW32).

Concerns about hygiene

Although relatively few, some participants expressed significant concerns regarding the cleanliness of the public breastfeeding environment.

“I will prefer environments where I don’t have to worry about infection. If there’s a room for breastfeeding and it looks clean, I will use it. But if not, I will just find any clean spot to sit and feed my baby.” (PW22).

The fourth theme was about the factors that reduced the motivation of participant mothers towards breastfeeding in public. This theme was categorized into two subthemes: negative energy & evil eye and spousal disapproval.

Negative energy & evil eye

A significant portion of the participants believed that their cultural belief in the “evil eye” and the negative energy of strangers could adversely affect the baby, leading to a decrease in milk supply or even the complete cessation of breastfeeding.

“Some people have negative energy, and that’s why I can’t breastfeed around them. When I’m breastfeeding, they ask, ‘Is your milk enough? Is it good for the baby?’ If they give me the evil eye, I might stop producing milk. Also, sometimes women’s milk sprays out unexpectedly in public. When people see that they have a lot of milk, they get jealous, and it causes the evil eye, or even the baby can get sick.” (PW9).

“I do believe in the evil eye to some extent. I don’t want my milk supply to stop.” (PW16).

“If the baby latches well or feeds well, the evil eye can affect them. People’s negative energy can stick with them, especially when others see the baby breastfeeding.” (PW30).

Spousal disapproval

The participants reported that their partners would not allow breastfeeding in public and interpreted this as being consistent with prevailing patriarchal social norms. These mothers stated that even if they wished to breastfeed, they would refrain from doing so due to the lack of their partners’ approval.

“Even if you want to breastfeed, at first, your husband won’t allow it. We live in a patriarchal society.” (PW10).

“I really believe that breastfeeding is something we can do. There’s absolutely no problem with it. But, you know, in our society, there’s this idea that women should be more in the background. The main issue is that husbands don’t really support it. They don’t want their wives to breastfeed in front of others.” (PW18).

The final theme that emerged from the study explains what mothers will need when breastfeeding in the public after discharge. These needs were categorized into three sub-themes: Using a cover, designated breastfeeding areas, and milk pumping.

Using a cover

All participants emphasised the need to use a cover when breastfeeding in public. They indicated that they would cover their breasts with items such as nursing covers, shawls, or scarves.

“I don’t think I’ll ever be able to breastfeed with my breast exposed. I think I will move to a quieter place and if my husband is with me I will get his support. I am going to try to breastfeed using a nursing cover or by covering myself with a cloth.” (PW14).

“Because of my own beliefs, I am going to cover myself up. There’s no need to do it in an overly exposed way. I would prefer to breastfeed openly, but of course, for various reasons, I will cover myself when I breastfeed.” (PW15).

Designated breastfeeding areas

The participants indicated they would prefer designated spaces, such as baby care rooms, for breastfeeding in public.

“I don’t know how I would breastfeed in places like the market, a wedding, or on the bus. At least in shopping malls, there are breastfeeding rooms, so I think I will breastfeed there.” (PW4).

“I think the breastfeeding room is the best. I will always carry a nursing cover with me, but when I’m outside, I’ll look for a baby care room or some private place to breastfeed.” (PW32).

Milk pumping

A number of participant mothers voiced strong opposition to the notion of breastfeeding in the presence of strangers and expressed milk pumping as a solution. These mothers highlighted the challenges of breastfeeding in public and stated that they would prefer to use bottles when outside.

“I’ve already bought a breast pump. “If I’m going outside, I’ll pump before I leave and will give the milk that way if there’s no private space.” (PW17).

“The market, malls, and anywhere with people will be uncomfortable for me. I wouldn’t want to breastfeed in a crowded place. I would go home if I can. I’d pump my milk and be prepared, then give it with a bottle, but I will avoid breastfeeding in front of people.” (PW21).

“I will probably use a bottle. I don’t think I will feel comfortable breastfeeding in public so I won’t be able to do that. I will have to bottle feed the baby.” (PW28).

The present study identified factors that influence breastfeeding behaviors of primiparous mothers in public in Kahramanmaras located in the eastern Mediterranean region of Türkiye. Given the lack of studies in which in-depth interviews about breastfeeding in public, the findings of the study contributed to the existing knowledge on the subject. Moreover, this study provides insight into how to support informed decision-making about breastfeeding in public and contributes to the counselling role of nurses responsible for maternity and women’s health services.

The majority of participants reported that people in their community would condemn breastfeeding in public, and some participants expressed disapproval of other women breastfeeding in public, aligning with the prevailing negative societal attitudes. Individuals’ cultural and social environment significantly influences their views on breastfeeding. Opposition to breastfeeding in public is a worldwide phenomenon, which can be largely attributable to stigmatization [24]. A study of online comments regarding a breastfeeding mother’s expulsion from a store in the UK found that the comments were mostly derogatory, harsh, and had a misogynistic language directed at the mother’s body [25]. These incidents of micro-aggressions and stigmatization directed towards breastfeeding mothers in public spaces have the potential to adversely impact their breastfeeding duration and contribute to a decline in self-esteem [11]. Consequently, the participants of the present study expressed a reluctance to breastfeed in public due to the potential condemnation from others.

The majority of participants described breastfeeding as a private matter and expressed a preference for privacy while breastfeeding, with some even preferring to be seen only by their spouses. This finding aligns with cultural norms in Islam, particularly the concept of mahremiyet. Derived from Arabic, mahremiyet refers to what is sacred or forbidden and is linked to intimacy, privacy, and secrecy. In Turkish culture, mahremiyet encompasses both private and sexual domains [26]. However, privacy is not exclusive to Turkish or Islamic cultures; it is a universal concept. In modern terms, it refers to an individual’s “right to be left alone” [27]. A review of the literature revealed only one study that specifically addressed privacy concerns of breastfeeding mothers in public. Rosen-Carole et al. (2018) surveyed 279 mothers and found that 25% of them had privacy concerns and that these concerns were more common among Asian or Pacific Islander women and less common among Black or African American women [28]. The concept of privacy or confidentiality surrounding breastfeeding in public remains an under-explored area, emphasizing the importance of our study’s contribution to this field.

A significant proportion of the participants perceived the breasts as a sexual organ and associated breastfeeding with sexuality, with one mother explicitly articulating that breastfeeding in public could be considered as an act of exhibitionism. Feminist scholars argue that a key factor preventing women from breastfeeding in public is the perception that breasts are primarily for visual pleasure or for satisfying men’s sexual desires [29]. In particular, in patriarchal societies, the view of breasts as sexual organs—rather than as nourishing—and their association with sexual invitation for men contribute to the social unacceptability of breastfeeding in public [15]. The sexualization of both the breast and the breastfeeding mother’s body presents a significant barrier to extended breastfeeding.

Some of the participants expressed a favorable view of breastfeeding in public, contending that it was a natural and appropriate behavior. Those who regarded breastfeeding as a fundamental right for their infants were more inclined to support breastfeeding in public. Some participants even asserted that they would breastfeed in public, despite its social unacceptability. One participant underscored the importance of fulfilling their baby’s natural needs, asserting that there was no issue with breastfeeding in public. A survey of 2021 breastfeeding women in China found that 65% of participants believed that breastfeeding was acceptable in public and more than 80% thought it was not against social morality [30]. Despite the common portrayal of breastfeeding as “natural and easy” in health literature and among health authorities, women continue to encounter social challenges when breastfeeding outside the home [31].

A number of participants described breastfeeding in public as unpleasant or disgusting, and these individuals expressed stronger opposition to the practice. In certain societies, bodily fluids such as menstrual blood or breast milk may be perceived as disgusting [32]. A study identified disgust at bodily fluids and their functions as one of the common reasons for opposition to breastfeeding in public [14]. However, there is limited research on the perception that breastfeeding in public is undesirable or disgusting for mothers who have given birth, and the underlying processes behind these views remain largely unexplored. This finding in our study may stem from the perception of breast milk as a pollutant that should not be exposed in public spaces and should be controlled.

Disapproval of breastfeeding in public was associated with a range of negative emotions among the participants, with discomfort about breastfeeding in the presence of men, including family members, being the predominant emotion. Consistent with the present findings, previous studies have documented that breastfeeding in public is an uncomfortable experience for both first-time and multipara women [10, 33]. The study identified embarrassment as the second most common emotion experienced by mothers while breastfeeding in public. One participant expressed that she would feel embarrassed breastfeeding in public, even if she used a breastfeeding cover. Similarly, Stearns (2011) reported that women felt embarrassed and tried to conceal themselves when breastfeeding in public [34]. The prevailing social disapproval of breastfeeding in public has been recognized as a contributing factor to the feelings of embarrassment reported by mothers [35]. The majority of participants in the present study indicated that they would feel more comfortable breastfeeding in public if people did not look at them strangely. Some participants also expressed concerns about the cleanliness of public spaces, such as breastfeeding rooms. A review of the existing literature reveals that these concerns are not unfounded [36]. A study conducted in the US found that more than 80% of 105 breastfeeding facilities were indoor environments, and only some of them had air temperature control [37]. Additionally, mothers who choose to breastfeed in private spaces, such as restrooms, may expose their infants to potential pathogens in these environments.

The study found that beliefs about negative energy and the evil eye influenced breastfeeding behavior in public. The term nazar (evil eye) is an Arabic word that is defined as “the eye that is believed to be possessed by certain people, and that can cause harm to people, houses, properties and even inanimate objects by looking at them with envy or admiration” [38]. Some participants expressed the belief that when breastfeeding in public, others might cast an “evil eye” due to envy or admiration for the abundance of milk or the baby’s latching. One participant explicitly articulated that the envy of others witnessing the profusion of milk was a contributing factor in the harm inflicted upon her infant. A study on newborn care practices in a predominantly Muslim community in Pemba Island, Tanzania, revealed that nearly all rural mothers applied kohl to their newborn’s eyes as a protective measure against people’s evil intentions [39]. Another qualitative study found that Tanzanian mothers expressed concerns about breastfeeding in public due to the prevailing cultural belief in the evil eye, leading to restrictions on public breastfeeding imposed by family elders [40]. In the Turkish cultural context, where this study was conducted, the belief in the evil eye during the postpartum period is prevalent, and protective rituals, such as reciting prayers and carrying evil eye beads, are commonly practiced [41].

A number of participants encountered difficulties breastfeeding in public due to their spouses’ disapproval, a phenomenon that aligns with the findings of limited number of studies currently available in the literature. The substantial influence of the father on mothers’ breastfeeding behavior is progressively recognized [42]. The findings of Coomson and Aryeetey (2018) indicate that women are more inclined to breastfeed in public when they have support from their spouses [43]. In addition, Ogbo et al. (2016) have demonstrated that the partners of breastfeeding mothers play a significant role in the early cessation of breastfeeding [44]. These findings underscore the necessity for interventions that promote community acceptance of breastfeeding and encourage spousal support, as spouses are likely to influence women’s motivation to breastfeed.

The study identified some of the needs of first-time mothers when breastfeeding in public. All participating mothers reported that they would cover their breasts when breastfeeding in public, even using a simple piece of cloth. Most mothers indicated that they would bring nursing covers when going out. In expressing these thoughts, the participants in fact explained how they made breastfeeding an acceptable activity in public. Decisions about breastfeeding can be shaped by social and cultural factors. In many societies, social norms exist to ensure that women do not disturb others, meet societal expectations, and maintain control over their own bodies when breastfeeding in public [33]. When mothers cover themselves while breastfeeding in public, they signal their intention to feed their babies, rather than using their breasts in a sexual manner or for display [35]. However, it is important to consider the potential drawbacks of nursing covers, which have been shown to hinder eye contact and communication between mother and child.

The majority of participants reported that they would often breastfeed in public in breastfeeding rooms or other designated areas. However, they also expressed concerns about finding solutions in situations where such areas were not available, such as on a bus. Previous studies have reported that home was the least problematic area for breastfeeding [28, 33, 36]. In many cultures, women are expected to breastfeed at home, and those who do so in public are often regarded as negligent or deficient in their parental abilities [15]. Many mothers attempt to find a suitable place to breastfeed in public but encounter difficulties. Consequently, as in our study, they abstain from breastfeeding in public and opt for milk pumping. This phenomenon aligns with the findings of an integrative review of studies conducted on mothers from 12 countries, which revealed that one strategy employed by mothers to avoid breastfeeding in public is to express milk and subsequently feed their infants from a bottle [45]. In this sense, milk pumping can be regarded as a method chosen by mothers to avoid being seen breastfeeding in public.

This study has several limitations. Despite the criteria and strategies used to strengthen validity and reliability, it is possible that researchers’ biases may have influenced the data collected or the analysis. This is the same as in any qualitative research. Secondly, the study was conducted in a specific centre and may not fully represent perspectives on breastfeeding in other parts of Türkiye or in different cultural settings. Finally, the study may be subject to biases such as social desirability or recall bias among new mothers.

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All authors made substantial contributions to the study’s conception, design, analysis, drafting and revision (AA, RSD, GK). AA performed data collection and the main part of analysis and manuscript drafting. All authors have read and approved the final manuscript.

Correspondence to Aslıhan Aksu.

Ethical approval for this study was granted by the Medical Research Ethics Committee of Kahramanmaras Sütçü İmam University (29.04.2024/12 − 06). Institutional permission was also obtained from Kahramanmaraş Sütçü İmam University Health Practice and Research Hospital where the study took place (21.05.2024–312134). All participants were informed about the purpose of the study, and written informed consent was obtained from each participant. The research adhered to the principles outlined in the Helsinki Declaration.

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The authors declare no competing interests.

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This study was presented as an oral presentation at the 2nd International Health Services Congress, which was organised by Toros University in Türkiye between 25 and 26 February.

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