This study aimed to examine the communication skills of nurses in terms of their interactions with puerperal primipara for breastfeeding guidance and to investigate the characteristics of higher quality care for puerperal women. The behaviors of 10 pairs of primipara and nurses providing breastfeeding guidance were monitored on the first and third days of puerperium. The time for which nurses engaged in specific communication skills was measured in seconds. The mothers and nurses were interviewed after breastfeeding guidance, and the interviews were analyzed qualitatively. The results showed that there was almost no eye contact between the mothers and their nurses on day 1, but nurses subconsciously used and adapted their communication skills to suit the mothers’ behaviors while teaching breastfeeding techniques. The mothers faced downwards as they breastfed but had positive impressions about the care provided by the nurses. However, on day 3, it was noted that mothers looked at the nurses to initiate communication, as they became used to breastfeeding; in contrast, the nurses took their gazes off the mothers more often, as the mothers required less technical guidance, and started to talk to themselves as they focused on breast care. The mothers appeared to be dissatisfied with the nurses’ responses that failed to meet their expectations.

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