Understanding Breastfeeding Initiation and Continuation in Rural Communities: A Combined Qualitative/Quantitative Approach
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To determine factors associated with breastfeeding in rural communities.
We combined qualitative and quantitative data from the Family Life Project, consisting of: (1) a longitudinal cohort study (N = 1292) of infants born September 2003–2004 and (2) a parallel ethnographic study (N = 30 families). Demographic characteristics, maternal and infant health factors, and health services were used to predict breastfeeding initiation and discontinuation using logistic and Cox regression models, respectively. Ethnographic interviews identified additional reasons for not initiating or continuing breastfeeding.
Fifty-five percent of women initiated breastfeeding and 18% continued for at least 6 months. Maternal employment at 2 months and receiving WIC were associated with decreased breastfeeding initiation and continuation. Ethnographic data suggested that many women had never even considered breastfeeding and often discontinued breastfeeding due to discomfort, embarrassment, and lack of assistance.
Breastfeeding rates in these rural communities lag behind national averages. Opportunities for increasing breastfeeding in rural communities include enhancing workplace support, maximizing the role of WIC, increasing hospital breastfeeding assistance, and creating a social environment in which breastfeeding is normative.
KeywordsBreastfeeding Rural Low-income Ethnography WIC Maternal employment
Women, infants and children supplemental nutrition program
American Academy of Pediatrics
Family Life Project
Temporary assistance for needy families
- 3.US Department of Health, Human Services. (2000). Healthy People 2010: Understanding and improving health (2nd ed.). Washington, DC: US Government Printing Office.Google Scholar
- 4.US Department of Health, Human Services. (2000). HHS Blueprint for action on breastfeeding. Washington, D.C.: US Government Printing Office.Google Scholar
- 6.Chandra, A., Martinez, G. M., Mosher, W. D., Abma, J. C., & Jones, J. (2005). Fertility, family planning, and reproductive health of U.S. women: data from the 2002 National Survey of Family Growth. National Center for Health Statistics. Vital Health Stat Series, 23(25), 1–160.Google Scholar
- 14.Clark, S. J., Savitz, L. A., & Randolph, R. K. (2001). Rural children’s health. Western Journal of Medicine, 178, 142–147.Google Scholar
- 16.Phares, T. M., Morrow, B., Lansky, A., Barfield, W. D., Prince, C. B., Marchi, K. S., Braveman, P. A., Williams, L. M., & Kinneburgh, B. (2004). Surveillance for disparities in maternal health-related behaviors-Selected states, Pregnancy Risk Assessment Monitoring System (PRAMS), 2000-2001. In: Surveillance Summaries, July 2, 2004, MMWR, 53(No.SS-4), 1–13.Google Scholar
- 19.Hilson, J., Rasmussen, K., & Kjolhede, C. (1997). Maternal obesity and breast-feeding success in a rural population of white women. American Journal of Nutrition, 66, 1371–1378.Google Scholar
- 23.Kaufman, A. S., Kaufman, N. L. (1994). Kaufman Functional Academic Skills Test (K-FAST). Circle Pines, Minnesota: American Guidance Service.Google Scholar
- 26.Runyan, D. K. (2001). Monitoring child health and well-being in large population surveys. In: Thornton A (Ed). Well-being of children and families: Research and data needs. Ann Arbor, Michigan: University of Michigan Press.Google Scholar
- 27.Research Triangle Institute. (2004). SUDAAN language manual. Release 9.0 ed. Research Triangle Park, NC: Research Triangle Institute.Google Scholar
- 32.US Department of Agriculture Food, Nutrition Service. (1987). The National WIC evaluation: An evaluation of the special supplemental food program for women, infants and children, Volume 1: Summary. Alexandria, Virginia: US Department of Agriculture.Google Scholar
- 34.Committee to Review the WIC Food Package. (2005). WIC food packages: Time for a change. Washington, DC: Institute of Medicine.Google Scholar