Becoming a parent is often described as a life-altering experience, and factors which facilitate this transition include professional support and access to sufficient knowledge. Common areas of concern for parents are breastfeeding and family sleep. To this end, the national child healthcare programme in Sweden provides care and parental support. Although most parents regularly attend child health centres, understanding of their perceptions and experiences of the provided care remains limited. In addition, little is known about the strategies parents use to create positive breastfeeding experiences and sleep situations within the family. Therefore, the overall aim of this thesis was to explore parents’ experiences of care and support at child health centres during the child’s first three years, and to describe parents’ strategies for creating a positive breastfeeding experience and sleep situation in the family.

This thesis comprises five studies, which employed both quantitative and qualitative research designs to address the research questions. In Studies I and II, data were collected through questionnaires and analysed using descriptive and analytical statistics; additionally, in Study II, a qualitative content analysis was conducted with the open-ended responses. In Study III, data were collected through semi-structured interviews and analysed using qualitative content analysis. In Studies IV and V, data were collected via online questionnaires and analysed using the critical incident technique.

Study I examined parents’ perceptions of care quality at child health centres. The findings show that parents’ overall perceptions of care quality indicated optimal quality; however, certain areas were identified as having suboptimal quality, including the need for additional information on topics such as dental care, allergy prevention, breastfeeding, sleep, child behaviour, and crying. Furthermore, parents perceived the care as being more aligned with healthcare routines than with their own preferences and needs. Relationships were seen between parents’ ratings and their sociodemographic characteristics: for example, parents born outside Nordic countries perceived the care quality as higher, as did parents with a non-academic education.

Study II aimed to describe parents’ satisfaction with the care at child health centres. Parents’ overall ratings of satisfaction indicated general satisfaction; however, parents born outside Nordic countries and first-time parents were more hesitant about visiting the same child health centre for future care needs. Parents’ open-ended comments highlighted the importance of timely access to support and of having multiple ways to get in touch. They appreciated child health nurses’ competence but also pointed out that nurses’ knowledge in areas such as breastfeeding and sleep was sometimes lacking. Parents valued the information they received, and they expressed a desire for more time to ask questions and discuss concerns. They also emphasised the significance of continuity with the nurse and stressed the need for care and support which is tailored to each family’s specific situation.

Study III sought to describe parents’ experiences of support from child health nurses at child health centres. Parents described feeling seen and listened to when child health nurses showed interest in the whole family. Parents with a foreign background emphasised the importance of cultural competence among child health nurses. Continuity and feeling safe with the nurse were described as essential to fostering a trusting relationship, and timely access to support was highlighted as important. Parents valued information and guidance which were responsive to their needs; by contrast, encounters in which nurses adhered rigidly to guidelines were experienced as less supportive. The importance of receiving support for specific concerns, such as breastfeeding, sleep, and emotional well-being, was also highlighted. Gaps in support or limited competence in these areas among nurses were experienced as stressful and contributing to a sense of lacking support.

Study IV aimed to describe mothers’ strategies for creating positive breastfeeding experiences. The findings show that mothers’ strategies centred on remaining calm and accepting that breastfeeding can be challenging in the early stages. Mothers emphasised the importance of skin-to-skin contact, responsive feeding, and ensuring correct positioning in preventing breastfeeding complications. Knowledge about breastfeeding, along with both social and professional support, was also described as essential. In addition, mothers highlighted the importance of adopting a positive mindset and a strong personal motivation to breastfeed.

Study V describes parents’ strategies and advice for creating a positive sleep situation in the family. Parents’ strategies centred on establishing consistent routines and being attentive to the child’s signals of tiredness, which enabled timely and appropriate bedtimes. Ensuring that the child was well-fed and content before sleep was also considered essential. Parents emphasised the importance of winding down through closeness and physical contact. In addition, some parents described co-sleeping as a way to provide the child with a sense of security.