Strengths and limitations of phase two of the study

There were a number of strengths and limitations to this phase of the study. The validity of research is concerned with the integrity of the conclusions that are drawn from it. In terms of internal validity, this can be a particular strength in qualitative research in that if the explicit focus of a piece of work is to understand a situation from the perspective of the participants, this encourages congruence between what is ‘observed’ and the conclusions drawn from this. Specifically, if a grounded theory approach, where there is explicit commitment to ‘grounding’ theory in the data generated, is used, as it was here, validity can be enhanced. The longitudinal nature of the study design with serial interviews meant that it was possible to elicit the timing and order of events accurately, and that it was possible to verify, clarify and check out issues raised at previous interviews. This allowed a deeper understanding of the women’s behaviour, perceptions and actions to be developed. Validity was

also enhanced through enabling women to talk about weaning as it was unfolding. Although not all of the 21 participant mothers completed four interviews, all of the mothers had commenced weaning at the time of their final interview, and nine women were interviewed when their babies were aged between nine and 11 months old, so were well into the weaning process. Thus it was possible to generate much data relevant to the aim of the study.

A lack of generalisability, or external validity, is a criticism often levelled at qualitative research. Generalising from the findings of qualitative research can, however, be misunderstood (Denscombe, 2010). The purpose is not to make generalisations from a probability sample to a wider population as, for example, a survey approach might do, as qualitative researchers do not set out to obtain statistically representative samples so that generalisations can be made (Fade, 2003). The relationship between a sample and a whole population is of a different order to the relationship between the particular, as studied by a qualitative researcher, and the generic (Coffey & Atkinson, 2006). Qualitative researchers are trying to gain an understanding about a phenomenon, and much can be learned from the study of just one instance (Corbin & Strauss, 2008). Any generalisations that can be made are theoretical generalisations, that is, abstractions from the data which are conceptual (Denscombe, 2010). This is the way in which generalizability was used in this study. Qualitative researchers often refer to ‘transferability’ or ‘wider resonance’, that is, the extent to which findings may be applied to other contexts. The generalisability of qualitative research does not derive from the representativeness of the sample, but from the concepts and theoretical ideas developed which may be relevant to other settings or groups of people (Corbin & Strauss, 2008; Green, 1999). Thus, in this study, it was the theoretical concepts developed from the data that may have wider resonance for understanding how mothers, in other similar situations and places carry out weaning, with similar consequences for their children. The theoretical account developed here might also offer some insights into the early development of overweight in children.

A number of steps were taken in order to ensure the reliability of the work. In keeping with Guba and Lincoln’s (1994) qualitative research quality criteria of dependability, which parallels reliability in quantitative research, an ‘auditing’ approach was adopted. A record was kept of all phases of the research process in order to track decisions made and actions taken. Regular supervision meetings were held to discuss the progress of the research. For example, the decision to halt

data generation was taken following discussion regarding the practicality of continuing given the timescale for the research and the likelihood that further interviews would generate new understandings. During the data analysis phase, vigorous discussion of the development of the categories of meaning helped to ensure that these were grounded in the data and were useful in understanding the phenomenon being studied.

In terms of limitations, the participant mothers were self-selected in that they volunteered to take part in the research and it may be that mothers who had a particular interest in feeding and weaning, or had particularly strong opinions about the issues, chose to participate. It is difficult to say whether this was the case. Participating mothers held a variety of views however, and whilst it was clear that some had experience of weaning and very definite ideas about how they would go about this, others had never really thought about it and did not, initially at least, have any particular knowledge about feeding or weaning babies.

Although the purpose of sampling was not to gain a representative sample of mothers in a quantitative sense, there were a range of women in terms of where they lived, whether they were first time mothers or had older children and in terms of socio-economic deprivation scores. However, the socio-economic deprivation scores were not unproblematic in that they reflected the area in which each mother lived rather than her own material circumstances. For example, one mother who had a professional occupation lived in a neighbourhood amongst the 10% most deprived in England, whilst another mother who had a semi-skilled occupation lived in an affluent area. Five of the mothers were not working outside the home at the time of their first interview (antenatally), however all of them were living with the father of their baby throughout the period of the study. Thus, no lone mothers were represented in this study, although there are a higher proportion of lone mothers in Halton than in England as a whole. Therefore, it is likely that mothers living in the poorest socio-economic circumstances were not included in the study.

There were no very young mothers in the study, with the ages of those participating ranging from 21 to 40 years at the time of their first interview. As described earlier, Halton has a higher percentage of teenage mothers than the England average, but the views of this group are not represented. It may have been that younger mothers had particular experiences which it would have been useful to access.

The total sample size of 21 mothers was adequate in that data saturation was reached and there were no new insights coming from the antenatal interviews. Not all mothers completed four interviews however, and although all babies had commenced weaning at the time of their mothers’ last interview, and 16 interviews were carried out when babies were aged six-and-a-half to eight-and-a-half months old, it would have been good to have been able to complete more than the nine interviews that took place when infants were aged nine-and-a-half to 11 months. However, even at this stage, it did seem that data saturation had been reached.

7.5 Possible future work

A large amount of qualitative data were generated for this study and it may be illuminating to go back to this, perhaps using narrative analysis to draw out continuity and change over time and developing some in-depth case studies in order to better characterise processes. Only mothers were interviewed for the current study, which was the intention of the work. However, given the findings, it may be useful to interview both fathers and health professionals in order to get their perspective on some of the issues raised. Specifically, mothers very much perceived themselves as in charge of weaning in terms of deciding upon courses of action (notwithstanding their ‘following the lead of the baby’). The perspectives of fathers, and clarifying how they see their role, may help develop an understanding of both the feeding and weaning actions of mothers and how babies are socialised into eating patterns, particularly within the wider family context. A lot of data generated concerned women’s relationships with health professionals, an aspect of which was the national feeding and weaning guidelines. It could also be illuminating to explore the perspectives of health professionals on some of the issues that were raised, in terms of thinking about how best to support mothers during the feeding and weaning process.

Finally, it would be useful to be able to follow up this sample of mothers and their babies as they get older and progress with their eating habits. None of the babies were eating exactly the same as the family by the end of the study so it would be illuminating to see how this developed, and whether in fact family meals became healthier, as some of the mothers suggested. It would also be interesting to see how weaning and eating more generally develops and what shapes these processes. With this in mind, at the final interviews with mothers they were asked if they were happy for their contact details to be retained after the end of the study in case there was an opportunity to undertake follow-up work in the future. All agreed to this.