Purpose: The aim of this study is to describe young women’s (16–25 years old) experiences of living with existential concerns for which they have sought support from healthcare professionals, teachers, family, or friends, among others.

Methods: This phenomenological study is based on a reflective lifeworld research (RLR) approach. Nine young women were interviewed about their experience of living with existential concerns.

Results: The results show the essential meaning of the phenomenon of “existential concerns” that can be described as living a life that is marked in a profound way by a feeling of being lost in an unknown terrain. To further understand the essential meaning, four constituents are described: the unpredictable body, longing for comprehension, playing a game, and longing to share one’s vulnerability.

Conclusions: Young women with existential concerns are vulnerable, as they are profoundly influenced by these concerns. They have to navigate through daily life while trying to fit in and to make their situation comprehensible. These young women have a longing to share their existential concerns with a trustworthy person, while at the same time they fear revealing their existential concerns and risking being rejected by others. A lifeworld-led, caring science approach, intertwined with the results of the present study, has the potential to direct caring practice.

Introduction: This paper describes first-line department healthcare professionals’ experiences of conversations with young adults (16–25 years) who express existential concerns. Existential concerns encompass questions about the meaning of life and the choices people must make, and they are sometimes expressed during the period in which a child is becoming an adult. Sometimes the transition to adulthood can be difficult, and many young adults seek support from people in first-line departments, such as primary care providers, youth guidance centre personnel and student health service employees in high schools and universities. Conversations in which existential concerns are recognised may be important for preventing mental illness in the future.

Aim: The study aimed to describe healthcare professionals’ lived experiences of conversations with young adults who express existential concerns.

Approach and methods: This qualitative study utilises thematic meaning analysis. Interviews were conducted with healthcare professionals working in first-line departments, and data were analysed based on the principles of reflective lifeworld research. The study followed ethical codes of conduct and conformed to the ethical guidelines adopted by the Swedish Research Council.

Findings: The results are presented in three themes of meaning: searching for innermost thoughts requires being present, uncertainty about the unpredictable and awakening of one’s own existential concerns.

Conclusions and implications: Healthcare professionals are affected when young adults express their existential concerns, and they need more support to strengthen their ability to stay present and create inviting atmospheres.

Aim: The overall aim of the thesis is to create knowledge about what it means for women to initiate breastfeeding and what consequences these meanings have from an existential perspective.

Approach and method: A lifeworld approach based on the epistemology of phenomenology and hermeneutics was used. Lifeworld interviews and meaningoriented analysis in accordance with the chosen lifeworld approach were performed. A synthesis and a philosophical analysis were carried out that facilitates an understanding of the existential meaning of initial breastfeeding and its consequences as a whole.

Main findings: Initiating breastfeeding, when it functions well, entails an existential challenge, a movement from a bodily performance to an embodied relationship with the infant and with oneself as a mother. When breastfeeding is experienced as being severely difficult, it entails an existential lostness as a mother, forcing her into a constant fight with herself, the infant, and others in order to find her way into motherhood. Severe breastfeeding difficulties can evoke existential vulnerability, forcing the mother to continue breastfeeding despite the difficulties, while hoping to be confirmed as a good mother; a fear of breastfeeding may be a consequence. Existential security is a necessary condition for continued breastfeeding whilst insecurity and fear of breastfeeding can lead to ceased attempts to breastfeed when experiencing severe initial difficulties. Initial breastfeeding and motherhood are intertwined in a way that affects the woman’s existence as a mother.

Conclusions: Initial breastfeeding is a complex phenomenon that is more than just a biological adaptation or a cultural issue; it touches on and evokes existential aspects of being a woman and a mother. Though anchored in both biology and culture, breastfeeding cannot be reduced to one or the other: it is both. There is a struggle between biology and culture that has existential consequences for women’s experiences of breastfeeding, the breastfeeding decision, and the women’s existence as a mother. There is a need for health professionals to look beyond the statistics of breastfeeding and consider the existential dimensions of breastfeeding-as-lived when encountering mothers wanting to breastfeed.

Background: The majority of new mothers in Sweden initiate breastfeeding and many experience initial difficulties. This experience is an important cause of early breastfeeding cessation. To increase understanding, there is a need to explore the lived experiences of the decision to continue or cease breastfeeding. The aim of this study is therefore to explain and understand how this decision is influenced by the meaning of severe initial difficulties.

Methods: A lifeworld hermeneutical approach was used for the study. The study was conducted in Sweden with eight mothers who experienced severe difficulties with initial breastfeeding. All except one were interviewed on two different occasions resulting in fifteen interviews. The interviews were conducted between 2010 and 2013.

Results: Mothers who experience severe difficulties with initial breastfeeding feel both overtaken and violated not only by their own infants and their own bodies but also by their anger, expectations, loneliness and care from health professionals. These feelings of being overtaken and invaded provoke an existential crisis and place mothers at a turning point in which these feelings are compared and put in relation to one another in the negotiation of the decision to continue or cease breastfeeding. This decision thus depends on the possibility of feeling secure with the breastfeeding relationship. If insecurity dominates, this can, in severe cases, create a feeling of fear of breastfeeding that is so great that there is no alternative but to stop breastfeeding.

Conclusions: Existential security in the breastfeeding relationship seems to be an underlying factor for confidence and therefore a necessary condition for continued breastfeeding when having severe initial breastfeeding difficulties. Unresolved feelings of insecurity may be a serious barrier to further breastfeeding that can result in a fear of breastfeeding. Such fear can force the mother to cease breastfeeding. This study highlights how women are situated in a complex cultural and biological context of breastfeeding that has existential consequences for them. An existential crisis forces mothers into a turning point for the breastfeeding decision. In the existential crisis, mothers' responsibility for the mother-infant relationship guides continuing or ceasing breastfeeding.

Many mothers initiate breastfeeding, but some of these experience difficulties. This study has two aims in order to contribute to the development of optimal care for these mothers: firstly to explain and understand the existential meanings of one mother's severe initial breastfeeding difficulties and how these meanings affected her continued breastfeeding and secondly, to reflect on a method for applying lifeworld hermeneutics to research on complex breastfeeding phenomena. This is an approach that acknowledges and focuses on the concrete and lived existence and what it means for humans. Within this approach, humans are understood as whole human beings interacting in the world. The study was conducted using lifeworld interviews with Anna, focusing on meanings of her difficult lived experience of initial breastfeeding. The existential interpretation suggests that such an experience can evoke existential vulnerability, a vulnerability that becomes evident in shameful feelings, such as dislike of breastfeeding, aversion to the milk-producing body and anger towards the child. Anna continued breastfeeding as a way to rid herself of the shame, hoping to be confirmed as a good mother. Such an experience may have negative consequences for the mother-child relationship and it can create fear for future breastfeeding. This study concludes that carers should be aware of individual existential dimensions for breastfeeding mothers.

A majority of women in Sweden initiate breastfeeding but almost a quarter stop or wean the infant in the first few weeks

after birth because of difficulties. In order to develop care that facilitates initiation of breastfeeding and enables mothers

to realize their expectations concerning breastfeeding, it is necessary to understand what having severe breastfeeding

difficulties means for women who experience them. The aim of this study is to describe the lived experiences of initiating

breastfeeding under severe difficulties. A reflective lifeworld research design was used. Eight women, seven primiparous

and one multipara, were interviewed within 2 months of giving birth. The essential meaning of the phenomenon is

described as ‘‘Existential lostness as a mother forcing oneself into a constant fight’’. This pattern is further explicated through its

constituents; shattered expectations, a lost time for closeness, being of no use to the infant, being forced to expose oneself,

and gaining strength through sharing. The results show that mothers with severe breastfeeding difficulties feel alone

and exposed because of their suffering and are lost in motherhood. Thus, adequate care for mothers should enhance the

forming of a caring relationship through sharing rather than exposing.